University of Maryland School of Medicine, Baltimore, MD, USA.
University of Maryland, College Park, MD, USA.
J Ethn Subst Abuse. 2023 Jan-Mar;22(1):89-105. doi: 10.1080/15332640.2021.1879702. Epub 2021 Feb 7.
Rates of opioid use disorder (OUD) have increased dramatically over the past two decades, a rise that has been accompanied by changing demographics of those affected. Early exposure to drugs is a known risk factor for later development of opioid use disorder; but how and whether this risk factor may differ between racial groups is unknown. Our study seeks to identify race differences in self-report of current and past substance use in OUD-diagnosed treatment-seeking individuals. Patients (n = 157) presenting for methadone maintenance treatment at a racially diverse urban opioid treatment program were approached and consented for study involvement. Participants were administered substance use history questionnaires and urine drug screening at intake. Chi-square, t-tests, and rank-sum were used to assess race differences in demographic variables. Logistic and linear regressions assessed the relationship between race and substance use for binary and continuous variables, respectively. 61% of the population identified as Black and 39% as White. Black participants were significantly older; age was thus included as a covariate. Logistic regressions demonstrated that despite similar urine toxicology at intake, White participants were significantly more likely to report having used prescription opioids and psychedelic, stimulant, and sedative substance classes prior to their first use of non-pharmaceutical opioids. Compared to Black participants, White treatment-seeking OUD-diagnosed individuals reported using a wider range of substances ever and prior to first use of non-pharmaceutical opioids. There were no differences, however, in presentation for OUD treatment, suggesting different pathways to OUD, which may carry important clinical implications.
在过去的二十年中，阿片类药物使用障碍（OUD）的发病率急剧上升，这与受影响人群的人口统计学变化相伴而来。早期接触毒品是日后发生阿片类药物使用障碍的已知危险因素；但是，这种危险因素在不同种族群体之间的差异以及是否存在差异尚不清楚。我们的研究旨在确定 OUD 确诊患者中种族差异与当前和过去物质使用的自我报告之间的关系。
在一个种族多样化的城市阿片类药物治疗计划中，向正在接受美沙酮维持治疗的患者提出并同意参与研究。参与者在接受治疗时接受了物质使用史问卷和尿液药物筛查。使用卡方检验、t 检验和秩和检验来评估种族差异在人口统计学变量中的差异。逻辑回归和线性回归分别评估了种族与二分类和连续变量之间的关系。人群中有 61%的人认为是黑人，39%的人认为是白人。黑人参与者明显年龄较大；因此，年龄被纳入协变量。
逻辑回归表明，尽管在接受治疗时尿液毒物检测相似，但白人参与者在首次使用非药物性阿片类药物之前，更有可能报告曾使用过处方类阿片药物和迷幻药、兴奋剂和镇静剂类药物。与黑人参与者相比，白人治疗性 OUD 确诊个体报告曾使用过更广泛的物质，并且在首次使用非药物性阿片类药物之前也使用过这些物质。然而，在 OUD 治疗的表现方面没有差异，这表明存在不同的 OUD 途径，这可能具有重要的临床意义。
