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美国成年人的处方阿片类药物使用、滥用和使用障碍:2015 年全国毒品使用与健康调查。

Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health.

机构信息

From Substance Abuse and Mental Health Services Administration, Rockville, Maryland; National Institute on Drug Abuse, Bethesda, Maryland; and Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC.

出版信息

Ann Intern Med. 2017 Sep 5;167(5):293-301. doi: 10.7326/M17-0865. Epub 2017 Aug 1.

Abstract

BACKGROUND

Despite the continuing epidemic of opioid misuse, data on the prevalence of prescription opioid use, misuse, and use disorders are limited.

OBJECTIVE

To estimate the prevalence of prescription opioid use, misuse, and use disorders and motivations for misuse among U.S. adults.

DESIGN

Survey.

SETTING

The 2015 National Survey on Drug Use and Health (NSDUH).

PARTICIPANTS

72 600 eligible civilian, noninstitutionalized adults were selected for NSDUH, and 51 200 completed the survey interview.

MEASUREMENTS

Prescription opioid use, misuse, and use disorders.

RESULTS

Weighted NSDUH estimates suggested that, in 2015, 91.8 million (37.8%) U.S. civilian, noninstitutionalized adults used prescription opioids; 11.5 million (4.7%) misused them; and 1.9 million (0.8%) had a use disorder. Among adults with prescription opioid use, 12.5% reported misuse; of these, 16.7% reported a prescription opioid use disorder. The most commonly reported motivation for misuse was to relieve physical pain (63.4%). Misuse and use disorders were most commonly reported in adults who were uninsured, were unemployed, had low income, or had behavioral health problems. Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids for free from friends or relatives for their most recent episode of misuse.

LIMITATION

Cross-sectional, self-reported data.

CONCLUSION

More than one third of U.S. civilian, noninstitutionalized adults reported prescription opioid use in 2015, with substantial numbers reporting misuse and use disorders. Relief from physical pain was the most commonly reported motivation for misuse. Economic disadvantage and behavioral health problems may be associated with prescription opioid misuse. The results suggest a need to improve access to evidence-based pain management and to decrease excessive prescribing that may leave unused opioids available for potential misuse.

PRIMARY FUNDING SOURCE

U.S. Department of Health and Human Services.

摘要

背景

尽管阿片类药物滥用的持续流行,但有关处方阿片类药物使用、滥用和使用障碍的数据有限。

目的

估计美国成年人处方阿片类药物使用、滥用和使用障碍的流行率以及滥用的动机。

设计

调查。

设置

2015 年全国药物使用与健康调查(NSDUH)。

参与者

选择了 72600 名符合条件的非住院平民成年人参加 NSDUH,并完成了调查采访。

措施

处方阿片类药物使用、滥用和使用障碍。

结果

加权 NSDUH 估计表明,2015 年,9180 万(37.8%)美国平民非住院成年人使用了处方阿片类药物;1150 万人(4.7%)滥用;190 万人(0.8%)患有使用障碍。在使用处方阿片类药物的成年人中,12.5%报告滥用;其中,16.7%报告有阿片类药物使用障碍。滥用的最常见动机是缓解身体疼痛(63.4%)。在没有保险、失业、收入低或有行为健康问题的成年人中,滥用和使用障碍最为常见。在滥用的成年人中,59.9%报告未经处方使用阿片类药物,40.8%在最近一次滥用时从朋友或亲戚那里免费获得处方阿片类药物。

限制

横断面,自我报告的数据。

结论

2015 年,超过三分之一的美国平民非住院成年人报告使用了处方阿片类药物,大量报告了滥用和使用障碍。缓解身体疼痛是最常见的滥用动机。经济劣势和行为健康问题可能与处方阿片类药物滥用有关。结果表明,需要改善获得循证疼痛管理的机会,并减少可能导致未使用阿片类药物滥用的过度处方。

主要资金来源

美国卫生与公众服务部。

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