National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia.
Drug Alcohol Depend. 2019 Jan 1;194:136-142. doi: 10.1016/j.drugalcdep.2018.10.010. Epub 2018 Nov 3.
Relatively little is known about factors that may lead to the development of a substance use disorder (SUD), across a range of drug classes. This study aimed to identify factors that predict the likelihood of transition from use to SUD and the speed with which this may occur at the population level, with a focus on the impact of pre-existing mental disorders.
Data were collected as part of the 2007 Australian National Survey of Mental Health and Wellbeing, a nationally representative survey of 8841 Australian adults. A series of discrete time survival analyses were undertaken on data pertaining to the age of onset of use and symptoms of use disorder, for alcohol, cannabis, sedatives, stimulants, and opioids, as well as the impact of pre-existing mood and anxiety disorders on the likelihood of developing a SUD.
Lifetime cumulative probability estimates indicated that 50.4% of stimulant, 46.6% of opioid, 39% of sedative, 37.5% of alcohol, and 34.1% of cannabis users would develop a SUD on those substances, within an estimated 14, 12, 8, 30, and 23 years after onset respectively. Pre-existing mental disorders were significantly associated with increased risk of developing a SUD for alcohol, cannabis and stimulant use disorder.
The relative speed associated with the transition from use to SUD emphasizes the narrow window of time available to intervene, underscoring the urgency of early identification of mental health conditions and the timely provision of appropriate evidence-based interventions, which could potentially prevent the development of secondary SUDs.
对于可能导致各种药物类别出现物质使用障碍（SUD）的因素，我们知之甚少。本研究旨在确定可预测从使用到 SUD 转变的可能性的因素，以及在人群层面上这种转变可能发生的速度，重点关注先前存在的精神障碍的影响。
数据是作为 2007 年澳大利亚国家心理健康和幸福感调查的一部分收集的，这是一项对 8841 名澳大利亚成年人进行的全国代表性调查。对与使用开始年龄和使用障碍症状相关的数据，进行了一系列离散时间生存分析，涉及酒精、大麻、镇静剂、兴奋剂和阿片类药物，以及先前存在的情绪和焦虑障碍对发生 SUD 的可能性的影响。
终身累积概率估计表明，在预计的 14、12、8、30 和 23 年内，分别有 50.4%的兴奋剂、46.6%的阿片类药物、39%的镇静剂、37.5%的酒精和 34.1%的大麻使用者会发展为这些物质的 SUD。先前存在的精神障碍与酒精、大麻和兴奋剂使用障碍发展为 SUD 的风险增加显著相关。
从使用到 SUD 的转变的相对速度强调了进行干预的时间窗口很窄，突显了早期识别心理健康状况和及时提供适当循证干预措施的紧迫性，这可能会预防继发性 SUD 的发展。
