Karjalainen Karoliina, Lintonen Tomi, Hakkarainen Pekka
National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
The Finnish Foundation for Alcohol Studies, P.O. Box 30, FI-00271 Helsinki, Finland.
Drug Alcohol Depend. 2017 Sep 1;178:430-434. doi: 10.1016/j.drugalcdep.2017.05.041. Epub 2017 Jul 4.
Non-medical use of prescription drugs (NMUPD) is known to be associated with illicit drug use, but less is known about how illicit drug use has changed in NMUPD. We examined (1) the changes in illicit drug use among Finnish non-medical users of prescription drugs during the 2000s and (2) whether the trends of illicit drug use differ by non-medical use of prescription drugs in the general population.
Data were derived from population-based (aged 15-69) Drug Surveys conducted in Finland in 2002, 2006, 2010 and 2014. The response rates varied between 63% and 48%. NMUPD during the last year was measured (n=252). Past-year illicit drug use among non-medical users of prescription drugs and the reference population not reporting NMUPD (n=10,967) was compared. Logistic regression was used to estimate the p-values for trends.
Illicit drug use has increased notably among Finnish non-medical users of prescription drugs (from 21% to 70%, p for trend<0.001). This was not explained by the respondents' gender, age, employment status or alcohol use. Among the reference population, illicit drug use also increased statistically significantly, but much more moderately (from 2.5% to 5.4%). The difference between the trends was confirmed by an interaction test (p=0.022).
NMUPD seems to be increasingly merging with illicit drug use. This indicates an increasing prevalence of polydrug use among non-medical users of prescription drugs, which may bring about more severe harms and worse health outcomes for users and more challenges in regard to treatment.
已知处方药的非医疗用途（NMUPD）与非法药物使用有关，但对于非法药物使用在NMUPD中如何变化了解较少。我们研究了（1）21世纪芬兰处方药非医疗使用者中非法药物使用的变化，以及（2）一般人群中非法药物使用趋势是否因处方药的非医疗使用而有所不同。
数据来源于2002年、2006年、2010年和2014年在芬兰进行的基于人群（年龄在15 - 69岁）的药物调查。应答率在63%至48%之间。测量了过去一年中的NMUPD（n = 252）。比较了处方药非医疗使用者和未报告NMUPD的参照人群（n = 10,967）中过去一年的非法药物使用情况。使用逻辑回归估计趋势的p值。
芬兰处方药非医疗使用者中的非法药物使用显著增加（从21%增至70%，趋势p<0.001）。这无法通过受访者的性别、年龄、就业状况或饮酒情况来解释。在参照人群中，非法药物使用也有统计学显著增加，但幅度小得多（从2.5%增至5.4%）。趋势差异通过交互检验得到证实（p = 0.022）。
NMUPD似乎越来越与非法药物使用相融合。这表明处方药非医疗使用者中多药使用的患病率在增加，这可能给使用者带来更严重的危害和更差的健康结果，以及在治疗方面带来更多挑战。
