Wines James D, Saitz Richard, Horton Nicholas J, Lloyd-Travaglini Christine, Samet Jeffrey H
Alcohol and Drug Abuse Research Center (ADARC), McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Drug Alcohol Depend. 2007 Jul 10;89(2-3):161-9. doi: 10.1016/j.drugalcdep.2006.12.019. Epub 2007 Feb 5.
The aim of this study was to determine predictors of non-fatal overdose (OD) among a cohort of 470 adults after detoxification from heroin, cocaine or alcohol.
We examined factors associated with time to OD during 2 years after discharge from an urban detoxification unit in Boston, MA, USA using multivariable regression analyses. Separate analyses were performed for both the total sample and a subgroup with problem opioid use.
Lifetime prevalence for any OD was 30.9% (145/470) in the total sample and 42.3% (85/201) in patients with opioid problems. During the 2-year follow-up, OD was estimated to occur in 16.9% of the total sample and 26.7% of the opioid problem subgroup, with new-onset (incidence) OD estimated at 5.7% and 11.0%, respectively. Factors associated with an increased hazard of OD in both samples included white race, more depressive symptoms, and prior OD regardless of intent. Prior suicidal ideation or attempt was not associated with future OD.
Findings underscore both the high prevalence of non-fatal OD among detoxification patients especially opioid users, and the potency of prior OD as a risk factor for future OD. Depressive symptoms, a modifiable risk factor, may represent a potential intervention target to prevent OD, including some "unintentional" ODs.
本研究旨在确定470名从海洛因、可卡因或酒精戒毒后的成年人队列中非致命过量用药（OD）的预测因素。
我们使用多变量回归分析，研究了美国马萨诸塞州波士顿市一家城市戒毒所出院后2年内与OD发生时间相关的因素。对总样本和有阿片类药物使用问题的亚组分别进行了分析。
总样本中任何OD的终生患病率为30.9%（145/470），有阿片类药物问题的患者中为42.3%（85/201）。在2年的随访期间，估计总样本中有16.9%发生OD，阿片类药物问题亚组中有26.7%发生OD，新发（发病率）OD估计分别为5.7%和11.0%。两个样本中与OD风险增加相关的因素包括白人种族、更多的抑郁症状以及既往OD（无论意图如何）。既往自杀意念或自杀未遂与未来OD无关。
研究结果强调了戒毒患者尤其是阿片类药物使用者中非致命OD的高患病率，以及既往OD作为未来OD风险因素的影响力。抑郁症状是一个可改变的风险因素，可能是预防OD（包括一些“非故意”OD）的潜在干预目标。
