Mojtabai Ramin
Department of Mental Health, Bloomberg School of Public Health and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
Pharmacoepidemiol Drug Saf. 2018 May;27(5):526-534. doi: 10.1002/pds.4278. Epub 2017 Sep 6.
This study examined recent trends and correlates of prescription opioid use and long-term use in the United States.
Data were from 47 356 adult participants of National Health and Nutrition Survey from 1999-2000 to 2013-2014. Participants were asked about prescription medications used in the past 30 days. Long-term use of prescription opioids was defined by use for 90 days or longer.
The prevalence of prescription opioid use increased from 4.1% of US adults in 1999-2000 to 6.8% in 2013-2014 (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.10-1.75, P = .007). This trend was driven by a sharp increase in long-term use which increased from 1.8% to 5.4% (OR = 2.22, 95% CI = 1.65-3.00, P < .001). Of all opioid users in 2013-2014, 79.4% were long-term users compared with 45.1% in 1999-2000. Long-term use was associated with poorer physical health, concurrent benzodiazepine use, and history of heroin use.
The findings highlight the need for research on potential benefits and harms of long-term use of opioids and efforts to restrict long-term use to patients for whom the benefits outweigh the risks.
本研究调查了美国处方阿片类药物使用及长期使用的近期趋势和相关因素。
数据来自1999 - 2000年至2013 - 2014年美国国家健康与营养调查的47356名成年参与者。参与者被问及过去30天内使用的处方药情况。处方阿片类药物的长期使用定义为使用90天或更长时间。
处方阿片类药物的使用患病率从1999 - 2000年美国成年人的4.1%增至2013 - 2014年的6.8%（优势比[OR]=1.38，95%置信区间[CI]=1.10 - 1.75，P = 0.007）。这一趋势是由长期使用的急剧增加所驱动，长期使用率从1.8%增至5.4%（OR = 2.22，95% CI = 1.65 - 3.00，P < 0.001）。在2013 - 2014年所有阿片类药物使用者中，79.4%为长期使用者，而在1999 - 2000年这一比例为45.1%。长期使用与较差的身体健康状况、同时使用苯二氮䓬类药物以及有海洛因使用史相关。
研究结果凸显了对阿片类药物长期使用的潜在益处和危害进行研究的必要性，以及将长期使用限制于那些获益大于风险的患者的努力。
