National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
South East Sydney Local Health District Drug and Alcohol Services, Sydney, Australia.
Drug Alcohol Rev. 2018 Nov;37(7):887-896. doi: 10.1111/dar.12859. Epub 2018 Oct 2.
Despite large increases in pharmaceutical opioid dependence and related mortality, few studies have focused on the characteristics and treatment experiences of those with pharmaceutical opioid dependence. We describe the formation of a prospective cohort of people receiving treatment for pharmaceutical opioid dependence and describe their baseline characteristics.
People who had entered treatment for pharmaceutical opioid dependence (n = 108) were recruited through drug treatment services in New South Wales, Australia. We describe baseline characteristics of those that commenced pharmaceutical opioids for pain or other reasons and conducted a thematic analysis of responses regarding their treatment experience.
Mean age was 41 years (SD 11), half were male (48%). Just over half reported lifetime heroin use (57%). Oxycodone (49%) and codeine (29%) were the most common opioids reported. Most (85%) reported past-year problematic pain, 38% reported chronic pain. Half (52%) reported moderate to severe depression symptoms. Most (66%) commenced opioids for pain, and this group were older, less likely to report a previous overdose and less likely to report use of illicit drugs compared to those commencing for other reasons. Five themes related to treatment expectations: (i) stigma; (ii) the restrictive nature of treatment; (iii) knowledge; (iv) pain; and (v) positive experience with buprenorphine.
This study describes the complexities in an important emerging treatment population of pharmaceutical opioid-dependent people. Findings highlights that addressing knowledge and perceptions around treatment may be critical to address the rising mortality associated with pharmaceutical opioid dependence.
尽管医药类阿片依赖及其相关死亡率大幅上升，但鲜有研究关注医药类阿片依赖者的特征和治疗经验。我们描述了一个接受医药类阿片依赖治疗的前瞻性队列的形成过程，并描述了他们的基线特征。
通过澳大利亚新南威尔士州的药物治疗服务，招募了因医药类阿片依赖而接受治疗的 108 人。我们描述了因疼痛或其他原因开始使用医药类阿片的患者的基线特征，并对他们的治疗经验进行了主题分析。
平均年龄为 41 岁（标准差 11），一半为男性（48%）。略多于一半的人报告有终生海洛因使用史（57%）。报告最常见的阿片类药物为羟考酮（49%）和可待因（29%）。大多数（85%）报告过去一年存在问题性疼痛，38%报告慢性疼痛。一半（52%）报告有中度至重度抑郁症状。大多数（66%）因疼痛开始使用阿片类药物，与因其他原因开始使用阿片类药物的患者相比，这组患者年龄较大，不太可能报告以前有过过量用药，也不太可能报告使用非法药物。与治疗预期相关的五个主题：（i）耻辱感；（ii）治疗的局限性；（iii）知识；（iv）疼痛；（v）丁丙诺啡的积极体验。
本研究描述了一个重要的新兴治疗人群——医药类阿片依赖者的复杂性。研究结果强调，解决治疗相关的知识和观念问题可能是解决与医药类阿片依赖相关的死亡率上升的关键。
