Department of Psychology, Old Dominion University, United States; Virginia Consortium Program in Clinical Psychology, United States.
Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, United States.
Addict Behav. 2019 May;92:168-172. doi: 10.1016/j.addbeh.2018.12.007. Epub 2018 Dec 10.
Military veterans wounded in combat are a high-risk group for emotional and physical distress, which may be exacerbated by misuse of prescription opioids and sedatives. The goal of the current study was to examine the prevalence and correlates of prescription opioid and sedative misuse among veterans wounded in combat.
We recruited veterans from the Combat Wounded Coalition (n = 212; 84% non-Hispanic White; 97.6% male) to complete an online survey of mental health and substance use disorder symptoms, assessed via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptoms Measure, the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, the Pain Enjoyment General Activity Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Prescription opioid and sedative misuse was assessed by frequency of use in the past year that was not currently prescribed or using more than prescribed.
Participants reported high rates of past year prescription opioid misuse (46.2%) and sedative misuse (21.7%). Misuse of both opioids and sedatives was associated with the most distress, including greater depression, anger, sleep disturbance, AUDIT scores, PTSD symptoms, suicidality, and pain interference. In multivariable multinomial logistic regression analyses, greater sleep disturbance (OR = 1.73) was associated with greater odds of sedative misuse versus no misuse. Higher AUDIT scores were associated with greater risk of sedative misuse (OR = 1.16) versus opioid misuse only.
Military veterans wounded in combat have high rates of prescription opioid misuse and sedative misuse. Sleep problems and AUDIT scores might help identify veterans who are at most risk for opioid and sedative misuse.
在战斗中受伤的退伍军人是情绪和身体困扰的高风险群体，滥用处方类阿片和镇静剂可能会使情况恶化。本研究的目的是调查战斗中受伤的退伍军人中处方类阿片和镇静剂滥用的流行率和相关因素。
我们从战斗伤员联盟招募了退伍军人（n=212；46.2%为非西班牙裔白人；97.6%为男性），让他们完成了一项关于心理健康和物质使用障碍症状的在线调查，该调查通过 DSM-5 自我评定 1 级交叉症状量表、DSM-5 创伤后应激障碍检查表、疼痛享受一般活动量表和酒精使用障碍识别测试（AUDIT）进行评估。通过过去一年未开处方或使用量超过处方的频率来评估处方类阿片和镇静剂的滥用情况。
参与者报告了过去一年滥用处方类阿片（46.2%）和镇静剂（21.7%）的高比率。滥用阿片类药物和镇静剂均与更多的痛苦相关，包括更严重的抑郁、愤怒、睡眠障碍、AUDIT 评分、创伤后应激障碍症状、自杀意念和疼痛干扰。在多变量多项逻辑回归分析中，更大的睡眠障碍（OR=1.73）与镇静剂滥用的可能性更大，而非无滥用相比。更高的 AUDIT 评分与镇静剂滥用（OR=1.16）而不是阿片类药物滥用的风险更高相关。
在战斗中受伤的退伍军人滥用处方类阿片和镇静剂的比率很高。睡眠问题和 AUDIT 评分可能有助于识别最有可能滥用阿片类药物和镇静剂的退伍军人。
