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焦虑敏感与慢性疼痛的阿片类药物使用者中阿片类药物滥用。

Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain.

机构信息

a Department of Psychology, University of Houston , Houston , TX , USA.

b Deparment of Psychiatry, McLean Hospital , Belmont , MA , USA.

出版信息

Am J Drug Alcohol Abuse. 2019;45(5):470-478. doi: 10.1080/00952990.2019.1569670. Epub 2019 Mar 21.

Abstract

: The opioid epidemic is a significant public health crisis, and this problem is particularly prevalent among individuals with chronic pain. Accordingly, there is an urgent need for interventions to mitigate the risk for opioid misuse and opioid use disorder among people with pain. Given that mental health problems, specifically anxiety, are common among people who misuse opioids, it is important to examine factors that link mental health problems with opioid misuse to ultimately inform the development of novel interventions. Anxiety sensitivity, a transdiagnostic vulnerability factor defined as the fear of anxiety-related physical sensations, may be one important mechanism in elevated opioid misuse among persons with chronic pain. : Therefore, the current cross-sectional study examined anxiety sensitivity (and construct sub-facets) as a predictor of opioid misuse among adults with chronic pain. : Adults reporting chronic pain and prescription opioid use completed an online survey. : Anxiety sensitivity was associated with multiple aspects of opioid misuse, including current opioid misuse, severity of opioid dependence, and number of opioids used to get high. The magnitude of effects ranged from medium to large. Associations between anxiety sensitivity and opioid misuse were observed over and above the variance accounted for by age, sex, income, education, perceived health, and pain severity. : These findings suggest that anxiety sensitivity may be an important treatment target among adults with chronic pain who misuse opioids. Future research should continue to explore the explanatory relevance of anxiety sensitivity in opioid misuse among individuals with chronic pain.

摘要

阿片类药物滥用是一个重大的公共卫生危机,而这个问题在慢性疼痛患者中尤为普遍。因此,迫切需要采取干预措施,降低疼痛患者发生阿片类药物滥用和阿片类药物使用障碍的风险。鉴于心理健康问题,特别是焦虑,在滥用阿片类药物的人群中很常见,因此,有必要研究将心理健康问题与阿片类药物滥用联系起来的因素,以便最终为新的干预措施提供信息。焦虑敏感性是一种跨诊断的脆弱性因素,定义为对与焦虑相关的身体感觉的恐惧,它可能是慢性疼痛患者中阿片类药物滥用升高的一个重要机制。

因此,目前的横断面研究考察了焦虑敏感性(及其结构子维度)作为慢性疼痛成年人阿片类药物滥用的预测因子。

报告慢性疼痛和处方阿片类药物使用的成年人完成了一项在线调查。

焦虑敏感性与阿片类药物滥用的多个方面相关,包括当前的阿片类药物滥用、阿片类药物依赖的严重程度以及用于获得快感的阿片类药物数量。效应的大小从中等到大不等。在考虑年龄、性别、收入、教育、感知健康和疼痛严重程度所解释的差异后,焦虑敏感性与阿片类药物滥用之间仍存在关联。

这些发现表明,焦虑敏感性可能是慢性疼痛滥用阿片类药物的成年人的一个重要治疗目标。未来的研究应继续探索焦虑敏感性在慢性疼痛个体阿片类药物滥用中的解释相关性。

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