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自我报告的阿片类药物使用障碍成年人的治疗需求和护理障碍:2015 至 2019 年美国药物使用和健康调查。

Self-Reported Treatment Need and Barriers to Care for Adults With Opioid Use Disorder: The US National Survey on Drug Use and Health, 2015 to 2019.

机构信息

Jannat Saini and Breah Johnson are with the University of Maryland School of Pharmacy, Baltimore. Danya M. Qato is with the University of Maryland School of Pharmacy and School of Medicine, Baltimore.

出版信息

Am J Public Health. 2022 Feb;112(2):284-295. doi: 10.2105/AJPH.2021.306577.

Abstract

To explore barriers to care and characteristics associated with respondent-reported perceived need for opioid use disorder (OUD) treatment and National Survey on Drug Use and Health (NSDUH)‒defined OUD treatment gap. We performed a cross-sectional study using descriptive and multivariable logistic regression analyses to examine 2015-2019 NSDUH data. We included respondents aged 18 years or older with past-year OUD. Of 1 987 961 adults, 10.5% reported a perceived OUD treatment need, and 71% had a NSDUH-defined treatment gap. There were significant differences in age distribution, health insurance coverage, and past-year mental illness between those with and without a perceived OUD treatment need. Older adults (aged ≥ 50 years) and non-White adults were more likely to have a treatment gap compared with younger adults (aged 18-49 years) and White adults, respectively. Fewer than 30% of adults with OUD receive treatment, and only 1 in 10 report a need for treatment, reflecting persistent structural barriers to care and differences in perceived care needs between patients with OUD and the NSDUH-defined treatment gap measure. Public health efforts aimed at broadening access to all forms of OUD treatment and harm reduction should be proactively undertaken. (. 2022;112(2):284-295. https://doi.org/10.2105/AJPH.2021.306577).

摘要

探讨与受访者报告的阿片类药物使用障碍(OUD)治疗需求以及国家药物使用和健康调查(NSDUH)定义的 OUD 治疗差距相关的障碍和特征。我们使用描述性和多变量逻辑回归分析进行了一项横断面研究,以检查 2015-2019 年 NSDUH 数据。我们纳入了过去一年有 OUD 的年龄在 18 岁或以上的受访者。在 1987961 名成年人中,10.5%报告存在 OUD 治疗需求,71%存在 NSDUH 定义的治疗差距。在有和没有 OUD 治疗需求的受访者中,年龄分布、医疗保险覆盖范围和过去一年的心理健康状况存在显著差异。与年轻成年人(18-49 岁)和白人成年人相比,年龄较大的成年人(≥50 岁)和非白人成年人更有可能存在治疗差距。接受 OUD 治疗的成年人不到 30%,只有 1/10 报告有治疗需求,这反映了持续存在的结构性护理障碍以及 OUD 患者和 NSDUH 定义的治疗差距衡量标准之间对护理需求的认知差异。应积极开展旨在扩大所有形式的 OUD 治疗和减少伤害机会的公共卫生工作。(2022;112(2):284-295。https://doi.org/10.2105/AJPH.2021.306577)。

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