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慢性非癌性疼痛与阿片类药物成瘾的药物辅助治疗结果之间的关联。

Associations between chronic non-cancer pain and medication assisted treatment outcomes for opiate addiction.

作者信息

Stevenson Erin, Cole Jennifer

机构信息

Evaluation Center, University of Kentucky, Lexington, KY.

Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY.

出版信息

Am J Addict. 2015 Mar;24(2):138-143. doi: 10.1111/ajad.12151.

Abstract

BACKGROUND AND OBJECTIVES

An increased percentage of individuals entering opioid addiction treatment programs also report the presence of chronic non-cancer pain (CNCP). This study examined associations between the presence of CNCP and 6-month medication assisted addiction treatment (MAT) outcomes.

METHODS

The sample included 585 individuals at opiate treatment programs who completed a structured intake interview and a 6-month follow-up telephone interview between March 2007 and December 2010. Of the sample, 115 individuals reported CNCP at intake and 6-month follow-up. Bivariate analyses compared individuals with CNCP (n = 115) and without CNCP (n = 470) at MAT intake.

RESULTS

A greater percentage of individuals with CNCP were older, were retired or disabled, and had experienced depression or anxiety before intake compared to individuals without CNCP. Results of binomial logistic regression models found that having CNCP was associated with increased odds of depression/anxiety at follow-up, but had no association with employment or substance use.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

The correlations between CNCP and co-occurring depression/anxiety among MAT clients indicate an area of special concern for providers. A full biopsychosocial, including a focus on history of chronic physical pain, might be beneficial to help highlight potential co-morbidities and to encourage closer monitoring of the intertwining relationships between addiction, CNCP, and depression/anxiety.

摘要

背景与目的

进入阿片类药物成瘾治疗项目的人群中,报告患有慢性非癌性疼痛(CNCP)的比例有所增加。本研究调查了CNCP的存在与6个月药物辅助成瘾治疗(MAT)结果之间的关联。

方法

样本包括585名在阿片类药物治疗项目中的个体,他们在2007年3月至2010年12月期间完成了结构化的入院访谈和6个月的随访电话访谈。在样本中,115名个体在入院时和6个月随访时报告患有CNCP。双变量分析比较了MAT入院时患有CNCP(n = 115)和未患有CNCP(n = 470)的个体。

结果

与未患有CNCP的个体相比,患有CNCP的个体中更大比例的人年龄较大、已退休或残疾,并且在入院前经历过抑郁或焦虑。二项逻辑回归模型的结果发现,患有CNCP与随访时抑郁/焦虑几率增加有关,但与就业或物质使用无关。

结论与科学意义

MAT患者中CNCP与同时存在的抑郁/焦虑之间的相关性表明这是提供者特别关注的一个领域。全面的生物心理社会评估,包括关注慢性身体疼痛史,可能有助于突出潜在的共病情况,并鼓励对成瘾、CNCP和抑郁/焦虑之间的相互关系进行更密切的监测。

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