Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA.
Drug Alcohol Depend. 2018 Apr 1;185:10-16. doi: 10.1016/j.drugalcdep.2017.11.035. Epub 2018 Feb 2.
Rates of both opioid and sedative use and misuse are rising. Comorbid opioid and sedative use is associated with especially severe consequences (e.g., overdose and poor health outcomes). Heroin users report multiple motivations for sedative use, including self-medication. We aimed to understand differences in lifetime substance use characteristics between heroin users with different sedative use histories.
Substance use data were collected from 385 non-treatment seeking heroin users. Subjects were divided into four lifetime sedative-use groups: no use, medical use only, non-medical use only, and mixed medical and non-medical use. We examined patterns of use of various substances of abuse (tobacco, alcohol, marijuana, cocaine, heroin, and sedatives) and individual characteristics associated with each.
Non-medical sedative use (alone or in addition to medical use) was associated with more negative consequences from using all substances. Medical sedative use alone was not related to increased overdose or emergency room visits associated with heroin use. Non-medical sedative use was associated with increases in 15 of the 21 measured heroin consequences and only one of those - health problems - was also associated with medical sedative use.
Concomitant non-medical sedative use and heroin use is associated with significantly greater negative outcomes than those experienced by heroin users who report use of sedatives only as prescribed. Understanding these differences offers insight into risks related to using both substances and may help treatment providers create targeted harm reduction interventions for this population.
阿片类药物和镇静剂的使用和滥用率都在上升。合并使用阿片类药物和镇静剂会导致特别严重的后果（例如，过量用药和健康状况不佳）。海洛因使用者报告了使用镇静剂的多种动机，包括自我治疗。我们旨在了解具有不同镇静剂使用史的海洛因使用者之间在终生物质使用特征上的差异。
从 385 名非治疗性寻求海洛因的使用者中收集了物质使用数据。受试者被分为四个终生镇静剂使用组：无使用、仅医疗使用、仅非医疗使用和混合医疗和非医疗使用。我们研究了各种滥用物质（烟草、酒精、大麻、可卡因、海洛因和镇静剂）的使用模式以及与每种物质相关的个体特征。
非医疗镇静剂使用（单独使用或与医疗使用一起使用）与使用所有物质的更多负面后果相关。单独使用医疗镇静剂与增加与海洛因使用相关的过量或急诊就诊无关。非医疗镇静剂的使用与 21 项测量的海洛因后果中的 15 项增加有关，而这些后果中只有一项与医疗镇静剂使用有关，即健康问题。
同时使用非医疗镇静剂和海洛因与报告仅按规定使用镇静剂的海洛因使用者相比，与显著更多的负面结果相关。了解这些差异为了解与同时使用这两种物质相关的风险提供了线索，并可能有助于治疗提供者为这一人群创建有针对性的减少伤害干预措施。
