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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.

DOI:10.1097/ADM.0000000000000512
PMID:31589181
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6785203/
Abstract

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.

摘要

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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本文引用的文献

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Smoking cessation in the context of recovery from drug and alcohol problems: Prevalence, predictors, and cohort effects in a national U.S. sample.在戒毒和戒酒康复背景下的戒烟:一项美国全国样本的流行率、预测因素和队列效应研究。
Drug Alcohol Depend. 2019 Feb 1;195:6-12. doi: 10.1016/j.drugalcdep.2018.11.017. Epub 2018 Dec 8.
2
Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy.美国人口中药物和酒精问题的康复发生率和途径:对实践、研究和政策的启示。
Drug Alcohol Depend. 2017 Dec 1;181:162-169. doi: 10.1016/j.drugalcdep.2017.09.028. Epub 2017 Oct 18.
3
Development and validation of a Brief Assessment of Recovery Capital (BARC-10) for alcohol and drug use disorder.用于酒精和药物使用障碍的康复资本简短评估量表(BARC - 10)的开发与验证
Drug Alcohol Depend. 2017 Aug 1;177:71-76. doi: 10.1016/j.drugalcdep.2017.03.022. Epub 2017 May 19.
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Anticipating the "Silver Tsunami": Prevalence Trajectories and Comorbidity Burden among Older Cancer Survivors in the United States.预测“银色海啸”:美国老年癌症幸存者的患病率轨迹与合并症负担
Cancer Epidemiol Biomarkers Prev. 2016 Jul;25(7):1029-36. doi: 10.1158/1055-9965.EPI-16-0133.
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A review of epidemiologic research on smoking behavior among persons with alcohol and illicit substance use disorders.对患有酒精和非法药物使用障碍者吸烟行为的流行病学研究综述。
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JAMA Psychiatry. 2015 Aug;72(8):757-66. doi: 10.1001/jamapsychiatry.2015.0584.
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The relationship between recovery and health-related quality of life.康复与健康相关生活质量之间的关系。
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Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.归因于精神和物质使用障碍的疾病全球负担:来自 2010 年全球疾病负担研究的结果。
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