Jones Christopher M, Christensen Aleta, Gladden R Matthew
Office of Science and Data Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, 200 Independence Ave SW RM434E2, Washington, DC 20201, United States.
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Chamblee, GA 30341, United States.
Drug Alcohol Depend. 2017 Jul 1;176:89-95. doi: 10.1016/j.drugalcdep.2017.03.011. Epub 2017 May 16.
The 2015 HIV outbreak in Indiana associated with prescription opioid injection coupled with rising rates of hepatitis C, especially in areas with long-standing opioid abuse, have raised concerns about prescription opioid injection. However, research on this topic is limited. We assessed trends in treatment admissions reporting injection, smoking, and inhalation abuse of prescription opioids and examined characteristics associated with non-oral routes of prescription opioid abuse in the U.S.
Prescription opioid abuse treatment admissions in the 2004-2013 Treatment Episode Data Set were used to calculate counts and percentages of prescription opioid treatment admissions reporting oral, injection, or smoking/inhalation abuse overall, by sex, age, and race/ethnicity. Multivariable multinomial logistic regression was used to identify demographic and substance use characteristics associated with injection or smoking/inhalation abuse.
From 2004-2013, oral abuse decreased from 73.1% to 58.9%; injection abuse increased from 11.7% to 18.1%; and smoking/inhalation abuse increased from 15.3% of admissions to 23.0%. Among treatment admissions, the following were associated with injection abuse: male sex, 18-54 year-olds, non-Hispanic whites, non-Hispanic other, homeless or dependent living, less than full-time work, living in the Midwest or South, ≥1 prior treatment episodes, younger age of first opioid use, and reporting use of cocaine/crack, marijuana, heroin, or methamphetamine.
The proportion of treatment admissions reporting prescription opioid injection and smoking/inhalation abuse increased significantly in the U.S. between 2004 and 2013. Expanding prevention efforts as well as access to medication-assisted treatment and risk reduction services for people who inject drugs is urgently needed.
2015年印第安纳州与处方阿片类药物注射相关的艾滋病毒疫情，再加上丙型肝炎发病率不断上升，尤其是在长期存在阿片类药物滥用的地区，引发了人们对处方阿片类药物注射的担忧。然而，关于这一主题的研究有限。我们评估了报告处方阿片类药物注射、吸烟和吸入滥用的治疗入院趋势，并研究了美国与处方阿片类药物非口服滥用相关的特征。
使用2004 - 2013年治疗事件数据集（Treatment Episode Data Set）中的处方阿片类药物滥用治疗入院数据，计算总体上、按性别、年龄和种族/民族划分的报告口服、注射或吸烟/吸入滥用的处方阿片类药物治疗入院的计数和百分比。多变量多项逻辑回归用于确定与注射或吸烟/吸入滥用相关的人口统计学和物质使用特征。
2004年至2013年期间，口服滥用从73.1%降至58.9%；注射滥用从11.7%增至18.1%；吸烟/吸入滥用从入院人数的15.3%增至23.0%。在治疗入院患者中，以下因素与注射滥用相关：男性、18 - 54岁、非西班牙裔白人、非西班牙裔其他种族、无家可归或依赖他人生活、非全职工作、居住在中西部或南部、既往有≥1次治疗经历、首次使用阿片类药物的年龄较小，以及报告使用可卡因/快克、大麻、海洛因或甲基苯丙胺。
2004年至2013年期间，美国报告处方阿片类药物注射和吸烟/吸入滥用的治疗入院比例显著增加。迫切需要扩大预防工作，以及为注射毒品者提供药物辅助治疗和降低风险服务。
