Center for Outcomes Research, JPS Health Network, 1500 S. Main Street, Fort Worth, Texas 76104 USA.
Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, Florida, 32610 USA.
Drug Alcohol Depend. 2019 Nov 1;204:107568. doi: 10.1016/j.drugalcdep.2019.107568. Epub 2019 Sep 20.
Morbidity and mortality attributed to prescription opioids are a crisis in the US and spreading globally. Sex differences related to these conditions have not been adequately assessed.
Through our community engagement program, data on demographics, health status, and substance use, including prescription opioids (e.g., Vicodin®, Oxycodone), were collected from community members in Florida (primarily North Central Florida) during a health needs assessment. Participants over 18 years of age were classified by opioid use: past 30-day, lifetime but not past 30-day, or no lifetime prescription opioid use. Descriptive statistics and chi-square tests were calculated, and multinomial logistic regression was used to calculate adjusted odds ratios (aOR; CI). Analyses were conducted for men and women separately to examine sex specific effects.
Among 9221 community members assessed, the mean age was 45 years, 60% were female, and 58% were black. Respondents who endorsed past 30-day use and lifetime use were more likely to be female. Prescription sedative use was the strongest risk factor for past 30-day (aOR = 3.96; 95% CI, 3.35-4.68) and lifetime (aOR = 2.67; 95% CI, 2.34-3.04) prescription opioid use, regardless of sex. Other factors including marijuana use and history of cancer were significantly associated with prescription opioid use; they varied by sex.
The risk factors identified in this community sample provide additional information not accounted for by national studies. Future examinations of the consequences of concomitant opioid and sedative use, especially among women, are needed.
在美国和全球范围内,与处方类阿片相关的发病率和死亡率是一个危机。与这些情况相关的性别差异尚未得到充分评估。
通过我们的社区参与计划,从佛罗里达州(主要是中北部佛罗里达州)的社区成员那里收集了人口统计学、健康状况和物质使用(包括处方类阿片,如 Vicodin®、Oxycodone)的数据,包括在健康需求评估期间。将年龄在 18 岁以上的参与者按阿片类药物使用情况进行分类:过去 30 天、过去 30 天内使用过但过去 30 天内未使用过、过去 30 天内未使用过处方类阿片。计算了描述性统计数据和卡方检验,并使用多变量逻辑回归计算了调整后的优势比(aOR;CI)。分别对男性和女性进行分析,以检查性别特异性影响。
在评估的 9221 名社区成员中,平均年龄为 45 岁,60%为女性,58%为黑人。过去 30 天内使用和过去 30 天内使用的受访者更有可能是女性。过去 30 天(aOR=3.96;95%CI,3.35-4.68)和过去 30 天(aOR=2.67;95%CI,2.34-3.04)使用处方类阿片的最强危险因素是处方镇静剂使用,无论性别如何。其他因素,包括大麻使用和癌症史,与处方类阿片使用显著相关;它们因性别而异。
在这个社区样本中确定的风险因素提供了国家研究未考虑的额外信息。需要进一步研究同时使用阿片类药物和镇静剂的后果,尤其是在女性中。