Department of Psychology, Texas State University, San Marcos, Texas, USA.
Department of Sociology, University of Central Florida, Orlando, Florida, USA.
Epidemiol Psychiatr Sci. 2020 Jan 29;29:e97. doi: 10.1017/S2045796020000037.
Prescription opioid misuse (POM) contributes to a larger opioid crisis in the US and Canada, with over 17 000 US POM-related overdose deaths in 2017. Our aims were to (1) identify specific profiles of respondents based on POM motives using the US National Survey on Drug Use and Health (NSDUH) and (2) compare profile respondents on sociodemographics, substance use and mental and physical health outcomes.
Analyses included 2017-18 NSDUH respondents with data on POM motives (n = 4810). POM was defined as prescription opioid use in a way not intended by the prescriber, including use without a prescription, in larger amounts or more frequently. Nine POM motives for the most recent episode were assessed, including 'to relieve physical pain' and 'to get high'. Latent classes, based on POM motives, were estimated. Classes were compared on sociodemographics, substance use and physical and mental health outcomes.
Eight latent classes were identified (in order of prevalence): pain relief only, relax-pain relief, sleep-pain relief, multi-motive, high, experimenter, emotional coping and dependent/hooked. Compared to the pain relief only group, the high and multi-motive classes had higher odds of all substance use outcomes, with the dependent/hooked class having higher odds on all but one outcome. Six of the eight classes had higher odds of past-year mental health treatment and suicidal ideation than the pain relief only class.
Screening for pain, pain conditions, problematic substance use and psychopathology are recommended in those with any POM. While those in the dependent/hooked, multi-motive and emotional coping classes are most likely to have prescription opioid use disorder (OUD), screening for OUD symptoms in all individuals with POM is also warranted.
处方阿片类药物滥用（POM）导致美国和加拿大阿片类药物危机加剧，2017 年美国与 POM 相关的过量用药死亡人数超过 17000 人。我们的目的是：(1) 使用美国全国药物使用与健康调查（NSDUH）基于 POM 动机识别受访者的具体特征；(2) 比较特征受访者的社会人口统计学、物质使用以及精神和身体健康结果。
分析包括具有 POM 动机数据的 2017-18 年 NSDUH 受访者（n=4810）。POM 定义为以非处方医生意图的方式使用处方阿片类药物，包括无处方使用、使用更大剂量或更频繁。评估了最近一次发作的 9 种 POM 动机，包括“缓解身体疼痛”和“获得快感”。基于 POM 动机估计潜在类别。比较类别在社会人口统计学、物质使用以及身体和精神健康结果方面的差异。
确定了 8 个潜在类别（按流行率顺序排列）：仅缓解疼痛、放松-缓解疼痛、睡眠-缓解疼痛、多动机、高、试验、情绪应对和依赖/上瘾。与仅缓解疼痛组相比，高和多动机组所有物质使用结果的几率更高，而依赖/上瘾组除了一个结果外，其他所有结果的几率都更高。八个类别中有六个类别的过去一年心理健康治疗和自杀意念的几率高于仅缓解疼痛组。
建议对有任何 POM 的患者进行疼痛、疼痛状况、有问题的物质使用和精神病理学筛查。虽然依赖/上瘾、多动机和情绪应对类别最有可能患有处方阿片类药物使用障碍（OUD），但对所有有 POM 的个体进行 OUD 症状筛查也是必要的。
