Tofighi Babak, Grossman Ellie, Goldfeld Keith S, Williams Arthur Robinson, Rotrosen John, Lee Joshua D
a Department of Population Health , New York University School of Medicine , New York , New York , USA.
b Division of General Internal Medicine , New York University School of Medicine , New York , New York , USA.
Subst Use Misuse. 2015;50(12):1571-8. doi: 10.3109/10826084.2015.1023455. Epub 2015 Nov 19.
On October 2012, Hurricane Sandy struck New York City, resulting in unprecedented damages, including the temporary closure of Bellevue Hospital Center and its primary care office-based buprenorphine program.
At 6 months, we assessed factors associated with higher rates of substance use in buprenorphine program participants that completed a baseline survey one month post-Sandy (i.e. shorter length of time in treatment, exposure to storm losses, a pre-storm history of positive opiate urine drug screens, and post-disaster psychiatric symptoms).
Risk factors of interest extracted from the electronic medical records included pre-disaster diagnosis of Axis I and/or II disorders and length of treatment up to the disaster. Factors collected from the baseline survey conducted approximately one month post-Sandy included self-reported buprenorphine supply disruption, health insurance status, disaster exposure, and post-Sandy screenings for PTSD and depression. Outcome variables reviewed 6 months post-Sandy included missed appointments, urine drug results for opioids, cocaine, and benzodiazepines.
129 (98%) patients remained in treatment at 6 months, and had no sustained increases in opioid-, cocaine-, and benzodiazepine-positive urine drug tests in any sub-groups with elevated substance use in the baseline survey. Contrary to our initial hypothesis, diagnosis of Axis I and/or II disorders pre-Sandy were associated with significantly less opioid-positive urine drug findings in the 6 months following Sandy compared to the rest of the clinic population.
These findings demonstrate the adaptability of a safety net buprenorphine program to ensure positive treatment outcomes despite disaster-related factors.
2012年10月，飓风桑迪袭击了纽约市，造成了前所未有的破坏，包括贝莱维医院中心及其基于办公室的丁丙诺啡初级保健项目暂时关闭。
在6个月时，我们评估了在桑迪飓风过后一个月完成基线调查的丁丙诺啡项目参与者中，与更高物质使用率相关的因素（即治疗时间较短、遭受风暴损失、风暴前阿片类药物尿液药物筛查呈阳性的病史以及灾后精神症状）。
从电子病历中提取的感兴趣的风险因素包括灾难前轴I和/或轴II障碍的诊断以及到灾难发生时的治疗时长。在桑迪飓风过后大约一个月进行的基线调查中收集的因素包括自我报告的丁丙诺啡供应中断、健康保险状况、灾难暴露以及桑迪飓风过后的创伤后应激障碍和抑郁症筛查。在桑迪飓风过后6个月审查的结果变量包括错过的预约、阿片类药物、可卡因和苯二氮卓类药物的尿液药物检测结果。
129名（98%）患者在6个月时仍在接受治疗，在基线调查中物质使用量升高的任何亚组中，阿片类药物、可卡因和苯二氮卓类药物阳性尿液药物检测均未持续增加。与我们最初的假设相反，与诊所其他人群相比，桑迪飓风前被诊断为轴I和/或轴II障碍的患者在桑迪飓风后的6个月中阿片类药物阳性尿液药物检测结果明显较少。
这些发现表明，尽管存在与灾难相关的因素，但安全网丁丙诺啡项目具有适应性，可确保积极的治疗结果。
