Human Nature Lab, Yale Institute for Network Science, Yale University, New Haven, CT, USA.
Department of Sociology, Yale University, New Haven, CT, USA.
BMC Psychiatry. 2022 Apr 2;22(1):236. doi: 10.1186/s12888-022-03884-5.
Despite the growing morbidity and mortality rates associated with opioid use disorder, a large gap still exists between treatment need and capacity. Low-threshold clinics utilizing medication for opioid use disorder (MOUD) treatment can increase treatment access but are understudied, and little is known about how patient demographic characteristics are associated with their social support and functioning in these settings.
We used multivariate regression to estimate associations between demographic characteristics and self-reported social support or functioning indicators among patients receiving MOUD in a low-threshold clinic using several validated instruments administered at intake: Behavior and Symptom Identification Scale, Brief Pain Inventory, and Life Events Checklist for DSM-5. Patients initiating MOUD treatment between April 1 and December 31, 2017, with complete surveys were included (N=582).
Patients were primarily male (62%), aged 34 or older (53%), non-Hispanic White (79%), separated or not married (86%), and unemployed (64%). Over 20% did not live in a house or apartment in the past month. Women were more likely to "get along" with people outside their family or in social situations and to identify their partner as their source of support. Women, non-White, and older patients were at higher risk of social functioning-disrupting events (physical/sexual assaults or experiencing chronic pain), while employment and housing were protective against exposure to these trauma-related events. However, employment and housing also decreased the odds of talking with others about substance use. The aforementioned results were obtained from multivariate logistic regression models and were significant to p<0.05.
Variation in support and functioning by demographic characteristics suggests that treatment facilities may benefit from adopting strategies that take baseline disparities in support and functioning into account.
尽管阿片类药物使用障碍相关的发病率和死亡率不断上升，但治疗需求与能力之间仍存在巨大差距。利用药物治疗阿片类药物使用障碍（MOUD）的低门槛诊所可以增加治疗机会，但研究不足，对于患者人口统计学特征如何与他们在这些环境中的社会支持和功能相关知之甚少。
我们使用多元回归来估计在利用几种经过验证的工具在低门槛诊所接受 MOUD 治疗的患者中，人口统计学特征与自我报告的社会支持或功能指标之间的关联。这些工具在就诊时使用：行为和症状识别量表、简明疼痛量表和 DSM-5 生活事件清单。纳入在 2017 年 4 月 1 日至 12 月 31 日期间开始接受 MOUD 治疗且完成调查的患者（N=582）。
患者主要为男性（62%），年龄在 34 岁或以上（53%），非西班牙裔白人（79%），分居或未婚（86%），失业（64%）。超过 20%的人在过去一个月内没有住在房子或公寓里。女性更有可能与家人或社交场合之外的人相处融洽，并将其伴侣视为支持的来源。女性、非白人和老年患者发生社会功能障碍事件（身体/性侵犯或经历慢性疼痛）的风险更高，而就业和住房则可预防接触这些与创伤相关的事件。然而，就业和住房也降低了与他人谈论药物使用的可能性。上述结果来自多元逻辑回归模型，且在 p<0.05 时具有统计学意义。
人口统计学特征方面的支持和功能的差异表明，治疗机构可能受益于采用考虑到支持和功能方面的基线差异的策略。
