Department of Psychology, Texas State University, San Marcos, TX, USA.
St. Joseph Mercy Health System, Ann Arbor, MI, USA; Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Addict Behav. 2019 Sep;96:89-93. doi: 10.1016/j.addbeh.2019.04.022. Epub 2019 Apr 22.
US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to elevated overdose and mortality risk. This work aimed to fill that gap through analyses of prescription fentanyl misuse correlates.
Data were from the 2015-16 National Survey on Drug Use and Health (N = 114,043), a nationally representative survey of the non-institutionalized US population. Respondents were (all past-year): those misusing prescription fentanyl (PF); those misusing other (non-fentanyl) prescription opioids (NFPO); and population controls. Respondent groups were compared using multinomial regression on sociodemographics, physical health, mental health and substance use. The PF and NFPO misuse groups were compared on opioid misuse characteristics, using logistic regression.
An estimated 4.4% misused NFPO, and 0.1% misused PF (past-year). Past-year heroin use was more common in those who misused PF (44.3%) than those who misused other NFPO (4.4%; relative risk ratio [RRR] = 7.1, 95%CI = 3.7-13.9) or population controls (0.1%, RRR = 35.1, 95%CI = 17.3-71.1). Non-alcohol substance use disorder (SUD) was similarly elevated in those who misused PF (78.7%) versus the other NFPO group (27.5%, RRR = 3.8, 95%CI = 1.8-8.2) or population controls (1.6%, RRR = 20.6, 95%CI = 9.4-45.5).
Respondents who misused prescription fentanyl were both more drug-involved generally and opioid-involved specifically; and likely need a combination of significant interventions and monitoring for their polysubstance use.
美国阿片类药物过量死亡人数持续攀升，2016 年至 2017 年增长了 12.0%。芬太尼是一种合成阿片类药物，是阿片类药物相关过量死亡的主要原因。虽然芬太尼相关过量是由非法芬太尼驱动的，但对于滥用处方芬太尼的人知之甚少，而处方芬太尼也与过量和死亡风险的增加有关。这项工作旨在通过分析处方芬太尼滥用的相关因素来填补这一空白。
数据来自 2015-16 年全国毒品使用与健康调查（N=114043），这是一项针对非机构化美国人口的全国代表性调查。受访者为（所有过去一年）：滥用处方芬太尼者（PF）；滥用其他（非芬太尼）处方类阿片者（NFPO）；和人口对照组。采用多变量回归比较社会人口统计学、身体健康、心理健康和物质使用方面的差异。采用逻辑回归比较 PF 和 NFPO 滥用组的阿片类药物滥用特征。
估计有 4.4%的人滥用 NFPO，0.1%的人滥用 PF（过去一年）。过去一年，海洛因使用在滥用 PF 的人群中更为常见（44.3%），而非滥用其他 NFPO 的人群（4.4%；相对风险比[RRR]为 7.1，95%置信区间[CI]为 3.7-13.9）或人口对照组（0.1%，RRR 为 35.1，95%CI 为 17.3-71.1）。滥用 PF 的人群中非酒精物质使用障碍（SUD）也同样升高（78.7%），而非滥用其他 NFPO 的人群（27.5%，RRR 为 3.8，95%CI 为 1.8-8.2）或人口对照组（1.6%，RRR 为 20.6，95%CI 为 9.4-45.5）。
滥用处方芬太尼的受访者在一般药物使用和特定阿片类药物使用方面都更为严重；并且可能需要对他们的多药物使用进行综合的重大干预和监测。
