美国酒精和其他药物滥用问题康复者的疾病医疗负担：来自全国康复调查的结果。
Medical Burden of Disease Among Individuals in Recovery From Alcohol and Other Drug Problems in the United States: Findings From the National Recovery Survey.
机构信息
Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School (DE, JFK); Department of Psychiatry, Columbia University Medical Center & New York State Psychiatric Institute (MCG); Chestnut Health Systems (WLW).
出版信息
J Addict Med. 2019 Sep/Oct;13(5):385-395. doi: 10.1097/ADM.0000000000000512.
OBJECTIVES
The medical sequalae of alcohol and other drug (AOD) problems exact a prodigious personal and societal cost, but little is known about the specific prevalence of such medical problems, and their relationship to quality of life and indices of well-being among those recovering from problematic AOD use. To better characterize the lifetime physical disease burden, this study investigated the prevalence of medical conditions commonly caused or exacerbated by excessive and chronic AOD exposure in a nationally representative sample of US adults in AOD problem recovery. Comparisons were made to the general US population. Demographic and clinical correlates of disease prevalence were also investigated along with the relationship between distinct medical conditions and indices of quality of life/well-being.
METHODS
Cross-sectional nationally representative survey of the US adult population who report resolving an AOD problem (n = 2002). Weighted lifetime prevalence of common medical conditions were estimated and compared to the US population. Demographic and clinical correlates of medical conditions, and also overall disease burden, were estimated using logistic regression.
RESULTS
Relative to the general population, prevalence of hepatitis C, chronic obstructive pulmonary disease, heart disease, and diabetes were elevated. Likelihood of having a lifetime diagnosis of a specific disease was related to primary substance used and sex. Quality of life was lower among those with physical disease histories relative to those without.
CONCLUSIONS
Findings highlight the increased medical burden associated with AOD problems, and speak to the need for earlier and more sustained intervention for AOD problems, greater integration of addiction treatment and primary health care, and longitudinal research to explore the complex, dynamic relationships between AOD use and physical disease.
目的
酒精和其他药物（AOD）问题的医学后遗症给个人和社会带来了巨大的代价，但人们对这些医学问题的具体流行程度及其与从 AOD 使用问题中恢复过来的人的生活质量和幸福感指数的关系知之甚少。为了更好地描述终生的身体疾病负担，本研究调查了在 AOD 问题康复的美国成年人的全国代表性样本中，常见的由过度和慢性 AOD 暴露引起或加重的疾病的患病率。并与一般美国人群进行了比较。还调查了疾病流行的人口统计学和临床相关性，以及不同的医疗条件与生活质量/幸福感指数之间的关系。
方法
对报告解决 AOD 问题的美国成年人（n=2002）进行了全国代表性的横断面调查。估计了常见医疗状况的终生患病率，并与美国人口进行了比较。使用逻辑回归估计了医疗状况的人口统计学和临床相关性，以及整体疾病负担。
结果
与一般人群相比，丙型肝炎、慢性阻塞性肺疾病、心脏病和糖尿病的患病率较高。特定疾病的终生诊断可能性与主要使用的物质和性别有关。与没有身体疾病史的人相比，那些有身体疾病史的人的生活质量较低。
结论
研究结果突出了与 AOD 问题相关的更高的医疗负担，并说明了需要更早和更持续的 AOD 问题干预，更加强化成瘾治疗和初级卫生保健的整合，以及进行纵向研究以探索 AOD 使用与身体疾病之间的复杂、动态关系。
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