Newville Howard, Roley Jason, Sorensen James L
Mount Sinai St. Luke's, New York, NY, United States.
University of California, San Francisco, San Francisco, CA, United States.
J Subst Abuse Treat. 2015 Jan;48(1):56-61. doi: 10.1016/j.jsat.2014.07.013. Epub 2014 Aug 6.
HIV has become a highly treatable disease due to advances in antiretroviral therapy (ART). Additionally, HIV-infected individuals often take opiates, barbiturates, and benzodiazepines to treat co-occurring conditions, including pain and symptoms of HIV. We sought to examine prescription medication misuse by surveying 295 HIV-infected patients receiving ART. Participants answered questions about their demographics, alcohol and other drug use, psychiatric diagnoses, ART adherence and side effects, and quality of life. Eleven percent of our sample acknowledged prescription medication misuse. In regression analysis, prescription medication misusers were more likely to report any drinking to intoxication (OR=4.31, 95% CI: 1.35-13.76, p=0.013), reported greater severity of ART side effects (OR=1.05, 95% CI: 1.01-1.10, p=0.041), and demonstrated poorer cognitive functioning (OR=0.97, 95% CI: 0.94-0.99, p=0.048) compared to those who did not misuse prescription medications. Special care should be taken by medical providers before prescribing medications that may be abused or diverted. Patients should also be screened for aberrant use, even if not prescribed. ART side effects, cognitive deficits, and alcohol abuse may serve as risk factors or indicators of prescription medication misuse, and should be monitored.
由于抗逆转录病毒疗法(ART)的进展,艾滋病病毒已成为一种高度可治疗的疾病。此外,感染艾滋病病毒的个体经常服用阿片类药物、巴比妥类药物和苯二氮卓类药物来治疗并发疾病,包括艾滋病相关疼痛和症状。我们通过对295名接受抗逆转录病毒治疗的艾滋病病毒感染者进行调查,试图研究处方药滥用情况。参与者回答了有关其人口统计学、酒精和其他药物使用、精神疾病诊断、抗逆转录病毒治疗依从性和副作用以及生活质量的问题。我们样本中有11%的人承认存在处方药滥用情况。在回归分析中,与未滥用处方药的人相比,处方药滥用者更有可能报告任何导致醉酒的饮酒情况(比值比=4.31,95%置信区间:1.35-13.76,p=0.013),报告抗逆转录病毒治疗副作用的严重程度更高(比值比=1.05,95%置信区间:1.01-1.10,p=0.041),并且认知功能较差(比值比=0.97,95%置信区间:0.94-0.99,p=0.048)。医疗服务提供者在开具可能被滥用或转移用途的药物之前应格外小心。即使未开具此类药物,也应对患者进行异常用药筛查。抗逆转录病毒治疗副作用、认知缺陷和酒精滥用可能是处方药滥用的风险因素或指标,应予以监测。