Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
J Addict Med. 2011 Mar;5(1):28-35. doi: 10.1097/ADM.0b013e3181e0364e.
To study substance use and psychiatric disorders among prescription opioid users, heroin users, and non-opioid drug users in a national sample of adults.
Analyses of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093).
Four groups were identified among 9140 illicit or non-prescribed drug users: heroin-other opioid users (1.0%; used heroin and other opioids), other opioid-only users (19.8%; used other opioids but never heroin), heroin-only users (0.5%; used heroin but never other opioids), and non-opioid drug users (78.7%; used drugs but never heroin or other opioids). After adjusting for variations in socioeconomic characteristics, history of substance abuse treatment, and familial substance abuse, heroin-other opioid users had greater odds of several substance use disorders (cocaine, hallucinogen, sedative, amphetamine, and tranquilizer) as compared with the other groups; heroin-only users had reduced odds of sedative and tranquilizer use disorders as compared with other opioid-only users. Non-opioid drug users had reduced odds of all substance use disorders and other mental disorders (mood, anxiety, pathological gambling, and personality) as compared with other opioid-only users. Past-year other opioid-only users also reported slightly lower scores on quality of life than past-year non-opioid drug users.
All opioid use groups had higher rates of substance use disorders than non-opioid drug users, and these rates were particularly elevated among heroin-other opioid users. Findings suggest the need to distinguish between these four groups in research and treatment as they may have different natural histories and treatment needs.
在一个全国性的成年人样本中，研究处方类阿片类药物使用者、海洛因使用者和非阿片类药物使用者的物质使用和精神障碍情况。
对 2001-2002 年全国酒精相关情况和流行病学调查（N=43093）的数据进行分析。
在 9140 名非法或非处方药物使用者中，确定了以下 4 个群体：海洛因-其他类阿片药物使用者（1.0%；同时使用海洛因和其他类阿片药物）、其他类阿片药物仅使用者（19.8%；仅使用其他类阿片药物，但从未使用过海洛因）、海洛因仅使用者（0.5%；仅使用过海洛因，但从未使用过其他类阿片药物）和非阿片类药物使用者（78.7%；使用过药物，但从未使用过海洛因或其他类阿片药物）。在调整了社会经济特征、物质滥用治疗史和家族物质滥用史的差异后，与其他群体相比，海洛因-其他类阿片药物使用者出现多种物质使用障碍（可卡因、致幻剂、镇静剂、苯丙胺和安定）的可能性更大；与其他类阿片药物仅使用者相比，海洛因仅使用者出现镇静剂和安定使用障碍的可能性更小。与其他类阿片药物仅使用者相比，非阿片类药物使用者出现所有物质使用障碍和其他精神障碍（情绪、焦虑、病态赌博和人格）的可能性更小。与过去一年使用非阿片类药物的患者相比，过去一年使用其他类阿片药物的患者报告的生活质量评分略低。
所有阿片类药物使用者出现物质使用障碍的比率均高于非阿片类药物使用者，而海洛因-其他类阿片药物使用者的比率则特别高。这些发现表明，在研究和治疗中需要区分这四个群体，因为他们可能具有不同的自然病史和治疗需求。
