Center for Interventions, Treatment, and Addiction Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH 45435, United States.
Division of Morphological Sciences and Biostatistics, Lifespan Health Research Center, Department of Community Health, Boonshoft School of Medicine, Wright State University, 3171 Research Boulevard, Dayton, OH 45420, United States.
Drug Alcohol Depend. 2014 Jan 1;134:259-266. doi: 10.1016/j.drugalcdep.2013.10.004. Epub 2013 Oct 23.
Increases in non-medical use of pharmaceutical opioids in the U.S. have resulted in increases in opioid dependence and unintentional overdose deaths. We characterize heterogeneity in opioid use patterns among a community-based sample of 18-23 year-olds who use non-medical pharmaceutical opioids, yet are not opioid dependent.
Respondent-driven sampling recruited 390 participants. Latent class analysis stratified by racial/ethnic group identified subgroups of non-medical opioid users based on: six-month frequency of use; number of opioid disorder criteria; oral vs. non-oral administration; number of types of opioids used; use of CNS depressants while under using opioids; and reason for opioid use. Multinomial logistic regression estimated the significance of covariates in predicting class membership.
Within whites and non-white groups, three classes emerged that were, generally, hierarchically ordered with respect to negative characteristics associated with non-medical opioid use. Within each group, the class with the least negative characteristics also had the highest proportion of individuals who use opioids only to self-medicate a health problem. Within each group's three classes, a larger proportion who had ≥ 2 opioid abuse and dependence disorder criteria always coincided with a larger proportion who use opioids ≥ 3 days per week, a larger proportion who used CNS depressants while under the influence of opioids, and a smaller proportion who used opioids only to self-medicate.
Differences in patterns of opioid use within each racial/ethnic group of young people who are not opioid dependent suggest the need for tailored interventions designed to reduce the risk of transition to opioid dependence.
美国非医疗用途的医药类阿片类药物的使用增加，导致阿片类药物依赖和非故意用药过量死亡的人数增加。我们对一个基于社区的 18-23 岁非医疗使用医药类阿片类药物但没有阿片类药物依赖的样本中的阿片类药物使用模式的异质性进行了描述。
通过受访者驱动抽样招募了 390 名参与者。按种族/族裔群体分层的潜在类别分析，根据以下标准确定非医疗性阿片类药物使用者的亚组：六个月内使用的频率；阿片类药物障碍标准的数量；口服与非口服给药；使用的阿片类药物类型数量；在使用阿片类药物时使用中枢神经系统抑制剂；以及使用阿片类药物的原因。多项逻辑回归估计了协变量在预测类别归属中的意义。
在白人和非白人组内，出现了三个类，这些类通常是根据与非医疗性阿片类药物使用相关的负面特征进行层次排序的。在每个群体内，负面特征最少的类也有最高比例的个体仅使用阿片类药物来自我治疗健康问题。在每个群体的三个类内，具有≥2 个阿片类药物滥用和依赖障碍标准的比例总是与使用阿片类药物≥3 天/周的比例、使用中枢神经系统抑制剂的比例以及仅使用阿片类药物来自我治疗的比例更大相关。
在没有阿片类药物依赖的每个种族/族裔年轻人群体中，阿片类药物使用模式的差异表明需要制定有针对性的干预措施，以降低向阿片类药物依赖过渡的风险。
