Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA.
Addict Behav. 2019 Oct;97:14-19. doi: 10.1016/j.addbeh.2019.05.017. Epub 2019 May 16.
Concurrent use of sedating substances (e.g. alcohol or benzodiazepines) with opioids is associated with increased negative consequences of opioid use; however, few studies have attempted to differentiate effects of using sedating substances on heroin-use outcomes. This study examines differences between heroin users who use alcohol or misuse sedatives regularly and those who do not.
Substance-use data were collected from 367 non-treatment seeking, chronic heroin-using, 18-to-55 year-old participants. We created 4 groups based on self-reported lifetime history of regular (at least weekly) substance use: heroin only (n = 95), heroin and sedatives (n = 21), heroin and alcohol (n = 151), and heroin, sedative, and alcohol (n = 100). Chi-square analyses and ANOVAs with Bonferroni post hoc tests were used to explore differences between these groups.
Heroin users who denied lifetime alcohol or nonmedical sedative use regularly endorsed fewer consequences associated with any substance they had used. Total adverse consequences of heroin use (e.g. health problems) were significantly higher among those who misused sedatives regularly, irrespective of alcohol use history (F(3,361) = 10.21; p < .001). Regular alcohol use did not independently impact heroin consequences but was associated with increased use of other substances.
Although polysubstance use is normative among heroin users, the risks depend on the substances used. Regular sedative use is associated with increased heroin consequences whereas regular alcohol use is not. This study refines the investigation of polysubstance use and highlights subgroup differences depending on types of substances used regularly. This knowledge is critical for understanding substance-use motivations and creating avenues for harm reduction.
阿片类药物与镇静物质（如酒精或苯二氮䓬类药物）同时使用会增加阿片类药物使用的负面后果；然而，很少有研究试图区分使用镇静物质对海洛因使用结果的影响。本研究考察了经常使用酒精或滥用镇静剂的海洛因使用者与不使用这些物质的海洛因使用者之间的差异。
从 367 名非治疗性、慢性、18 至 55 岁的海洛因使用者中收集了药物使用数据。我们根据自我报告的终生定期（至少每周）物质使用史创建了 4 个组：仅使用海洛因（n=95）、海洛因和镇静剂（n=21）、海洛因和酒精（n=151）以及海洛因、镇静剂和酒精（n=100）。卡方分析和方差分析与 Bonferroni 事后检验用于探索这些组之间的差异。
否认定期使用酒精或非医疗镇静剂的海洛因使用者报告的与他们使用的任何物质相关的后果较少。无论是否有饮酒史，经常滥用镇静剂的海洛因使用者的海洛因使用总不良后果（例如健康问题）显著更高（F(3,361)=10.21；p<0.001）。定期饮酒不会独立影响海洛因后果，但与其他物质的使用增加有关。
尽管海洛因使用者中多药使用很常见，但风险取决于使用的物质。经常使用镇静剂与增加的海洛因后果相关，而经常使用酒精则不然。本研究细化了对多药使用的调查，并根据经常使用的物质类型突出了亚组差异。这种知识对于理解物质使用动机和为减少伤害创造途径至关重要。
