Pouget Enrique R, Fong Chunki, Rosenblum Andrew
a Center for Policing Equity at John Jay College of Criminal Justice , New York , New York , USA.
b National Development and Research Institutes, Inc. , New York , New York , USA.
Subst Use Misuse. 2018 Jan 28;53(2):290-300. doi: 10.1080/10826084.2017.1334070. Epub 2017 Aug 30.
Recent data suggest an increase in use of heroin and non-medical use of prescription opioids (POs) in the United States, but it is unclear if these trends are consistent across racial/ethnic groups. In a nationwide prevalence study, 69,140 patients newly admitted to an opioid treatment program (OTP) completed a brief self-administered survey of past month heroin use and PO misuse from January 2005 through September 2016. We calculated heroin use and PO misuse prevalence rates, and prevalence rate ratios of Black and Latino OTP entrants compared to White entrants over time. Initially, Black and Latino respondents reported much higher prevalence of heroin use and much lower prevalence of PO misuse than White respondents. Heroin use increased among White respondents, while it decreased among Black respondents, resulting in rates that were no longer significantly different. PO misuse prevalence decreased among White respondents while it increased among Black respondents, but remained significantly higher among White respondents. Heroin use decreased and PO misuse increased among Latino respondents during the late 2000s, but these trends largely reversed in more recent years. Among OTP entrants, racially/ethnically disparate rates of heroin use, and to a lesser extent, of PO misuse have become more similar over time. These trends were stronger when analysis was restricted to OTP entrants who either had no previous OTP history or were younger. To understand potential impacts of interventions to deter PO misuse and to maximize the effectiveness of OTPs it is important to consider potential changes in opioid use across racial/ethnic groups.
近期数据显示，美国海洛因使用量及处方阿片类药物（PO）的非医疗用途有所增加，但尚不清楚这些趋势在不同种族/族裔群体中是否一致。在一项全国性患病率研究中，69140名新进入阿片类药物治疗项目（OTP）的患者在2005年1月至2016年9月期间完成了一项关于过去一个月海洛因使用情况和PO滥用情况的简短自我管理调查。我们计算了海洛因使用和PO滥用的患病率，以及随着时间推移，黑人及拉丁裔OTP进入者与白人进入者的患病率比值。最初，黑人和拉丁裔受访者报告的海洛因使用率远高于白人受访者，而PO滥用率则远低于白人受访者。白人受访者的海洛因使用率上升，而黑人受访者的海洛因使用率下降，导致两者不再有显著差异。白人受访者的PO滥用患病率下降，而黑人受访者的PO滥用患病率上升，但白人受访者的PO滥用患病率仍显著更高。在21世纪后期，拉丁裔受访者的海洛因使用率下降，PO滥用率上升，但近年来这些趋势大多逆转。在OTP进入者中，随着时间的推移，不同种族/族裔群体在海洛因使用以及在较小程度上的PO滥用方面的差异变得更加相似。当分析仅限于没有OTP治疗史或年龄较小的OTP进入者时，这些趋势更为明显。为了解阻止PO滥用的干预措施的潜在影响并使OTP的效果最大化，考虑不同种族/族裔群体阿片类药物使用的潜在变化非常重要。
