Department of Epidemiology and Public Health, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201 United States.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201 United States; Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201 United States.
Drug Alcohol Depend. 2019 Nov 1;204:107518. doi: 10.1016/j.drugalcdep.2019.06.020. Epub 2019 Aug 30.
Prescription drug misuse in older adults is a growing public health problem. It is important to understand factors which predispose older adults to misuse prescription drugs, and social isolation may play an important role. In this study, we examined the association between social isolation proxy variables (living alone, being unmarried, and not attending religious services) and prescription opioid/benzodiazepine misuse in older adults.
With pooled cross-sectional data from the National Survey on Drug Use and Health (2015-2017), we used multinomial multiple logistic regression models to analyze the association between each social isolation proxy variable and past-year prescription opioid/benzodiazepine misuse. We controlled for potentially confounding variables including sociodemographic, physical/mental health, and substance use variables.
Being unmarried was associated with approximately three times increased odds of combined opioid and benzodiazepine misuse (OR 2.98, 95% CI 1.75, 5.08), a finding that persisted after adjusting for multiple potential confounders. Further analysis showed this finding persisted for divorced/separated and never married individuals, but not widowed. Not attending religious services was also associated with prescription opioid/benzodiazepine misuse, but only in unadjusted analyses. There was no association between living alone and opioid/benzodiazepine misuse.
Increased odds of combined opioid and benzodiazepine prescription drug misuse was observed among unmarried older adults. Given the susceptibility of older adults to the harms of these medications, further exploration of the role of marital relationships and other forms of social connectedness in prescription drug misuse in this vulnerable population is indicated.
老年人中处方药物滥用是一个日益严重的公共卫生问题。了解使老年人易患处方药物滥用的因素非常重要，而社会隔离可能起着重要作用。在这项研究中，我们研究了社会隔离替代变量（独居、未婚和不参加宗教服务）与老年人处方类阿片/苯二氮䓬类药物滥用之间的关联。
我们使用来自全国药物使用和健康调查（2015-2017 年）的汇总横断面数据，使用多项逻辑回归模型分析了每个社会隔离替代变量与过去一年处方类阿片/苯二氮䓬类药物滥用之间的关联。我们控制了潜在的混杂变量，包括社会人口统计学、身体/心理健康和物质使用变量。
未婚与联合使用阿片类药物和苯二氮䓬类药物的滥用风险增加约三倍相关（OR 2.98，95% CI 1.75，5.08），这一发现即使在调整了多个潜在混杂因素后仍然存在。进一步分析表明，这一发现对于离婚/分居和从未结婚的个体仍然存在，但对于丧偶的个体则不存在。不参加宗教服务也与处方类阿片/苯二氮䓬类药物滥用有关，但仅在未调整分析中。独居与阿片类/苯二氮䓬类药物滥用之间没有关联。
未婚的老年人大幅增加了联合使用阿片类药物和苯二氮䓬类药物处方药物滥用的风险。鉴于老年人对这些药物的危害敏感，进一步探索婚姻关系和其他形式的社会联系在这个脆弱人群中对处方药物滥用的作用是必要的。
