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阿片类药物依赖者中抗组胺能抗焦虑药及其他处方药的非医疗使用情况

Nonmedical Use of Antihistaminergic Anxiolytics and Other Prescription Drugs among Persons with Opioid Dependence.

作者信息

Dahlman Disa, Abrahamsson Tove, Kral Alex H, Hakansson Anders

机构信息

Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Malmo Addiction Centre, Malmo, Sweden.

Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA.

出版信息

J Addict. 2016;2016:9298571. doi: 10.1155/2016/9298571. Epub 2016 Dec 20.

Abstract

. Nonmedical prescription drug use (NMPDU) is an increasing problem, insufficiently studied among people in opioid maintenance treatment (OMT). This study investigates the prevalence of and factors associated with NMPDU for drug classes insufficiently described in opioid-dependent populations, including antihistaminergic anxiolytics and central stimulants. . Study participants were recruited at two OMT clinics in Malmo, Sweden, between October 2014 and December 2015 ( = 73) and interviewed about their use, motivations for use, and acquisition and administration of prescription drugs. . The majority of the sample reported lifetime NMPDU: 60% for benzodiazepine-like hypnotics (z-drugs), 21% for pregabalin, 19% for stimulants, and 12%-15% for antihistaminergic anxiolytics. Lower age was associated with nonmedical benzodiazepine use (Adjusted Odds Ratio = 0.89; 95% Confidence Interval = 0.82-0.97). Illicit acquisition was reported by 61% of people using z-drugs, 46% of people using pregabalin, and 38% of people using prescription stimulants, but only by 6-10% of people using antihistaminergic anxiolytics. . The substantial nonmedical use of pregabalin, z-drugs, and prescription stimulants found in this study suggests that clinicians should prescribe these drugs with great caution. Nonmedical use of antihistaminergic anxiolytics does not seem to be a clinical issue among people in OMT in a Swedish setting, but we propose future studies to monitor their use.

摘要

非医疗用途的处方药使用(NMPDU)是一个日益严重的问题,在阿片类药物维持治疗(OMT)人群中对此研究不足。本研究调查了在阿片类药物依赖人群中描述不足的药物类别(包括抗组胺能抗焦虑药和中枢兴奋剂)的NMPDU患病率及其相关因素。2014年10月至2015年12月期间,在瑞典马尔默的两家OMT诊所招募了研究参与者(n = 73),并就他们对处方药的使用情况、使用动机以及获取和服用情况进行了访谈。大多数样本报告有终生NMPDU:苯二氮䓬类催眠药(Z类药物)为60%,普瑞巴林为21%,兴奋剂为19%,抗组胺能抗焦虑药为12% - 15%。年龄较小与非医疗用途的苯二氮䓬使用相关(调整后的优势比 = 0.89;95%置信区间 = 0.82 - 0.97)。使用Z类药物的人中有61%、使用普瑞巴林的人中有46%、使用处方兴奋剂的人中有38%报告通过非法途径获取药物,但使用抗组胺能抗焦虑药的人中只有6% - 10%是这样。本研究中发现普瑞巴林、Z类药物和处方兴奋剂存在大量非医疗用途,这表明临床医生在开具这些药物时应极其谨慎。在瑞典的OMT人群中,抗组胺能抗焦虑药的非医疗用途似乎不是一个临床问题,但我们建议未来开展研究以监测其使用情况。

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