Subramaniam Geetha A, Stitzer Maxine A
Department of Psychiatry, Johns Hopkins University, Mountain Manor Treatment Center, 3800 Frederick Ave, Baltimore, MD 21229, USA.
Drug Alcohol Depend. 2009 Apr 1;101(1-2):13-9. doi: 10.1016/j.drugalcdep.2008.10.015. Epub 2008 Dec 9.
To compare the clinical characteristics of treatment-seeking prescription opioid-using adolescents with DSM-IV opioid use disorder (OUD) to those with heroin-using OUD adolescents.
We analyzed the data on OUD adolescents (94, ages 14-18 years) extracted from the parent study dataset comparing clinical characteristics of treatment-seeking OUD to non-OUD adolescents from a adolescent substance abuse treatment program in Baltimore, MD. The sample consisted of 41 non-heroin prescription opioid-using and 53 heroin-using OUD adolescents who were assessed cross-sectionally using standardized interviews and self-reports. Chi-square and t-tests were performed to determine group differences on demographic, substance use, psychiatric and HIV-risk behaviors.
Both groups were older (mean 17 years), predominantly Caucasian, and had a suburban residence; they had high rates of co-occurring psychiatric disorders (83%) and they reported moderately high depression symptoms. The heroin-using sample was more likely to have dropped out of school, be dependent on opioids and inject drugs using needles. The prescription opioid-using OUD youth were more likely to meet criteria for multiple SUDs (including prescription sedatives and psychostimulants), current ADHD and report selling drugs; and more likely to be court ordered to current treatment and report prior psychiatric treatment.
Both groups of treatment-seeking OUD adolescents had multiple comorbidities but there were substantial differences between prescription opioid-users and heroin-users. These differences may suggest different prognoses and treatment implications. Future research may shed light on the factors leading to differences in choice of opioids and their impact on treatment outcomes; and assess the role of agonist assisted treatments and integrated psychiatric care.
比较寻求治疗的患有DSM-IV阿片类药物使用障碍（OUD）的青少年与患有海洛因使用障碍的青少年的临床特征。
我们分析了从母研究数据集提取的关于OUD青少年（94名，年龄14 - 18岁）的数据，该数据集比较了来自马里兰州巴尔的摩一个青少年药物滥用治疗项目的寻求治疗的OUD青少年与非OUD青少年的临床特征。样本包括41名非海洛因处方阿片类药物使用的OUD青少年和53名海洛因使用的OUD青少年，他们通过标准化访谈和自我报告进行横断面评估。进行卡方检验和t检验以确定两组在人口统计学、物质使用、精神疾病和HIV风险行为方面的差异。
两组年龄均较大（平均17岁），主要为白种人，居住在郊区；他们共病精神障碍的发生率较高（83%），且报告有中度较高的抑郁症状。使用海洛因的样本更有可能辍学、对阿片类药物依赖并使用针头注射毒品。使用处方阿片类药物的OUD青年更有可能符合多种物质使用障碍（包括处方镇静剂和精神兴奋剂）的标准、患有当前的注意力缺陷多动障碍（ADHD）并报告有贩毒行为；更有可能被法庭责令接受当前治疗并报告曾接受过精神治疗。
两组寻求治疗的OUD青少年都有多种共病，但处方阿片类药物使用者和海洛因使用者之间存在显著差异。这些差异可能表明不同的预后和治疗意义。未来的研究可能会阐明导致阿片类药物选择差异的因素及其对治疗结果的影响；并评估激动剂辅助治疗和综合精神护理的作用。
