Research Division, Institute of Mental Health, 10 Buangkok View, Singapore 539747, Singapore.
National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore 539747, Singapore.
Int J Environ Res Public Health. 2018 Sep 11;15(9):1978. doi: 10.3390/ijerph15091978.
Prescription drugs (PD) undoubtedly help people with various physical or psychiatric ailments. Nevertheless, they are often diverted and misused (use without prescription or for purposes/in ways not intended by the prescriber). This study compared the sociodemographic and clinical correlates of those who misused PDs, used illegal drugs and co-ingested both, to identify those who were at a high risk of misusing these drugs. Retrospective analysis of the treatment outcome monitoring (TOM) data for the period of 2013⁻2017 identified 1369 subjects for the study; 295 patients presented with PD use disorder (PDUD alone), 811 with illegal drug use disorder (IDUD alone), and 263 had both PDUD and IDUD. The study sample included treatment seeking population (Singaporeans and permanent residents). TOM data included data collected through direct interviews (addiction severity, quality of life) and from the clinical case notes (diagnosis, co-morbidities, socio demographic information, etc.). The most commonly misused prescription and illegal drugs were benzodiazepines (63.1%) and heroin (63.4%), respectively. Those who co-ingested both PD and illegal drugs (PDUD+IDUD) had a significantly higher addiction severity score, lower quality of life and higher psychiatric co-morbidities than that of IDUD alone at baseline. When compared to Chinese patients, Malay and Indian patients had lower odds ( < 0.05) of PDUD alone and PDUD+IDUD than Chinese patients; divorcees had higher odds of PDUD+IDUD than those who were married. Those with primary and secondary qualifications had higher odds (2.1 and 2.9 times, respectively) of PDUD+IDUD than those with tertiary qualification and those in managerial or professional roles had higher odds of PDUD alone than those who were unemployed. Gender, ethnicity, marital status, education and occupational classes were associated with PDUD and IDUD. These characteristics can be helpful to identify those who are at the risk of PDUD and incorporate strict prescription monitoring to their care.
处方药（PD）无疑可以帮助患有各种身体或精神疾病的人。然而，它们经常被转移和滥用（未经处方使用或用于处方医生未指定的目的/方式）。本研究比较了滥用 PD、使用非法药物和两者兼用者的社会人口统计学和临床相关性，以确定那些有滥用这些药物高风险的人。对 2013-2017 年治疗结果监测（TOM）数据的回顾性分析确定了 1369 名研究对象；295 名患者表现出 PD 使用障碍（仅 PDUD），811 名患者表现出非法药物使用障碍（仅 IDUD），263 名患者同时表现出 PDUD 和 IDUD。研究样本包括寻求治疗的人群（新加坡人和永久居民）。TOM 数据包括通过直接访谈（成瘾严重程度、生活质量）和临床病例记录（诊断、合并症、社会人口统计学信息等）收集的数据。最常被滥用的处方和非法药物分别是苯二氮䓬类（63.1%）和海洛因（63.4%）。与仅 IDUD 相比，同时摄入 PD 和非法药物（PDUD+IDUD）的患者在基线时成瘾严重程度评分更高，生活质量更低，且合并的精神疾病更多。与中国患者相比，马来族和印度族患者出现单独 PDUD 和 PDUD+IDUD 的可能性较低（<0.05）；与已婚者相比，离婚者出现 PDUD+IDUD 的可能性更高。具有小学和中学学历的人出现 PDUD+IDUD 的可能性分别是具有高等教育学历的人的 2.1 倍和 2.9 倍，而从事管理或专业工作的人出现单独 PDUD 的可能性高于失业者。性别、种族、婚姻状况、教育程度和职业类别与 PDUD 和 IDUD 有关。这些特征有助于识别那些有 PDUD 风险的人，并在他们的治疗中纳入严格的处方监测。
