University of Kentucky, 235 Dickey Hall, Lexington, KY 40506, United States.
University of Kentucky, 141 Medical Behavioral Science Building, Lexington, KY 40506, United States.
Addict Behav. 2018 Oct;85:14-20. doi: 10.1016/j.addbeh.2018.04.022. Epub 2018 Apr 30.
The Centers for Disease Control and Prevention has deemed nonmedical opioid use (NMOU) an epidemic. Population-based survey data indicate high rates of NMOU among Caucasians, however, these estimates exclude incarcerated samples and may underestimate use among criminal justice-involved African Americans. Despite opioid-associated risks of co-occurring mental illness and mortality, to our knowledge, this is the first study to examine NMOU and mental health among a sample of African American men receiving corrections-based substance use disorder (SUD) treatment in jail, prison, or the community.
We conducted a cross-sectional study examining trends and mental health correlates of NMOU during the year prior to each participant's incarceration, across five cohorts of African American men (N = 4021) enrolled in corrections-based SUD treatment between the years, 2010 and 2014. A series of chi-square, ANOVAs, correlations, and logistic regression models were conducted.
Over 20% of our sample reported NMOU during the year prior to incarceration. On average, participants were 36-years-old, earned 13 years of education, and were generally unemployed, prior to incarceration. We found a statistically significant positive linear trend between NMOU prior to incarceration and cohort year. The final stepwise multivariate regression model was significant and revealed, older age was associated with lower odds of NMOU. More years of education and frequent mental health symptoms were associated with significantly increased odds of NMOU.
Our findings are unique in that extant literature has primarily described NMOU as a 'White suburban' problem. Culturally-adapted behavioral interventions and medication assisted therapies are discussed.
疾病控制与预防中心已将非医疗性阿片类药物使用（NMOU）视为一种流行病。基于人群的调查数据表明，白种人中 NMOU 的发生率很高，然而，这些估计排除了被监禁的样本，可能低估了涉及刑事司法的非裔美国人中的使用情况。尽管阿片类药物与同时发生的精神疾病和死亡率有关，但据我们所知，这是第一项研究，在监狱、监狱或社区中接受基于矫正的物质使用障碍（SUD）治疗的非裔美国男性样本中，研究 NMOU 和心理健康之间的关系。
我们进行了一项横断面研究，在 2010 年至 2014 年期间，对五批接受基于矫正的 SUD 治疗的非裔美国男性（N=4021）进行了研究，调查了他们在被监禁前一年 NMOU 的趋势和心理健康相关性。进行了一系列卡方检验、方差分析、相关分析和逻辑回归模型。
我们的样本中超过 20%的人报告在被监禁前一年有 NMOU。平均而言，参与者在被监禁前年龄为 36 岁，受教育 13 年，通常没有工作。我们发现，NMOU 与队列年份之间存在显著的正线性趋势。最终的逐步多元回归模型具有统计学意义，结果表明，年龄越大，NMOU 的可能性越低。受教育程度越高和经常出现心理健康症状与 NMOU 的可能性显著增加相关。
我们的研究结果是独特的，因为现有文献主要描述 NMOU 是一种“白人郊区”问题。讨论了文化适应性行为干预和药物辅助治疗。
