阿片类药物脱毒成年患者成瘾严重程度、感染艾滋病毒风险及生活质量的性别和种族/族裔差异:来自国家药物滥用治疗临床试验网络的结果

Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network.

作者信息

Wu Li-Tzy, Ling Walter, Burchett Bruce, Blazer Dan G, Shostak Jack, Woody George E

机构信息

Department of Psychiatry and Behavioral Sciences, School of Medicine, Durham, NC, USA.

出版信息

Subst Abuse Rehabil. 2010 Dec;2010(1):13-22. doi: 10.2147/SAR.S15151.

Abstract

PURPOSE

Detoxification often serves as an initial contact for treatment and represents an opportunity for engaging patients in aftercare to prevent relapse. However, there is limited information concerning clinical profiles of individuals seeking detoxification, and the opportunity to engage patients in detoxification for aftercare often is missed. This study examined clinical profiles of a geographically diverse sample of opioid-dependent adults in detoxification to discern the treatment needs of a growing number of women and whites with opioid addiction and to inform interventions aimed at improving use of aftercare or rehabilitation. METHODS: The sample included 343 opioid-dependent patients enrolled in two national multi-site studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-002). Patients were recruited from 12 addiction treatment programs across the nation. Gender and racial/ethnic differences in addiction severity, human immunodeficiency virus (HIV) risk, and quality of life were examined. RESULTS: Women and whites were more likely than men and African Americans to have greater psychiatric and family/social relationship problems and report poorer health-related quality of life and functioning. Whites and Hispanics exhibited higher levels of total HIV risk scores and risky injection drug use scores than African Americans, and Hispanics showed a higher level of unprotected sexual behaviors than whites. African Americans were more likely than whites to use heroin and cocaine and to have more severe alcohol and employment problems. CONCLUSIONS: Women and whites show more psychopathology than men and African Americans. These results highlight the need to monitor an increased trend of opioid addiction among women and whites and to develop effective combined psychosocial and pharmacologic treatments to meet the diverse needs of the expanding opioid-abusing population. Elevated levels of HIV risk behaviors among Hispanics and whites also warrant more research to delineate mechanisms and to reduce their risky behaviors.

摘要

目的

戒毒通常是治疗的初始接触阶段,也是促使患者接受后续护理以预防复发的契机。然而,关于寻求戒毒治疗的个体临床特征的信息有限,而且促使患者接受戒毒后续护理的机会常常被错过。本研究调查了地理位置各异的正在接受戒毒治疗的阿片类药物依赖成年人群的临床特征,以了解越来越多的阿片类药物成瘾女性和白人的治疗需求,并为旨在改善后续护理或康复利用情况的干预措施提供依据。方法:样本包括参与国家药物滥用治疗临床试验网络两项全国多中心研究(CTN001 - 002)的343名阿片类药物依赖患者。患者从全国12个成瘾治疗项目中招募。研究了成瘾严重程度、人类免疫缺陷病毒(HIV)风险和生活质量方面的性别及种族/民族差异。结果:与男性和非裔美国人相比,女性和白人更有可能存在更严重的精神及家庭/社会关系问题,且报告的健康相关生活质量和功能较差。白人和西班牙裔的HIV总风险评分及危险注射吸毒评分高于非裔美国人,西班牙裔的无保护性行为水平高于白人。非裔美国人比白人更有可能使用海洛因和可卡因,且存在更严重的酒精及就业问题。结论:女性和白人比男性和非裔美国人表现出更多的精神病理学问题。这些结果凸显了监测女性和白人中阿片类药物成瘾增加趋势的必要性,并开发有效的综合心理社会和药物治疗方法,以满足不断扩大的阿片类药物滥用人群的多样化需求。西班牙裔和白人中较高的HIV风险行为水平也需要更多研究来阐明机制并减少其危险行为。

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