Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 7201 Wisconsin Ave, Ste.533G6, Bethesda, Rockville, MD 20814, USA.
Transdisciplinary Center for Health Equity Research, Department of Health Education, College of Education and Human Development, Texas A&M University, 4243 TAMU, 311F Blocker Building, College Station, TX 77843, USA.
Int J Environ Res Public Health. 2020 Jun 17;17(12):4321. doi: 10.3390/ijerph17124321.
Opioid misuse can lead to use disorder and other adverse outcomes. Identifying sociodemographic risk profiles and understanding misuse patterns in combination with health indicators can inform prevention science and clinical practice. A latent class analysis of opioid misuse was conducted on noninstitutionalized United States civilians aged 18 and older that reported opioid dependence or abuse in the 2017 National Survey of Drug Use and Health ( = 476; weighted = 2,018,922). Opioid misuse was based on heroin and/or prescription pain reliever use, and associated determinants of health and mental health indicators. Five misuse profiles were identified: (1) single heroin or prescription misuse with high-income; (2) female prescription pain reliever misuse with psychological distress and suicidality; (3) younger polyopioid misuse with the highest proportion of Hispanics and heroin use; (4) older polyopioid misuse with the highest proportion of non-Hispanic blacks and disability; and (5) older non-Hispanic white male exclusive dual heroin and/or prescription misuse (27%, 20%, 38%, 10%, and 5% of sample, respectively). The identified risk profiles can inform public health practice to develop interventions for acute and immediate response by providing etiological evidence and to inform prevention and intervention efforts along the continuum from opioid initiation to use disorder.
阿片类药物滥用可导致用药障碍和其他不良后果。确定社会人口统计学风险特征，并结合健康指标了解滥用模式，可以为预防科学和临床实践提供信息。对在 2017 年全国药物使用和健康调查中报告阿片类药物依赖或滥用的 18 岁及以上非机构化美国平民（=476；加权=2,018,922）进行了阿片类药物滥用的潜在类别分析。阿片类药物滥用是基于海洛因和/或处方止痛药的使用，以及与健康和心理健康指标相关的决定因素。确定了五种滥用模式：（1）单一海洛因或处方滥用与高收入；（2）女性处方止痛药滥用与心理困扰和自杀意念；（3）年轻的多阿片类药物滥用与最高比例的西班牙裔和海洛因使用；（4）年龄较大的非西班牙裔黑人多阿片类药物滥用与最高比例的非西班牙裔黑人和残疾；（5）年龄较大的非西班牙裔白人男性专用双重海洛因和/或处方滥用（分别占样本的 27%、20%、38%、10%和 5%）。确定的风险特征可以为公共卫生实践提供信息，以便通过提供病因证据为急性和即时反应制定干预措施，并为从阿片类药物起始到用药障碍的连续体提供预防和干预努力提供信息。
