New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, United States of America; Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, 665 Broadway, 11th Floor, New York, NY 10012, United States of America; New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, United States of America.
New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, United States of America; Center for Drug Use and HIV/HCV Research, NYU College of Global Public Health, 665 Broadway, 11th Floor, New York, NY 10012, United States of America; New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, United States of America; VA New York Harbor Healthcare System, New York, NY 10010, United States of America.
Prev Med. 2019 Apr;121:94-98. doi: 10.1016/j.ypmed.2019.02.018. Epub 2019 Feb 11.
Adults ≥50 years of age have high rates of prescription opioid use. The purpose of this study is to estimate the prevalence and correlates of prescription opioid misuse among middle-aged and older adults in the United States who use prescription opioids. Data from adults age ≥ 50 from the two most recent cohorts (2015 and 2016) of the National Survey of Drug Use and Health were examined (N = 17,608). Characteristics of past-year prescription opioid misusers, including demographics, substance use, depression, chronic disease, and emergency department (ED) use, were compared to adults who used prescription opioids as prescribed in the past year and non-users. We used multivariable logistic regression to determine correlates of prescription opioid misuse among adults who used prescription opioids. Among the entire sample, 61.4% reported no past-year prescription opioid use, 36.0% reported past-year prescription opioid use without misuse, and 2.5% reported past-year prescription opioid misuse. Among past-year prescription opioid users, 6.6% reported misuse. Past-year misuse was higher among males, adults age 50-64, misusers of prescription sedatives, stimulants, and tranquilizers, users of other substances (i.e., tobacco, marijuana, cocaine), and those with alcohol use disorder. Past-year misuse was lower among adults with 2 or more chronic diseases. Past-year prescription misuse of sedatives (AOR 4.08 [95% CI 2.05-8.12]), stimulants (AOR 3.88 [95% CI 2.00-7.53]), and tranquilizers (AOR 10.02 [95% CI 6.48-15.50]) were all associated with past-year opioid misuse. Characteristics of opioid misusers determined in this study-particularly misuse of other substances-may help determine middle-aged and older adults at risk for prescription opioid misuse.
年龄在 50 岁及以上的成年人有很高的处方类阿片类药物使用率。本研究的目的是估计美国使用处方类阿片类药物的中年和老年成年人中处方类阿片类药物滥用的流行率和相关因素。从国家药物使用和健康调查中最近的两个队列（2015 年和 2016 年）中年龄在 50 岁及以上的成年人中获取数据（N=17608）。将过去一年的处方类阿片类药物滥用者的特征（包括人口统计学、物质使用、抑郁、慢性疾病和急诊室使用情况）与过去一年按规定使用处方类阿片类药物的成年人和非使用者进行比较。我们使用多变量逻辑回归来确定在过去一年中使用处方类阿片类药物的成年人中处方类阿片类药物滥用的相关因素。在整个样本中，61.4%的人报告过去一年没有使用处方类阿片类药物，36.0%的人报告过去一年使用处方类阿片类药物但没有滥用，2.5%的人报告过去一年有处方类阿片类药物滥用。在过去一年使用处方类阿片类药物的人群中，有 6.6%的人报告滥用。男性、50-64 岁的成年人、滥用处方镇静剂、兴奋剂和安定药的人、使用其他物质（即烟草、大麻、可卡因）的人以及有酒精使用障碍的人过去一年的滥用率更高。有两种或两种以上慢性疾病的成年人过去一年的滥用率较低。过去一年镇静剂（AOR 4.08[95%CI 2.05-8.12]）、兴奋剂（AOR 3.88[95%CI 2.00-7.53]）和安定剂（AOR 10.02[95%CI 6.48-15.50]）的处方类阿片类药物滥用均与过去一年的阿片类药物滥用有关。本研究中确定的阿片类药物滥用者的特征（特别是其他物质的滥用）可能有助于确定中年和老年成年人中处方类阿片类药物滥用的风险。
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