Steve Hicks School of Social Work, University of Texas at Austin , Austin , Texas , USA.
Department of Emergency Medicine, Warren Alpert Medical School, Brown University , Providence , Rhode Island , USA.
Subst Abus. 2019;40(2):247-255. doi: 10.1080/08897077.2019.1573208. Epub 2019 Feb 27.
Opioid use disorder (OUD) and overdose deaths among the US population continue to increase. This study examined associations of OUD and other substance use disorders with substance abuse treatment use and perceived treatment need among US adults aged 18+ who misused opioids. The 2015-2016 National Survey on Drug Use and Health provided data ( = 5100 respondents who misused opioids in the past year). We used multivariable logistic regression models to examine associations of opioid and other substance use disorders with treatment use and perceived treatment need, adjusting for sociodemographic and health statuses. The data showed that 4.7% of adults misused opioids and 19.1% of those who misused had an OUD. Of those with an OUD, only 31.5% had received substance abuse treatment in the past year and 13.6% perceived the need for such treatment. Of those with an OUD, heroin use disorder (adjusted odds ratio [AOR] = 2.59, 95% confidence interval [CI] = 1.59-4.23) and having been arrested/booked (AOR = 1.98, 95% CI = 1.18-3.33) were associated with higher odds of receiving treatment, whereas lack of health insurance (AOR = 0.49, 95% CI = 0.25-0.94) was associated with lower odds. Heroin use disorder (AOR = 2.16, 95% CI = 1.23-3.83) and higher mental health impairment scores (AOR = 1.05, 95% CI = 1.01-1.09) were associated with higher odds of perceived treatment need. The overall low socioeconomic status and high rates of polysubstance use disorders among those with OUD indicate that they need financial and other help to access treatment and relapse prevention services. The very low rates of perceived treatment need also point to the need for strategies to increase individuals' recognition of their need for treatment.
在美国人群中,阿片类药物使用障碍(OUD)和过量死亡人数继续增加。本研究调查了 OUD 和其他物质使用障碍与滥用阿片类药物的 18 岁及以上美国成年人的物质滥用治疗使用和感知治疗需求之间的关联。2015-2016 年全国药物使用和健康调查提供了数据(=5100 名过去一年滥用阿片类药物的受访者)。我们使用多变量逻辑回归模型来研究阿片类药物和其他物质使用障碍与治疗使用和感知治疗需求之间的关联,同时调整了社会人口统计学和健康状况。数据显示,4.7%的成年人滥用阿片类药物,其中 19.1%的人患有 OUD。在患有 OUD 的人中,只有 31.5%的人在过去一年中接受过物质滥用治疗,13.6%的人认为需要接受这种治疗。在患有 OUD 的人中,海洛因使用障碍(调整后的优势比 [AOR] = 2.59,95%置信区间 [CI] = 1.59-4.23)和被捕/入狱(AOR = 1.98,95% CI = 1.18-3.33)与更高的治疗接受几率相关,而缺乏医疗保险(AOR = 0.49,95% CI = 0.25-0.94)与较低的治疗几率相关。海洛因使用障碍(AOR = 2.16,95% CI = 1.23-3.83)和更高的心理健康受损评分(AOR = 1.05,95% CI = 1.01-1.09)与更高的感知治疗需求几率相关。OUD 患者的整体社会经济地位较低和多种物质使用障碍的高发生率表明,他们需要经济和其他帮助来获得治疗和预防复发的服务。感知治疗需求的极低比率也表明需要制定战略来提高个人对治疗需求的认识。