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美国处方阿片类药物注射滥用的趋势和关键相关因素。

Trends and key correlates of prescription opioid injection misuse in the United States.

机构信息

Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, Washington, D.C. 20052, United States.

出版信息

Addict Behav. 2018 Mar;78:145-152. doi: 10.1016/j.addbeh.2017.10.018. Epub 2017 Nov 22.

Abstract

BACKGROUND

Despite concerns over increasing harms associated with prescription opioid injection misuse, there is a paucity of research on the magnitude, characteristics, injection practices, and syringe sources for people who inject prescription opioids; limiting the implementation of targeted policy and programmatic initiatives.

MATERIALS AND METHODS

Data from the 2003 through 2014 National Surveys on Drug Use and Health were used to estimate prescription opioid injection trends and examine risky injection practices and syringe sources for people who inject prescription opioids. Multivariable logistic regression was used to identify characteristics associated with prescription opioid injection.

RESULTS

Among people 12years or older, the rate of prescription opioid injection misuse increased from 1.6 per 1000 in 2003-2005 to 2.7 per 1000 in 2012-2014 (p value for trend <0.05). Groups with increased odds of prescription opioid injection included: males, non-Hispanic whites, having an annual household income <$50,000, the uninsured, people with Medicaid, and people with past-year use disorders for cocaine, heroin, or prescription opioids. Risky injection practices such as reusing a needle and sharing needles were common among people with a history of prescription opioid injection misuse.

CONCLUSION

This study found significant increases in prescription opioid injection misuse trends in the U.S. These findings underscore the need to bring to scale evidence-based interventions to increase the provision of medication-assisted treatment for opioid use disorders and expand access to comprehensive risk-reduction services for people who inject drugs.

摘要

背景

尽管人们对与处方类阿片类药物注射滥用相关的危害日益增加感到担忧,但对于注射处方类阿片类药物的人群的规模、特征、注射行为和注射器来源,研究却很少,这限制了有针对性的政策和规划举措的实施。

材料和方法

本研究使用了 2003 年至 2014 年全国毒品使用和健康调查的数据,以估计处方类阿片类药物注射的趋势,并研究注射处方类阿片类药物人群的危险注射行为和注射器来源。多变量逻辑回归用于确定与处方类阿片类药物注射相关的特征。

结果

在 12 岁及以上人群中,处方类阿片类药物注射误用率从 2003-2005 年的每千人 1.6 例上升到 2012-2014 年的每千人 2.7 例(趋势检验 P 值<0.05)。具有更高处方类阿片类药物注射几率的人群包括:男性、非西班牙裔白人、家庭年收入<50000 美元、没有保险、拥有医疗补助以及过去一年可卡因、海洛因或处方类阿片类药物使用障碍的人群。有过处方类阿片类药物注射滥用史的人群中,重复使用针具和共用针具等危险注射行为较为常见。

结论

本研究发现美国处方类阿片类药物注射误用趋势显著增加。这些发现强调了需要大规模实施基于证据的干预措施,以增加对阿片类药物使用障碍的药物辅助治疗的提供,并扩大为注射毒品人群提供全面的减少风险服务。

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