Amanda M. Midboe (
Thomas Byrne is an investigator in the Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, in Bedford, Massachusetts.
Health Aff (Millwood). 2019 Aug;38(8):1289-1297. doi: 10.1377/hlthaff.2019.00281.
Veterans who are homeless or unstably housed are at increased risk for opioid-related morbidity and mortality. However, there is a limited understanding of the scope of the opioid epidemic and gaps in care for these populations. We conducted a retrospective observational study to examine opioid use disorder (OUD) in a national sample of veterans who accessed specialized homeless programs in the Veterans Health Administration. Additionally, in a subgroup of veterans with a history of OUD, we examined several opioid-related measures: opioid dose, concomitant opioid-benzodiazepine prescribing, and receipt of medication for addiction treatment (MAT) and overdose prevention medication (naloxone). Rates of OUD history varied significantly across age, gender, and program type. Among the subgroup of homeless veterans with an OUD history, prescribing practices and rates of MAT and naloxone receipt varied significantly by age and specialized homeless program. Rates of receipt of MAT and naloxone were moderate and low, respectively, indicating opportunities for program-specific interventions.
退伍军人无家可归或住房不稳定,患阿片类药物相关疾病和死亡的风险增加。然而,对于阿片类药物流行的范围以及这些人群的护理差距的了解有限。我们进行了一项回顾性观察性研究,以检查在退伍军人健康管理局中使用专门的无家可归者计划的退伍军人中阿片类药物使用障碍(OUD)的情况。此外,在有 OUD 病史的退伍军人亚组中,我们检查了几种与阿片类药物相关的措施:阿片类药物剂量、同时开具阿片类药物-苯二氮䓬类药物以及接受药物成瘾治疗(MAT)和过量预防药物(纳洛酮)的情况。OUD 病史的发生率在年龄、性别和计划类型方面存在显著差异。在有 OUD 病史的无家可归退伍军人亚组中,处方实践以及 MAT 和纳洛酮的使用率随年龄和专门的无家可归计划而有显著差异。MAT 和纳洛酮的使用率分别为中等和低,表明存在针对特定计划的干预机会。