美国的非医疗处方阿片类药物使用及《精神疾病诊断与统计手册》第五版中的非医疗处方阿片类药物使用障碍

Nonmedical Prescription Opioid Use and DSM-5 Nonmedical Prescription Opioid Use Disorder in the United States.

作者信息

Saha Tulshi D, Kerridge Bradley T, Goldstein Risë B, Chou S Patricia, Zhang Haitao, Jung Jeesun, Pickering Roger P, Ruan W June, Smith Sharon M, Huang Boji, Hasin Deborah S, Grant Bridget F

机构信息

Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Ln, Room 3083, Rockville, MD 20852.

出版信息

J Clin Psychiatry. 2016 Jun;77(6):772-80. doi: 10.4088/JCP.15m10386.

DOI:10.4088/JCP.15m10386

PMID:27337416

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5555044/

Abstract

OBJECTIVE

The authors present 12-month and lifetime prevalence, correlates, psychiatric comorbidity, and treatment of nonmedical prescription opioid use (NMPOU) and DSM-5 NMPOU disorder (NMPOUD).

METHODS

Data were derived from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) (N = 36,309).

RESULTS

Prevalences of 12-month and lifetime NMPOU were 4.1% and 11.3%, exceeding rates in the 2001-2002 NESARC (1.8%, 4.7%). Twelve-month and lifetime rates of DSM-5 NMPOUD were 0.9% and 2.1%. NESARC-III DSM-IV NMPOUD rates (0.8%, 2.9%) were greater than those observed in the 2001-2002 NESARC (0.4% and 1.4%). Rates of NMPOU were greater among men, but no sex differential was observed for NMPOUD. Prevalences of NMPOU and NMPOUD were generally greater among 18- to 64-year-old individuals, whites, and Native Americans, and individuals with lower socioeconomic status. Associations were observed between 12-month and lifetime NMPOU and NMPOUD and other drug use disorders, posttraumatic stress disorder, and borderline, schizotypal, and antisocial personality disorders; persistent depression and major depressive disorder (for NMPOU); and bipolar I disorder (for NMPOUD). Only 5.5% and 17.7% of individuals with 12-month NMPOU and NMPOUD were ever treated.

CONCLUSIONS

NMPOU and NMPOUD have considerably increased over the past decade, are associated with a broad array of risk factors and comorbidities, and largely go untreated in the United States. More information on the determinants, characteristics, and outcomes of NMPOU and NMPOUD is needed to support evidence-based interventions and prevention.

摘要

目的

作者呈现非医疗处方阿片类药物使用（NMPOU）及《精神疾病诊断与统计手册》第5版（DSM - 5）非医疗处方阿片类药物使用障碍（NMPOUD）的12个月患病率和终生患病率、相关因素、精神共病情况及治疗情况。

方法

数据源自2012 - 2013年全国酒精及相关状况流行病学调查-III（NESARC - III）（N = 36,309）。

结果

12个月和终生NMPOU的患病率分别为4.1%和11.3%，超过了2001 - 2002年NESARC中的患病率（1.8%，4.7%）。DSM - 5 NMPOUD的12个月患病率和终生患病率分别为0.9%和2.1%。NESARC - III中DSM - IV NMPOUD的患病率（0.8%，2.9%）高于2001 - 2002年NESARC中的患病率（0.4%和1.4%）。NMPOU的患病率男性更高，但NMPOUD未观察到性别差异。NMPOU和NMPOUD的患病率在18至64岁个体、白人、美洲原住民以及社会经济地位较低的个体中通常更高。观察到12个月和终生NMPOU及NMPOUD与其他药物使用障碍、创伤后应激障碍、边缘性、分裂样和反社会人格障碍之间存在关联；持续性抑郁和重度抑郁症（与NMPOU相关）；以及双相I型障碍（与NMPOUD相关）。12个月NMPOU和NMPOUD的个体中分别仅有5.5%和17.7%接受过治疗。