Albright David L, McDaniel Justin, Laha-Walsh Kirsten, Morrison Beth, McIntosh Shanna
Hill Crest Foundation Endowed Chair, Mental Health Research, School of Social Work, University of Ala-bama, Tuscaloosa, Alabama.
Assistant Professor, Public Health, Southern Illinois University, Carbondale, Illinois.
J Opioid Manag. 2020 Jul/Aug;16(4):283-289. doi: 10.5055/jom.2020.0582.
Opioid use is a continuing problem for the United States. Individuals who use opioids have a high risk of misuse, especially with prescription opioids. Substances that are often used in combination with opioids include methamphetamines, sedatives, and benzodiazepines, as well as tobacco, alcohol, and marijuana, but not in a medical setting. We sought to determine (a) the relationship between various drugs (eg, methamphetamine, benzodiazepines) and opioid use, as well as (b) the relationship between polysubstance use and opioid use.
We created a screening instrument that requested the patients seeking medical care at Federally Qualified Health Centers (FQHC) and Veterans Affairs (VA) hospitals in West Alabama self-report their substance usage.
This study took place in outpatient primary care settings (FQHCs and VA hospitals) in west Alabama.
De-identified electronic health records for 346 adults were obtained from consenting medical facilities. Missing data were found in 33 of the records obtained. The final usable sample for this study was 311.
The screening tool was comprised of five sections: demographics, tobacco use, alcohol abuse, drug use, and mental health. The primary outcome measure of this study was the number of days of opioid use in the past 30 days.
Thirteen individuals (4.18 percent) reported opioid use in the last 30 days. While polysubstance or dual sub-stance use was not in the majority of the participant responses, the significant substances that were used in conjunction with opioids were methamphetamine, hallucinogens, and benzodiazepines.
Individuals who are polysubstance users have a higher likelihood of opioid use. Interventions that target opioid use would serve the population stronger by including screenings and potential treatments for polysubstance use additionally.
阿片类药物的使用在美国一直是个问题。使用阿片类药物的个体滥用风险很高，尤其是处方阿片类药物。常与阿片类药物联合使用的物质包括甲基苯丙胺、镇静剂和苯二氮䓬类药物，以及烟草、酒精和大麻，但并非在医疗环境中使用。我们试图确定（a）各种药物（如甲基苯丙胺、苯二氮䓬类药物）与阿片类药物使用之间的关系，以及（b）多物质使用与阿片类药物使用之间的关系。
我们创建了一种筛查工具，要求在阿拉巴马州西部的联邦合格健康中心（FQHC）和退伍军人事务（VA）医院寻求医疗服务的患者自我报告其物质使用情况。
本研究在阿拉巴马州西部的门诊初级保健机构（FQHC和VA医院）进行。
从同意参与的医疗机构获取了346名成年人的去识别化电子健康记录。在获取的记录中有33份存在缺失数据。本研究的最终可用样本为311份。
筛查工具包括五个部分：人口统计学、烟草使用、酒精滥用、药物使用和心理健康。本研究的主要结局指标是过去30天内使用阿片类药物的天数。
13名个体（4.18%）报告在过去30天内使用过阿片类药物。虽然大多数参与者的回答中不存在多物质或双重物质使用情况，但与阿片类药物联合使用的重要物质是甲基苯丙胺、致幻剂和苯二氮䓬类药物。
多物质使用者使用阿片类药物的可能性更高。针对阿片类药物使用的干预措施若能额外纳入对多物质使用的筛查和潜在治疗，将更有效地服务于这一人群。
