在老龄化治疗人群中，处方阿片类药物滥用和共病的模式。
Patterns of prescription opioid abuse and comorbidity in an aging treatment population.
机构信息
Washington University Department of Psychiatry, Campus Box 8134, 660 S. Euclid Avenue, St. Louis MO 63110, USA.
出版信息
J Subst Abuse Treat. 2012 Jan;42(1):87-94. doi: 10.1016/j.jsat.2011.07.003. Epub 2011 Aug 9.
Abstract
Very little is known about the impact of age and gender on drug abuse treatment needs. To examine this, we recruited 2,573 opioid-dependent patients, aged from 18 to 75 years, entering treatment across the country from 2008 to 2010 to complete a self-administered survey examining drug use histories and the extent of comorbid psychiatric and physical disorders. Moderate to very severe pain and psychiatric disorders, including polysubstance abuse, were present in a significant fraction of 18- to 24-year-olds, but their severity grew exponentially as a function of age: 75% of those older than 45 years had debilitating pain and psychiatric problems. Women had more pain than men and much worse psychiatric issues in all age groups. Our results indicate that a "one-size-fits-all" approach to prevention, intervention, and treatment of opioid abuse that ignores the shifting needs of opioid-abusing men and women as they age is destined to fail.
摘要
关于年龄和性别对药物滥用治疗需求的影响，人们知之甚少。为了研究这一问题，我们招募了 2573 名年龄在 18 至 75 岁之间的阿片类药物依赖患者，他们在 2008 年至 2010 年间从全国各地进入治疗，完成了一项自我管理的调查，调查了他们的药物使用史和共病精神和身体障碍的程度。中度至重度疼痛和精神障碍，包括多种物质滥用，在相当一部分 18 至 24 岁的人群中存在，但随着年龄的增长，其严重程度呈指数级增长：超过 45 岁的患者中有 75%患有致残性疼痛和精神问题。在所有年龄组中，女性的疼痛比男性更严重，精神问题也更严重。我们的研究结果表明，一种忽视滥用阿片类药物的男性和女性随着年龄增长而不断变化的需求的“一刀切”方法，用于预防、干预和治疗阿片类药物滥用注定会失败。
相似文献
1
Patterns of prescription opioid abuse and comorbidity in an aging treatment population.在老龄化治疗人群中，处方阿片类药物滥用和共病的模式。
J Subst Abuse Treat. 2012 Jan;42(1):87-94. doi: 10.1016/j.jsat.2011.07.003. Epub 2011 Aug 9.
2
Psychiatric and substance use comorbidity among treatment-seeking opioid abusers.寻求治疗的阿片类药物滥用者中的精神疾病与物质使用共病情况。
Arch Gen Psychiatry. 1997 Jan;54(1):71-80. doi: 10.1001/archpsyc.1997.01830130077015.
3
Understanding the demand side of the prescription opioid epidemic: Does the initial source of opioids matter?了解处方阿片类药物流行的需求端：阿片类药物的初始来源重要吗？
Drug Alcohol Depend. 2017 Apr 1;173 Suppl 1:S4-S10. doi: 10.1016/j.drugalcdep.2016.03.014.
4
Risk factors for incident nonmedical prescription opioid use and abuse and dependence: results from a longitudinal nationally representative sample.非医疗处方阿片类药物使用、滥用和依赖的发生风险因素：来自全国代表性纵向样本的结果。
Drug Alcohol Depend. 2013 Sep 1;132(1-2):107-13. doi: 10.1016/j.drugalcdep.2013.01.010. Epub 2013 Feb 9.
5
How do prescription opioid users differ from users of heroin or other drugs in psychopathology: results from the National Epidemiologic Survey on Alcohol and Related Conditions.处方类阿片使用者与海洛因或其他药物使用者在精神病理学方面有何不同：来自国家酒精和相关条件流行病学调查的结果。
J Addict Med. 2011 Mar;5(1):28-35. doi: 10.1097/ADM.0b013e3181e0364e.
6
Assessment and treatment of comorbid psychiatric disorders in opioid-dependent patients.阿片类药物依赖患者共病精神障碍的评估与治疗。
Clin J Pain. 2002 Jul-Aug;18(4 Suppl):S14-27. doi: 10.1097/00002508-200207001-00003.
7
Physical pain is common and associated with nonmedical prescription opioid use among people who inject drugs.身体疼痛很常见，且与注射吸毒者使用非医疗处方阿片类药物有关。
Subst Abuse Treat Prev Policy. 2017 May 30;12(1):29. doi: 10.1186/s13011-017-0112-7.
8
Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients.美沙酮维持治疗患者的精神病理学、物质使用与身体疼痛体验之间的关系。
J Clin Psychiatry. 2009 Sep;70(9):1213-8. doi: 10.4088/JCP.08m04367. Epub 2009 Jul 14.
9
Women who abuse prescription opioids: findings from the Addiction Severity Index-Multimedia Version Connect prescription opioid database.滥用处方阿片类药物的女性：来自成瘾严重程度指数-多媒体版连接处方阿片类药物数据库的研究结果。
Drug Alcohol Depend. 2009 Jul 1;103(1-2):65-73. doi: 10.1016/j.drugalcdep.2009.03.014. Epub 2009 May 5.
10
The prevalence of mental and physical health disorders among older methadone patients.老年美沙酮患者中精神和身体健康障碍的患病率。
Am J Geriatr Psychiatry. 2008 Jun;16(6):488-97. doi: 10.1097/JGP.0b013e31816ff35a.
引用本文的文献
1
Predictors of Multiwave Opioid Use Among Older American Adults.美国老年成年人多波阿片类药物使用的预测因素
Innov Aging. 2023 Jul 13;7(10):igad068. doi: 10.1093/geroni/igad068. eCollection 2023.
2
Screening the "Invisible Population" of Older Adult Patients for Prescription Pain Reliever Non-Medical Use and Use Disorders.筛查老年患者中处方止痛药非医疗使用和使用障碍的“隐形人群”。
Subst Use Misuse. 2023;58(1):153-159. doi: 10.1080/10826084.2022.2148483. Epub 2022 Dec 15.
3
The Emergency Department Longitudinal Integrated Care (ED-LINC) intervention targeting opioid use disorder: A pilot randomized clinical trial.针对阿片类药物使用障碍的急诊科纵向综合护理（ED-LINC）干预：一项试点随机临床试验。
J Subst Abuse Treat. 2022 May;136:108666. doi: 10.1016/j.jsat.2021.108666. Epub 2021 Nov 24.
4
Chronic Pain, Opioid Use Disorder, and Clinical Management Among Older Adults.老年人的慢性疼痛、阿片类药物使用障碍及临床管理
Focus (Am Psychiatr Publ). 2021 Jul;19(3):294-302. doi: 10.1176/appi.focus.20210002. Epub 2021 Jul 9.
5
Canadian Guidelines on Opioid Use Disorder Among Older Adults.《加拿大老年人阿片类药物使用障碍指南》
Can Geriatr J. 2020 Mar 30;23(1):123-134. doi: 10.5770/cgj.23.420. eCollection 2020 Mar.
6
Chronic non-cancer pain among adults with substance use disorders: Prevalence, characteristics, and association with opioid overdose and healthcare utilization.成年人物质使用障碍中的慢性非癌性疼痛：流行率、特征以及与阿片类药物过量和医疗保健利用的关联。
Drug Alcohol Depend. 2020 Apr 1;209:107902. doi: 10.1016/j.drugalcdep.2020.107902. Epub 2020 Feb 11.
7
Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994-2011.随着时间的推移，加拿大人口中阿片类药物（可待因、吗啡或哌替啶）使用模式的变化：对 1994-2011 年全国纵向人口健康调查的分析。
BMJ Open. 2019 Jul 24;9(7):e029613. doi: 10.1136/bmjopen-2019-029613.
8
Factors Influencing Judgments to Consult Prescription Monitoring Programs: A Factorial Survey Experiment.影响咨询处方监测项目决策的因素：一项析因调查实验
Pain Manag Nurs. 2020 Feb;21(1):48-56. doi: 10.1016/j.pmn.2019.04.001. Epub 2019 May 24.
9
A hidden aspect of the U.S. opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder.美国阿片类药物危机的一个隐藏方面：患有阿片类药物使用障碍的老年人群首次接受治疗的人数增加。
Drug Alcohol Depend. 2018 Dec 1;193:142-147. doi: 10.1016/j.drugalcdep.2018.10.002. Epub 2018 Oct 18.
10
Heroin use onset among nonmedical prescription opioid users in the club scene.夜店场景中非医疗用途处方阿片类药物使用者中 heroin 使用的起始情况。 （注：heroin 一般指海洛因，因不清楚上下文，按原文翻译）
Drug Alcohol Depend. 2017 Oct 1;179:131-138. doi: 10.1016/j.drugalcdep.2017.06.034. Epub 2017 Jul 26.
本文引用的文献
1
Multiple Determinants of Specific Modes of Prescription Opioid Diversion.处方阿片类药物特定转移模式的多种决定因素。
J Drug Issues. 2011 Spring;41(2):283-304. doi: 10.1177/002204261104100207.
2
A flood of opioids, a rising tide of deaths.阿片类药物泛滥，死亡人数不断攀升。
N Engl J Med. 2010 Nov 18;363(21):1981-5. doi: 10.1056/NEJMp1011512.
3
Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective.阿片类药物的治疗用途、滥用和非医疗用途：十年展望。
Pain Physician. 2010 Sep-Oct;13(5):401-35.
4
Emergency department visits among recipients of chronic opioid therapy.接受慢性阿片类药物治疗者的急诊科就诊情况。
Arch Intern Med. 2010 Sep 13;170(16):1425-32. doi: 10.1001/archinternmed.2010.273.
5
Emergency department visits involving nonmedical use of selected prescription drugs in the United States, 2004-2008.2004 - 2008年美国涉及特定处方药非医疗用途的急诊科就诊情况。
J Pain Palliat Care Pharmacother. 2010 Sep;24(3):293-7. doi: 10.3109/15360288.2010.503730.
6
Risks for opioid abuse and dependence among recipients of chronic opioid therapy: results from the TROUP study.慢性阿片类药物治疗患者中阿片类药物滥用和依赖的风险：来自 TROUP 研究的结果。
Drug Alcohol Depend. 2010 Nov 1;112(1-2):90-8. doi: 10.1016/j.drugalcdep.2010.05.017. Epub 2010 Jul 14.
7
Nicotine dependence predicts repeated use of prescribed opioids. Prospective population-based cohort study.尼古丁依赖预测处方类阿片的重复使用。前瞻性基于人群的队列研究。
Ann Epidemiol. 2010 Dec;20(12):890-7. doi: 10.1016/j.annepidem.2010.03.010. Epub 2010 Jun 2.
8
Determinants of fentanyl and other potent µ opioid agonist misuse in opioid-dependent individuals.阿片类依赖者中芬太尼和其他强效µ阿片激动剂滥用的决定因素。
Pharmacoepidemiol Drug Saf. 2010 Oct;19(10):1057-63. doi: 10.1002/pds.1989.
9
Prescription opioid use among patients seeking treatment for opioid dependence.阿片类药物依赖患者寻求治疗中的处方类阿片类药物使用情况。
J Addict Med. 2010 Jun;4(2):108-13. doi: 10.1097/ADM.0b013e3181b5a713.
10
Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis.老年人慢性非癌痛阿片类药物治疗相关结局的系统评价和荟萃分析。
J Am Geriatr Soc. 2010 Jul;58(7):1353-69. doi: 10.1111/j.1532-5415.2010.02920.x. Epub 2010 Jun 1.
Zotero 插件