青少年阿片类物质使用障碍专科治疗中的药物辅助治疗
Medication-Assisted Treatment for Adolescents in Specialty Treatment for Opioid Use Disorder.
作者信息
Feder Kenneth A, Krawczyk Noa, Saloner Brendan
机构信息
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
出版信息
J Adolesc Health. 2017 Jun;60(6):747-750. doi: 10.1016/j.jadohealth.2016.12.023. Epub 2017 Mar 1.
PURPOSE
The American Academy of Pediatrics recently recommended that pediatricians consider medication-assisted treatment (MAT) for adolescents with severe opioid use disorders. Little is known about adolescents' current use of MAT.
METHODS
We use data on episodes of specialty treatment for heroin or opioid use (n = 139,092) from a database of publicly funded treatment programs in the U.S. We compare the proportions of adolescents and adults who received MAT, first using unadjusted comparison of proportions, then using logistic regression to adjust for potential confounders.
RESULTS
Only 2.4% (95% confidence interval [CI], 1.4%-3.7%) of adolescents in treatment for heroin received MAT, as compared to 26.3% (95% CI, 26.0%-26.6%) of adults. Only .4% (95% CI, .2%-.7%) of adolescents in treatment for prescription opioids received MAT, as compared to 12.0% (95% CI, 11.7%-12.2%) of adults. Regression-adjusted results were qualitatively similar.
CONCLUSIONS
Regulatory changes and expansions of Medicaid/CHIP coverage for MAT may be needed to improve MAT access.
目的
美国儿科学会最近建议儿科医生考虑对患有严重阿片类药物使用障碍的青少年采用药物辅助治疗（MAT）。目前对于青少年当前使用MAT的情况知之甚少。
方法
我们使用了来自美国公共资助治疗项目数据库中关于海洛因或阿片类药物使用的专科治疗发作数据（n = 139,092）。我们比较接受MAT的青少年和成年人的比例，首先使用未调整的比例比较，然后使用逻辑回归来调整潜在的混杂因素。
结果
接受海洛因治疗的青少年中只有2.4%（95%置信区间[CI]，1.4%-3.7%）接受了MAT，而成人这一比例为26.3%（95%CI，26.0%-26.6%）。接受处方阿片类药物治疗的青少年中只有0.4%（95%CI，0.2%-0.7%）接受了MAT，而成人这一比例为12.0%（95%CI，11.7%-12.2%）。回归调整后的结果在质量上相似。
结论
可能需要对MAT的监管进行变革，并扩大医疗补助/儿童健康保险计划（Medicaid/CHIP）的覆盖范围，以改善MAT的可及性。
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