University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin.
Survey of the Health of Wisconsin, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
WMJ. 2020 Jun;119(2):102-109.
The opioid epidemic is a national crisis. The objectives of this report were to describe prescription opioid use in Wisconsin from 2008 through 2016 using unique populationrepresentative data and to assess which demographic, health, and behavioral health characteristics were related to past 30-day prescribed opioid use.
Data were obtained from the Survey of the Health of Wisconsin (SHOW), a statewide representative sample of 4,487 adults. Prescription medication use was ascertained via in-person interviews that included an inventory of all prescription medications used by the respondent in the past 30 days. The data were weighted to represent the adult population of Wisconsin, aged 21 to 74. Chi-square, logistic regression, and descriptive statistics were used to analyze data.
From 2008 to 2016, 6.4% (95% CI, 5.5-7.3) of adults age 21 years or older reported using a prescribed opioid in the past 30 days. Hydrocodone was the most prescribed opioid class followed by oxycodone. People 50 years of age and older, self-identified black or Hispanic, urban dwellers, those with a high school education or less, and those having incomes below 200% of the federal poverty level (FPL) reported significantly higher rates of prescribed opioid use relative to others. Participants reporting physician-diagnosed drug or alcohol abuse, current smokers, and those currently suffering from depression also reported significantly higher use.
These data from 2008-2016 demonstrate concerning levels of prescription opioid use and provide data on which population groups may be most vulnerable. While policies and clinical practice have changed since 2016, ongoing evaluation of prescribing practices, including consideration of behavioral health issues when prescribing opioids, is called for.
阿片类药物滥用危机是美国的全国性危机。本报告的目的是利用独特的人群代表性数据描述 2008 年至 2016 年威斯康星州的处方阿片类药物使用情况,并评估哪些人口统计学、健康和行为健康特征与过去 30 天内开具的阿片类药物处方有关。
数据来自威斯康星州健康调查(SHOW),这是一项全州代表性样本,包括 4487 名成年人。通过面对面访谈确定处方药物的使用情况,访谈中包括受访者在过去 30 天内使用的所有处方药物清单。数据经过加权处理,以代表年龄在 21 至 74 岁的威斯康星州成年人人口。采用卡方检验、逻辑回归和描述性统计分析数据。
2008 年至 2016 年,6.4%(95%CI,5.5-7.3)的 21 岁及以上成年人报告在过去 30 天内使用过处方阿片类药物。氢可酮是最常被开具的阿片类药物,其次是羟考酮。50 岁及以上、自我认定为黑种人或西班牙裔、居住在城市、受教育程度为高中及以下、收入低于联邦贫困线(FPL)200%的人群,报告的处方阿片类药物使用比例显著高于其他人群。报告有医生诊断的药物或酒精滥用、当前吸烟者以及目前患有抑郁症的参与者,报告的使用比例也显著更高。
这些来自 2008 年至 2016 年的数据表明,处方阿片类药物的使用水平令人担忧,并提供了有关哪些人群可能最易受到影响的数据。尽管自 2016 年以来政策和临床实践发生了变化,但仍需要不断评估处方实践,包括在开具阿片类药物时考虑行为健康问题。