Islam M Mofizul, Wollersheim Dennis
Department of Public Health, La Trobe University, Melbourne, Victoria 3086, Australia.
Health Information Management, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria 3086, Australia.
J Clin Med. 2019 Mar 1;8(3):293. doi: 10.3390/jcm8030293.
Excessive and non-medical use of prescription opioids is a public health crisis in many settings. This study examined the distribution of user types based on duration of use, trends in and associated factors of dispensing of prescription opioids in New South Wales and Victoria, Australia.
10% sample of unit-record data of four-year dispensing of prescription opioids was analysed. Quantities dispensed were computed in defined daily dose (DDD). Multilevel models examined factors associated with the duration of dispensing and the quantity dispensed in local government areas.
Overall, 53% were single-quarter, 37.3% medium-episodic (dispensed 2⁻6 quarters), 5% long-episodic (dispensed 7⁻11 quarters) and 5% were chronic users (dispensed 12⁻14 quarters). More than 80% of opioids in terms of DDD/1000 people/day were dispensed to long-episodic and chronic users. Codeine and oxycodone were most popular items-both in terms of number of users and quantity dispensed. Duration of dispensing was significantly higher for women than men. Dispensing quantity and duration increased with increasing age and residence in relatively poor neighborhoods.
Although only 5% were chronic users, almost 60% of opioids (in DDD/1000 people/day) were dispensed to them. Given that chronic use is linked to adverse health outcomes, and there is a progression toward chronic use, tailored interventions are required for each type of users.
在许多情况下，处方阿片类药物的过度和非医疗使用是一场公共卫生危机。本研究调查了澳大利亚新南威尔士州和维多利亚州基于使用时长的用户类型分布、处方阿片类药物的配药趋势及相关因素。
对四年期处方阿片类药物配药单位记录数据的10%样本进行分析。配药量以限定日剂量（DDD）计算。多水平模型研究了与地方政府区域内配药时长和配药量相关的因素。
总体而言，53%为单季度用户，37.3%为中度发作性用户（配药2至6个季度），5%为长期发作性用户（配药7至11个季度），5%为慢性用户（配药12至14个季度）。按DDD/1000人/天计算，超过80%的阿片类药物配给了长期发作性和慢性用户。可待因和羟考酮是最常用的药物——无论是在用户数量还是配药量方面。女性的配药时长显著高于男性。配药量和配药时长随着年龄增长以及居住在相对贫困社区而增加。
虽然只有5%是慢性用户，但几乎60%的阿片类药物（按DDD/1000人/天计算）配给了他们。鉴于慢性使用与不良健康后果相关，且存在向慢性使用发展的趋势，需要针对每种类型的用户采取量身定制的干预措施。
