Branham Douglas Keith
a University of Kentucky , Department of Health Management and Policy , Lexington , Kentucky , USA.
Subst Use Misuse. 2018 Mar 21;53(4):694-701. doi: 10.1080/10826084.2017.1363232. Epub 2017 Sep 27.
Prescription drug abuse has become a major issue in the United States in recent years. Prescription drug monitoring programs (PDMPs) are designed to help health care providers to prevent such abuses. There may be unintended effects of these programs. Specifically, PDMPs may move prescription opioid users to begin use of heroin.
This article aims to evaluate the impact of PDMPs on heroin abuse across several different states through use of treatment admissions records obtained from the Treatment Episode Data Set.
Operational dates and other characteristics of state PDMPs were obtained from the Prescription Drug Monitoring Program Training and Technical Assistance Center. Data for the dependent variable were collected from the Treatment Episodes Data Set from 1992 to 2012. Interrupted time-series analyses using autoregressive integrated moving average modeling were used to estimate the effect of presence of an operational PDMP on the number of admissions reporting heroin as their primary drug being used.
The relationship between heroin admissions and prescription opioid admissions was significant for the average data (β = 0.41, p = 0.0017) and the 5-year data (β = 0.5, p = 0.036), both showing positive associations between heroin and prescription drug admissions in states in the post PDMP implementation period. Conclusions/Importance: The study found a positive relationship that between heroin and prescription opioid admissions post PDMP implementation. Future research should attempt to identify what this relationship means and how this information can be used to improve opioid policy.
近年来，处方药滥用已成为美国的一个主要问题。处方药监测计划（PDMPs）旨在帮助医疗保健提供者预防此类滥用行为。这些计划可能会产生意想不到的影响。具体而言，PDMPs可能会促使处方阿片类药物使用者开始使用海洛因。
本文旨在通过使用从治疗事件数据集获得的治疗入院记录，评估PDMPs对几个不同州海洛因滥用的影响。
从处方药监测计划培训和技术援助中心获取州PDMPs的运行日期和其他特征。因变量的数据从1992年至2012年的治疗事件数据集中收集。使用自回归积分移动平均模型进行中断时间序列分析，以估计运行中的PDMPs对报告使用海洛因为主要药物的入院人数的影响。
海洛因入院人数与处方阿片类药物入院人数之间的关系在平均数据（β = 0.41，p = 0.0017）和5年数据（β = 0.5，p = 0.036）中均具有显著性，两者均显示在PDMPs实施后各州海洛因与处方药入院人数之间存在正相关。结论/重要性：该研究发现PDMPs实施后海洛因与处方阿片类药物入院人数之间存在正相关关系。未来的研究应试图确定这种关系意味着什么，以及如何利用这些信息来改善阿片类药物政策。
