Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.
Yale Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, Connecticut.
Am J Addict. 2019 Feb;28(2):92-100. doi: 10.1111/ajad.12861. Epub 2019 Jan 21.
Amidst a surging national crisis of opioid use, concern has been expressed about its impact on veterans, but no study has presented a population-based comparison of opioid use disorder (OUD) among veterans and non-veterans. We analyzed national epidemiologic data to compare rates, correlates and impacts of the opioid crisis on male veterans and non-veterans.
Restricted data from 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were used to compare veteran and non-veteran men on rates of OUD, as well as correlates of OUD including socio-demographic characteristics, psychiatric and substance use co-morbidities, and reductions in health-related quality of life (HRQOL).
About 2.0% of veterans and 2.7% of non-veterans, estimated at 418,000 and 2.5 million men, respectively, met criteria for life-time OUD. In both groups, OUD was associated with younger age, lower income levels, and fewer years of education. OUD was associated minority race among veterans, but with non-Hispanic white race among non-veterans. Both veteran and non-veteran adults with OUD were at least five times more likely than their peers to have both psychiatric and substance use co-morbidities (p < .001) and they experienced strongly reduced HRQOL scores (Cohen's d = -.50 to -.93).
Veterans and non-veterans experience similar risk of OUD, similar correlates and adverse HRQOL impacts suggesting that similar treatment approaches may be effective for both groups.
Our findings highlight comparable vulnerability of veterans to non-veterans in both the risk of OUD and adverse effects on HRQOL. (Am J Addict 2018;XX:1-9).
在阿片类药物使用的全国性危机中，人们对其对退伍军人的影响表示关注，但尚无研究对退伍军人和非退伍军人的阿片类药物使用障碍（OUD）进行基于人群的比较。我们分析了全国性的流行病学数据，以比较男性退伍军人和非退伍军人中阿片类药物危机的发生率、相关因素和影响。
使用 2012 年至 2013 年国家酒精和相关条件流行病学调查-III（NESARC-III）的受限数据，比较退伍军人和非退伍军人男性 OUD 的发生率，以及 OUD 的相关因素，包括社会人口统计学特征、精神和物质使用合并症，以及健康相关生活质量（HRQOL）的降低。
大约 2.0%的退伍军人和 2.7%的非退伍军人，估计分别有 418,000 人和 250 万男性，符合终身 OUD 的标准。在这两个群体中，OUD 与年龄较小、收入水平较低和受教育年限较少有关。OUD 与退伍军人中的少数民族有关，但与非西班牙裔白人有关非退伍军人。退伍军人和非退伍军人成年人中患有 OUD 的人比同龄人患有精神和物质使用合并症的可能性至少高出五倍（p<0.001），并且他们的 HRQOL 评分明显降低（Cohen's d=-0.50 至-0.93）。
退伍军人和非退伍军人都面临着 OUD 的相似风险、相似的相关因素和对 HRQOL 的不利影响，这表明类似的治疗方法可能对这两个群体都有效。
我们的研究结果强调了退伍军人和非退伍军人在 OUD 的风险和对 HRQOL 的不利影响方面的相似脆弱性。
