University of Michigan, Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, Ann Arbor, MI, USA; University of Michigan, Institute for Research on Women and Gender, Ann Arbor, MI, USA.
Massachusetts General Hospital, Pediatric and Adult Psychopharmacology Units, Boston, MA, USA; Harvard University, School of Medicine, Department of Psychiatry, Boston, MA, USA.
Addict Behav. 2019 Mar;90:285-293. doi: 10.1016/j.addbeh.2018.11.010. Epub 2018 Nov 14.
To examine the age-specific risk of past-year substance use disorders (SUDs) associated with use and misuse of prescription opioids, stimulants, sedatives and tranquilizers.
The authors analyzed nationally representative data from 114,043 U.S. individuals aged 12 and older in the 2015-2016 National Survey on Drug Use and Health. For each controlled medication class, logistic regression was used to model any past-year SUD as a function of use pattern: no use or misuse, use without misuse, prescription drug misuse (PDM). Among individuals reporting PDM, logistic regression was used to model any past-year SUD as a function of PDM subtype (misuse of someone else's medication only, misuse of one's own medication only, and misuse of one's own and someone else's medication). Analyses were stratified by age group.
Controlled medication use was associated with higher odds of any past-year SUD compared to no use in many age groups and medication classes. Compared to non-use, PDM was associated with higher odds of any past-year SUD across virtually all age groups and medication classes. Compared to misuse of one's own medication only, misuse of both someone else's and one's own medication was associated with higher odds of any past-year SUD for many age groups and medication classes among individuals reporting PDM.
Clinicians should screen all controlled medication users for PDM and SUDs. Age-specific screening may be required due to heterogeneity in the prevalence and risks of use and misuse of different medications. Determination of PDM subtype can guide interventions to prevent SUDs.
研究与处方类阿片、兴奋剂、镇静剂和安定剂使用和滥用相关的过去一年物质使用障碍（SUD）的年龄特异性风险。
作者分析了来自美国 12 岁及以上的 114043 名个体在 2015-2016 年全国药物使用和健康调查中的全国代表性数据。对于每一种受管制药物类别，使用逻辑回归将任何过去一年的 SUD 作为使用模式的函数进行建模：无使用或滥用、无滥用的使用、处方药物滥用（PDM）。在报告 PDM 的个体中，使用逻辑回归将任何过去一年的 SUD 作为 PDM 亚型的函数进行建模（仅滥用他人的药物、仅滥用自己的药物以及同时滥用自己和他人的药物）。分析按年龄组分层。
与许多年龄组和药物类别中的无使用相比，受控药物的使用与更高的任何过去一年 SUD 的几率相关。与非使用相比，PDM 与几乎所有年龄组和药物类别中更高的任何过去一年 SUD 的几率相关。与仅滥用自己的药物相比，在报告 PDM 的个体中，对于许多年龄组和药物类别，同时滥用他人和自己的药物与更高的任何过去一年 SUD 的几率相关。
临床医生应筛查所有受控药物使用者的 PDM 和 SUD。由于不同药物的使用和滥用的普遍性和风险存在差异，可能需要进行特定年龄的筛查。确定 PDM 亚型可以指导预防 SUD 的干预措施。
