Sheridan David C, Laurie Amber, Hendrickson Robert G, Fu Rongwei, Kea Bory, Horowitz B Zane
Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon.
Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon; School of Public Health, Oregon Health and Science University, Portland, Oregon.
J Emerg Med. 2016 Nov;51(5):485-490. doi: 10.1016/j.jemermed.2016.06.049. Epub 2016 Sep 3.
Opioid abuse is a public health epidemic in the United States. Much literature has focused on the prescribing practices of physicians and opioid misuse by adults. However, there are limited data on the effect of opioid prescriptions on adolescent recreational ingestion of these medications.
The objective of this study was to assess for a relationship between opioid prescribing practices across the United States and adolescent opioid ingestion calls to poison centers.
This was an observational study using the National Poison Data System. The study population consisted of poison center calls regarding adolescents between 2005 and 2010 in the database with a coding of "intentional abuse" and an opioid ingestion. National opioid prescription estimates were generated using nationally representative outpatient and inpatient databases.
There were 4186 adolescent opioid ingestion calls during the study period. There was a general increase between 2005 and 2010 in both teen opioid abuse calls (617 in 2005 to 782 in 2010) and national opioid prescriptions (approximately 78 million in 2005 to 108 million in 2010). For each opioid prescription increase per 100 persons per year, the annual teen opioid abuse calls increased by 1.8% (95% confidence interval 0.9-2.8%), equivalent to an absolute increase of about 0.04 to 0.05 calls per 100,000 teens annually.
There appears to be an association between opioid prescriptions nationally and poison center calls for adolescent opioid ingestions. This is particularly important in this patient population because of impulsivity and early exposure to substance abuse. Providers should be aware of the nonmedical use of opioids by adolescents and educate patients accordingly.
在美国,阿片类药物滥用是一场公共卫生危机。许多文献都聚焦于医生的处方行为以及成年人对阿片类药物的不当使用。然而,关于阿片类药物处方对青少年非医疗性服用这些药物的影响的数据却很有限。
本研究的目的是评估美国各地的阿片类药物处方行为与青少年拨打中毒控制中心热线报告阿片类药物摄入情况之间的关系。
这是一项利用国家中毒数据系统进行的观察性研究。研究人群包括数据库中2005年至2010年间关于青少年的中毒控制中心热线报告,这些报告被编码为“故意滥用”且涉及阿片类药物摄入。使用具有全国代表性的门诊和住院数据库得出全国阿片类药物处方估计数。
在研究期间,有4186起青少年阿片类药物摄入热线报告。2005年至2010年间,青少年阿片类药物滥用热线报告(从2005年的617起增至2010年的782起)和全国阿片类药物处方(从2005年约7800万增至2010年1.08亿)总体上都有所增加。每100人每年的阿片类药物处方量每增加一次,青少年阿片类药物滥用热线报告每年就增加1.8%(95%置信区间为0.9%-2.8%),相当于每10万名青少年每年绝对增加约0.04至0.05起热线报告。
全国范围内的阿片类药物处方与中毒控制中心接到的青少年阿片类药物摄入热线报告之间似乎存在关联。鉴于青少年的冲动性以及早期接触药物滥用的情况,这在该患者群体中尤为重要。医疗服务提供者应意识到青少年对阿片类药物的非医疗性使用,并据此对患者进行教育。