Pochard Liselotte, Dupouy Julie, Frauger Elisabeth, Giocanti Adeline, Micallef Joëlle, Lapeyre-Mestre Maryse
Service de Pharmacologie Clinique, Faculté de Médecine, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance de Toulouse, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.
Service de Pharmacologie Clinique et Pharmacovigilance, Centre d'Evaluation et d'Information sur la Pharmacodépendance Paca Corse, Hôpital de la Timone, 13005, Marseille, France.
Fundam Clin Pharmacol. 2018 Apr;32(2):188-197. doi: 10.1111/fcp.12346. Epub 2018 Jan 29.
Pregnancy can be a motivation for decrease in drug abusing but may also represent a period of high vulnerability for relapse. We aimed to assess psychoactive substance use among women with substance use disorders followed in addiction care centers in France. We analyzed data from women aged 15-44 years included in the 'Observation of illegal drugs and misuse of psychotropic medication (OPPIDUM) survey', an annual cross-sectional survey collecting details on psychoactive substances used. Characteristics of women included in 2005-2012 yearly surveys were compared depending on their pregnant or not pregnant status. Factors, including pregnancy, associated with illicit substance use and medication misuse were investigated through logistic regression. The study included 518 pregnant and 6345 nonpregnant women; 85.3% pregnant women were on opioid maintenance therapy (OMT) (vs. 77.1% of nonpregnant). Pregnancy was associated with lower illicit substance use (adjusted OR 0.71 [0.58-0.88]) and with lower medication misuse (0.66 [0.49-0.89]), whereas financial insecurity and living as a couple were associated with increased risk. Raising children was significantly associated with less risk of substance use. Each substance taken separately, the part of women using illicit substance or misusing medication did not differ depending on whether they were pregnant or not, except for heroin (24.5% in pregnant vs. 17.9% nonpregnant; <0.001). This nationwide study provides new insights into psychoactive substance use in a large mixed population of women with drug use disorders. Results outline the challenge of preventing drug use and initiating care strategies with a specific approach on socio-economic environment.
怀孕可能是减少药物滥用的一个动机，但也可能是复发的高风险期。我们旨在评估在法国成瘾护理中心接受治疗的患有物质使用障碍的女性中精神活性物质的使用情况。我们分析了“非法药物和精神药物滥用观察（OPPIDUM）调查”中纳入的15 - 44岁女性的数据，该年度横断面调查收集了所使用精神活性物质的详细信息。根据2005 - 2012年年度调查中女性的怀孕或未怀孕状态，对其特征进行了比较。通过逻辑回归研究了包括怀孕在内的与非法物质使用和药物滥用相关的因素。该研究纳入了518名孕妇和6345名非孕妇；85.3%的孕妇接受阿片类药物维持治疗（OMT）（非孕妇为77.1%）。怀孕与较低的非法物质使用（调整后的比值比为0.71 [0.58 - 0.88]）和较低的药物滥用（0.66 [0.49 - 0.89]）相关，而经济不安全和同居则与风险增加相关。抚养孩子与物质使用风险较低显著相关。单独来看每种物质，使用非法物质或滥用药物的女性比例在怀孕与否方面没有差异，但海洛因除外（孕妇中为24.5%，非孕妇中为17.9%；<0.001）。这项全国性研究为大量患有药物使用障碍的混合女性群体中精神活性物质的使用提供了新的见解。结果概述了预防药物使用以及针对社会经济环境采取特定方法启动护理策略的挑战。
