Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States.
Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States.
Addict Behav. 2018 Nov;86:17-23. doi: 10.1016/j.addbeh.2018.05.005. Epub 2018 May 16.
Patterns in non-medical prescription opioid (NMPO) and heroin use have recently shifted, with evidence that NMPO-only users transition to NMPO and heroin co-use. Co-use is associated with increased risk of morbidity and overdose, highlighting the need for further investigation. This study aims to quantify, describe, and explore trends in co-use.
Using data from the 2003-2014 National Surveys on Drug Use and Health, we compared co-use to NMPO- and heroin-only use across demographic, substance use and mental health characteristics with chi-squared tests. Logistic regression models assessed trends in opioid use overall, and among co-users.
From 2003 to 2014, the prevalence of all opioid use (NMPO-only, heroin-only, and co-use) and NMPO-only use decreased 6.08% (p < 0.01) and 4.65% (p < 0.001), respectively, while prevalence of heroin-only use increased 21.32% (non-significant). Co-use increased 248.17% (p < 0.001) overall, and did so in all demographic, substance use, and mental health groups. Demographic, substance use, and mental health characteristics of co-users were more similar to the heroin-only group than to NMPO-only. The highest co-use prevalence was among those: without health insurance (8.72%), aged 26-34 (9.76%), reporting unemployment (12.08%), and with a major depressive episode, psychological distress, and who illicitly use or abuse drugs other than opioids or marijuana in the past year (9.33%, 10.75%, 11.87%, and 16.81%, respectively).
The increased prevalence of co-use and differences across demographic, substance use, and mental health characteristics highlight the need for targeted prevention and response interventions for this emerging, high-risk group.
非医用处方类阿片（NMPO）和海洛因的使用模式最近发生了变化，有证据表明，仅使用 NMPO 的用户会过渡到同时使用 NMPO 和海洛因。共同使用与发病率和过量用药风险增加有关，这突显了进一步调查的必要性。本研究旨在定量、描述和探讨共同使用的趋势。
使用 2003-2014 年全国毒品使用与健康调查的数据，我们通过卡方检验比较了共同使用与 NMPO 仅使用和海洛因仅使用在人口统计学、物质使用和心理健康特征方面的差异。逻辑回归模型评估了总体上以及共同使用者中阿片类药物使用的趋势。
从 2003 年到 2014 年，所有阿片类药物使用（NMPO 仅使用、海洛因仅使用和共同使用）和 NMPO 仅使用的流行率分别下降了 6.08%（p<0.01）和 4.65%（p<0.001），而海洛因仅使用的流行率增加了 21.32%（无统计学意义）。共同使用总体增加了 248.17%（p<0.001），并且在所有人口统计学、物质使用和心理健康群体中均如此。共同使用者的人口统计学、物质使用和心理健康特征与海洛因仅使用者更为相似，而与 NMPO 仅使用者相异。共同使用的最高流行率见于以下人群：没有医疗保险（8.72%）、年龄在 26-34 岁之间（9.76%）、报告失业（12.08%）、以及在过去一年中经历过重大抑郁发作、心理困扰、非法使用或滥用除阿片类药物或大麻以外的药物（分别为 9.33%、10.75%、11.87%和 16.81%）。
共同使用的流行率增加以及在人口统计学、物质使用和心理健康特征方面的差异突显了需要针对这一新兴高风险群体制定有针对性的预防和应对干预措施。
