Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington (Rhee); Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut (Rhee, Rosenheck); Mental Illness, Research, Education and Clinical Center of New England, U.S. Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut (Rosenheck).
Psychiatr Serv. 2019 Nov 1;70(11):992-999. doi: 10.1176/appi.ps.201900163. Epub 2019 Jul 30.
The study examined rates, patterns, and correlates of drug treatment services use among adults with opioid use disorder compared with adults with other drug use disorders.
Data were from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which surveyed a nationally representative sample of noninstitutionalized U.S. civilian adults. The proportions reporting drug treatment services use were compared between those with opioid use disorder and those with other drug use disorders. Multivariable-adjusted regression analyses identified factors associated with service use.
Adults with opioid use disorder (N=330, unweighted) reported a very low rate of any drug-related health services use (17.3%), although the rate was higher than among adults with other drug use disorders (7.4%) (p<0.001). Crisis-related services were the most common type of service used among adults with opioid use disorder (6.2%)-significantly higher than the rate among those with other drug use disorders (0.6%) (p<0.001). Few (3.3%) adults with opioid use disorder used outpatient drug treatment services. Among all adults with drug use disorders, opioid use disorder was associated with greater odds of using drug treatment services (adjusted odds ratio=2.43; 95% confidence interval=1.38-4.28). Living in the West and reporting moderate to extreme pain were associated with a lower likelihood of service use among all adults with drug use disorders (p<0.05 for each).
Most adults with opioid use disorder remain untreated, much less received outpatient treatment to address their addiction. Interventions are needed to improve access to and motivation for care among these vulnerable adults.
本研究考察了与其他药物使用障碍相比，阿片类药物使用障碍患者接受药物治疗服务的比例、模式和相关因素。
数据来自于 2012-2013 年全国酒精相关情况及健康调查 III 期，该调查对美国非住院的成年公民进行了全国代表性抽样。比较了患有阿片类药物使用障碍和其他药物使用障碍的患者报告的药物治疗服务使用比例。多变量调整回归分析确定了与服务使用相关的因素。
患有阿片类药物使用障碍的成年人（未加权 n=330）报告了极低比例的任何与药物相关的健康服务使用（17.3%），尽管这一比例高于其他药物使用障碍患者（7.4%）（p<0.001）。危机相关服务是阿片类药物使用障碍患者最常使用的服务类型（6.2%）-显著高于其他药物使用障碍患者（0.6%）（p<0.001）。很少（3.3%）的阿片类药物使用障碍患者使用门诊药物治疗服务。在所有药物使用障碍患者中，阿片类药物使用障碍与使用药物治疗服务的几率更大相关（调整后的优势比=2.43；95%置信区间=1.38-4.28）。在所有患有药物使用障碍的成年人中，居住在西部和报告中度到极度疼痛与服务使用的可能性降低相关（p<0.05）。
大多数阿片类药物使用障碍患者未得到治疗，更不用说接受门诊治疗来解决他们的成瘾问题了。需要采取干预措施，以改善这些脆弱成年人获得和接受治疗的机会。
