Cochran Gerald, McCarthy Rebecca, Gordon Adam J, Tarter Ralph E
University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA, 15260, USA; University of Pittsburgh, School of Medicine, M240 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA.
VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15224, USA.
Drug Alcohol Depend. 2017 Oct 1;179:13-17. doi: 10.1016/j.drugalcdep.2017.06.013. Epub 2017 Jul 14.
Combining opioid medications and alcohol has serious implications for patient health, including overdose. Information regarding those who use/misuse opioid medications and engage in unhealthy alcohol use is limited to pharmacological and epidemiological descriptions. This study presents opioid medication misuse and behavioral, mental, and physical health characteristics of persons filling opioid medications that are engaged in unhealthy alcohol use.
We conducted a cross-sectional survey at 5 community pharmacies in Southwestern, Pennsylvania among patients filling opioid medications. Respondents completed validated opioid medication misuse, alcohol use, illicit drug use, depression, posttraumatic stress disorder (PTSD), and physical health functioning assessments. We present univariate and multivariate statistics describing opioid medication misuse and health risks among those positive for unhealthy alcohol use.
A total of 344 patients completed the survey (75.8% response). A total of 15.9% of respondents screened positive for opioid medication misuse, of whom 20.3% reported unhealthy alcohol use. Taking opioid medications too often was reported among a larger proportion of the sample with unhealthy alcohol use (34.3%) compared to those without (22.1%, p=0.04). Further, among respondents with unhealthy alcohol use, illicit drug use (Adjusted odds ratio [AOR]=12.14, 95% Confidence Interval [CI]=1.64-89.72) and PTSD (AOR=9.77, 95% CI=1.70-56.11) were associated with increased odds for opioid medication misuse.
Results suggest respondents with unhealthy alcohol use had distinct health profiles, which may place them at risk for opioid misuse and adverse events, such as overdose. Continued research must work to further understand these relationships and identify intervention and treatment strategies.
将阿片类药物与酒精混合使用对患者健康有严重影响,包括过量用药。关于使用/滥用阿片类药物且存在不健康饮酒行为的人群的信息,仅限于药理学和流行病学描述。本研究呈现了开具阿片类药物且存在不健康饮酒行为的人群中阿片类药物滥用情况以及行为、心理和身体健康特征。
我们在宾夕法尼亚州西南部的5家社区药店对开具阿片类药物的患者进行了横断面调查。受访者完成了经过验证的阿片类药物滥用、饮酒情况、非法药物使用、抑郁、创伤后应激障碍(PTSD)和身体健康功能评估。我们呈现了描述不健康饮酒呈阳性者中阿片类药物滥用和健康风险的单变量和多变量统计数据。
共有344名患者完成了调查(应答率为75.8%)。共有15.9%的受访者阿片类药物滥用筛查呈阳性,其中20.3%报告有不健康饮酒行为。与无不健康饮酒行为者(22.1%,p = 0.04)相比,在有不健康饮酒行为的样本中,报告过于频繁服用阿片类药物的比例更高(34.3%)。此外,在有不健康饮酒行为的受访者中,非法药物使用(调整优势比[AOR]=12.14,95%置信区间[CI]=1.64 - 89.72)和创伤后应激障碍(AOR = 9.77,95% CI = 1.70 - 56.11)与阿片类药物滥用几率增加相关。
结果表明,有不健康饮酒行为的受访者有独特的健康状况,这可能使他们面临阿片类药物滥用及诸如过量用药等不良事件的风险。后续研究必须努力进一步了解这些关系,并确定干预和治疗策略。