Meier Andrea, Lambert-Harris Chantal, McGovern Mark P, Xie Haiyi, An Melissa, McLeman Bethany
Departments of Psychiatry, Geisel School of Medicine at Dartmouth , Lebanon, New Hampshire , USA .
Am J Drug Alcohol Abuse. 2014 Jul;40(4):304-11. doi: 10.3109/00952990.2014.910519. Epub 2014 May 8.
Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice.
To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings.
We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics.
Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p < 0.05). Use of prescription opioids in combination with sedatives (OR: 3.81, p < 0.01) or cocaine (OR: 2.24, p < 0.001) also were associated with PTSD severity. The odds of having co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males (OR: 2.63, p < 0.001). Younger patients (18-34 years old) also were at higher risk (OR: 1.86, p < 0.01).
Prescription opioid use problems are a risk factor for co-occurring PTSD symptom severity. Being female or younger increase the likelihood of this co-morbidity. Further research is needed to confirm these finding, particularly using more rigorous diagnostic procedures. These data suggest that patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms.
处方阿片类药物是滥用物质中增长最为迅速的类别，会导致严重的发病率、死亡率及医疗费用。患有处方阿片类药物问题的人若同时患有精神疾病，治疗结果往往不佳。需要有关处方阿片类药物滥用与特定疾病（如创伤后应激障碍，PTSD）共病发生率的数据，以便为临床实践提供更充分的信息。
确定社区成瘾治疗机构中当前同时存在处方阿片类药物使用问题和PTSD症状严重程度的患病率。
我们提取了2011年期间三家成瘾治疗机构573名新入院患者的管理和病历信息。系统收集了有关PTSD症状、物质使用及患者人口统计学数据。
处方阿片类药物的使用与同时存在的PTSD症状严重程度显著相关（比值比：1.42，p < 0.05）。同时使用处方阿片类药物和镇静剂（比值比：3.81，p < 0.01）或可卡因（比值比：2.24，p < 0.001）也与PTSD严重程度相关。女性同时出现PTSD症状和处方阿片类药物使用问题的几率几乎是男性的三倍（比值比：2.63，p < 0.001）。年轻患者（18 - 34岁）也面临更高风险（比值比：1.86，p < 0.01）。
处方阿片类药物使用问题是同时出现PTSD症状严重程度的一个风险因素。女性或年轻会增加这种共病的可能性。需要进一步研究来证实这些发现，特别是采用更严格的诊断程序。这些数据表明，对于有处方阿片类药物使用问题的患者，应仔细评估其PTSD症状。
