5600 Fishers Lane, 15E85C, Rockville, MD.
Substance Abuse and Mental Health Services Administration, Rockville, Maryland, USA.
J Clin Psychiatry. 2018 Aug 14;79(5):17m11973. doi: 10.4088/JCP.17m11973.
To simultaneously examine characteristics associated with prescription opioid use, misuse, and use disorders among US adults and assess correlates of their motivations for prescription opioid misuse.
Data were examined from 51,200 adults 18 years or older who participated in the 2015 National Survey on Drug Use and Health. Prescription opioid use disorders were based on DSM-IV criteria. Bivariable and multivariable multinomial logistic regressions were applied.
Prescription opioid use disorders were associated with ages 18-29 and 30-49 years, male sex, good/fair/poor health, suicidal ideation, and tobacco use, alcohol or cocaine use disorders, heroin use or use disorders, and other psychotropic medication misuse or use disorders. Among US adult prescription opioid misusers, 63.4% reported that the main motivation for their most recent misuse was to relieve physical pain, followed by seeking to get high (11.6%) or to relax (10.9%). Sociodemographic characteristics, mental illness, and specific substance use and use disorders were associated with specific motivations for misusing prescription opioids. Among adults with prescription opioid use, reporting pain relief as a motivation for prescription opioid misuse was associated with suicidal ideation, cannabis and heroin use or use disorders, cocaine use disorders, and other psychotropic misuse or use disorders.
Our results suggest that clinicians should assess prescription opioid misuse and its motivations and screen for multiple co-occurring behavioral health conditions in patients who misuse prescription opioids.
同时考察与美国成年人处方类阿片药物使用、滥用和使用障碍相关的特征,并评估其处方类阿片药物滥用动机的相关因素。
本研究对 51200 名年龄在 18 岁及以上的参加 2015 年全国毒品使用与健康调查的成年人的数据进行了检查。根据 DSM-IV 标准诊断处方类阿片使用障碍。采用二变量和多变量多项逻辑回归分析。
处方类阿片使用障碍与 18-29 岁和 30-49 岁、男性、健康状况良好/一般/差、有自杀意念以及吸烟、饮酒或可卡因使用障碍、海洛因使用或使用障碍以及其他精神药物滥用或使用障碍有关。在美国成年处方类阿片滥用者中,63.4%报告他们最近一次滥用的主要动机是缓解身体疼痛,其次是寻求快感(11.6%)或放松(10.9%)。社会人口学特征、精神疾病以及特定的物质使用和使用障碍与滥用处方类阿片的特定动机有关。在有处方类阿片使用的成年人中,将缓解疼痛作为滥用处方类阿片的动机与自杀意念、大麻和海洛因使用或使用障碍、可卡因使用障碍以及其他精神药物滥用或使用障碍有关。
我们的研究结果表明,临床医生应该评估处方类阿片药物的滥用情况及其动机,并对滥用处方类阿片的患者进行多重共患行为健康状况的筛查。