McKnight Erin R, Bonny Andrea E, Lange Hannah L H, Kline David M, Abdel-Rasoul Mahmoud, Gay Joseph R, Matson Steven C
a Nationwide Children's Hospital , Division of Adolescent Medicine , Columbus , OH , USA.
b The Ohio State University, College of Medicine , Columbus , OH , USA.
Am J Drug Alcohol Abuse. 2017 May;43(3):299-305. doi: 10.1080/00952990.2016.1216999. Epub 2016 Sep 19.
Little is known about the relationship between opioid prescribing practices and the prevalence of adolescent opioid misuse.
To examine the relationships between both opioid prescriptions filled by adolescents and adults and adolescents seeking treatment for opioid misuse in Ohio.
Analyses of large statewide databases from 2008 to 2012, including all 88 counties in Ohio. The Ohio Board of Pharmacy provided data regarding prescription opioids filled by adolescents (12-20 years, N = 50,030,820 doses) and adults (>20 years, N = 3,811,288,395 doses) by county of residence. The Ohio Department of Mental Health and Drug Addiction Services provided annual treatment admissions for adolescent opioid misuse by county of residence (N = 6446).
Adults filled prescriptions for nearly 100 oral opioid doses per capita annually, while adolescents filled prescriptions for approximately 7 oral opioid doses per capita annually. In Bayesian Poisson modeling examining the effect of annual adult per capita dose on adolescent treatment admissions, adjusted for annual adolescent per capita dose and year, an increase of one in the annual adult per capita opioid dose resulted in an increase of 1.3% (RR = 1.013, 95% HPD CI = [1.008, 1.017]) in the rate of adolescent treatment admissions. This association corresponds to a 99.99% chance that the adolescent treatment rate increases when the annual per capita adult dose is increased by one unit.
The amount of opioids filled by adults in Ohio, although relatively stable from 2008 to 2012, is approximately 13 times that filled by adolescents and is significantly associated with adolescents seeking treatment for opioid misuse. Efforts to decrease adolescent opioid misuse should also focus on reducing adult opioid prescriptions.
关于阿片类药物处方行为与青少年阿片类药物滥用流行率之间的关系，人们所知甚少。
研究俄亥俄州青少年和成年人开具的阿片类药物处方与青少年因阿片类药物滥用寻求治疗之间的关系。
对2008年至2012年全州范围的大型数据库进行分析，涵盖俄亥俄州所有88个县。俄亥俄州药房委员会提供了按居住县划分的青少年（12 - 20岁，N = 50,030,820剂）和成年人（>20岁，N = 3,811,288,395剂）开具的处方阿片类药物的数据。俄亥俄州心理健康与药物成瘾服务部提供了按居住县划分的青少年阿片类药物滥用年度治疗入院人数（N = 6446）。
成年人每年人均开具近100剂口服阿片类药物处方，而青少年每年人均开具约7剂口服阿片类药物处方。在贝叶斯泊松模型中，在调整了青少年人均年度剂量和年份后，研究成年人年度人均剂量对青少年治疗入院人数的影响，成年人年度人均阿片类药物剂量每增加一剂，青少年治疗入院率增加1.3%（RR = 1.013，95% HPD可信区间 = [1.008, 1.017]）。当成年人年度人均剂量增加一个单位时，青少年治疗率增加的概率为99.99%。
俄亥俄州成年人开具的阿片类药物数量，尽管在2008年至201年期间相对稳定，但约为青少年开具数量的13倍，且与青少年因阿片类药物滥用寻求治疗显著相关。减少青少年阿片类药物滥用的努力也应侧重于减少成人阿片类药物处方。
