Division of Rheumatic and Autoimmune Diseases, University of Minnesota, Minneapolis, Minnesota.
Division of Rheumatic and Autoimmune Diseases, University of Minnesota, Minneapolis, Minnesota.
J Pain. 2018 Oct;19(10):1104-1112. doi: 10.1016/j.jpain.2018.04.004. Epub 2018 Apr 17.
Many classes of medications have been evaluated in chronic low back pain (cLBP), however their utilization in the community remains unclear. We examined patterns of prescription medication use among Americans with cLBP in a nationally representative, community-based sample. The Back Pain Survey was administered to a representative sample of U.S. adults aged 20 to 69 years (N = 5,103) during the 2009 to 2010 cycle of the National Health and Nutrition Examination Survey. cLBP was defined as self-reported pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold on most days for at least 3 months (N = 700). Home-based interviews with pill bottle verification were used to capture commonly prescribed medications for chronic pain. Among the sample of U.S. adults with cLBP aged 20 to 69 years, 36.9% took at least 1 prescription pain medication in the past 30 days; of them, 18.8% used opioids, 9.7% nonsteroidal anti-inflammatory drugs, 8.5% muscle relaxants, and 6.9% gabapentin or pregabalin. Nonpain antidepressants and hypnotics were used by 17.8% and 4.7%, respectively. Opioids were used long-term in 76.9% of cases (median = 2 years) and were frequently coadministered with antidepressants, benzodiazepines, or hypnotics. Ninety-four percent of prescription opioids in the cLBP population were used by individuals with less than a college education. Opioids were the most widely used prescription analgesic class in community-based U.S. adults with cLBP and were often coadministered with other central nervous system-active medications. Opioid use was highly prevalent among less educated Americans with cLBP.
Because prescription opioid use is an issue of national concern, we examined pain-related prescription medication use in community-dwelling U.S. adults with cLBP. Opioids were the most common prescription pain medication, typically used long-term, in combination with other central nervous system-active agents, and disproportionately among individuals with less than a college education.
许多类别的药物已在慢性下背痛 (cLBP) 中进行了评估，但其在社区中的使用情况仍不清楚。我们在一个具有全国代表性的社区基础样本中检查了患有 cLBP 的美国人的处方药物使用模式。在 2009 年至 2010 年全国健康和营养检查调查周期中，向年龄在 20 至 69 岁的美国成年人的代表性样本 (N = 5,103) 进行了背痛调查。cLBP 的定义为自我报告的肋骨下方区域和水平臀褶皱之间的疼痛在大多数日子里持续至少 3 个月 (N = 700)。使用基于家庭的访谈和药丸瓶验证来捕获慢性疼痛的常用处方药。在年龄在 20 至 69 岁的患有 cLBP 的美国成年人样本中，36.9%在过去 30 天内至少服用了 1 种处方止痛药；其中，18.8%使用阿片类药物，9.7%使用非甾体抗炎药，8.5%使用肌肉松弛剂，6.9%使用加巴喷丁或普瑞巴林。非疼痛抗抑郁药和催眠药的使用率分别为 17.8%和 4.7%。阿片类药物的长期使用在 76.9%的病例中（中位数为 2 年），并经常与抗抑郁药、苯二氮䓬类药物或催眠药联合使用。cLBP 人群中 94%的处方类阿片药物由受教育程度低于大学的个体使用。阿片类药物是社区中 cLBP 美国成年人中使用最广泛的处方镇痛药类别，并且经常与其他中枢神经系统活性药物联合使用。阿片类药物的使用在受教育程度较低的 cLBP 美国人中非常普遍。
由于处方类阿片类药物的使用是一个全国性的问题，我们检查了社区居住的患有 cLBP 的美国成年人的与疼痛相关的处方药物使用情况。阿片类药物是最常见的处方止痛药，通常长期使用，与其他中枢神经系统活性药物联合使用，而且在受教育程度较低的个体中使用比例过高。
