MMWR Morb Mortal Wkly Rep. 2022 Jun 10;71(23):749-756. doi: 10.15585/mmwr.mm7123a1.
In 2019, 65.8 million U.S. adults reported past-month binge drinking and 35.8 million reported illicit drug use or prescription pain reliever misuse during the past month; 20.4 million met diagnostic criteria for a substance use disorder during the past year (1). Approximately 81,000 persons died of a drug overdose* during May 2019-May 2020; excessive alcohol use contributes to an estimated 95,000 deaths per year (2). Persons with a substance use disorder are at elevated risk for overdose and associated harms (3). To examine the prevalence of past 30-day substance use patterns and the severity of problems experienced across seven biopsychosocial domains (alcohol, drug, employment, family, legal, medical, and psychiatric), CDC used 2019 data from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) Addiction Severity Index-Multimedia Version (ASI-MV) tool (4); these data are collected from adults aged ≥18 years who seek substance use treatment in the United States. Alcohol was the most commonly reported substance used during the past 30 days (35.8%), followed by cannabis (24.9%), prescription opioids (misuse) (18.5%), illicit stimulants (14.0%), heroin (10.2%), prescription sedatives or tranquilizers (misuse) (8.5%), cocaine (7.4%), illicit fentanyl (4.9%), and prescription stimulants (misuse) (1.8%). Polysubstance use (use of two or more substances) during the past 30 days was reported by 32.6% of respondents. Among the biopsychosocial domains measured, 45.4% of assessments reported more severe problems with drugs; others reported psychiatric (35.2%), legal (28.8%), medical (27.4%), employment (25.0%), alcohol (24.2%), and family problems (22.8%). These findings highlight the complex nature of substance use in the United States, the interplay between substance use and mental illness, and the complex challenges that persons with substance use disorder face when seeking treatment. Actions to enhance comprehensive substance use programs that incorporate polysubstance use and co-occurring mental health problems into strategies for prevention, treatment, and response are needed, as is expanded linkage to services. CDC provides data and resources to equip and inform states, territories, and local jurisdictions to help improve opioid prescribing practices, improve linkage to care for the treatment of opioid use disorder, and prevent and reverse overdoses..
2019 年，6580 万美国成年人报告过去一个月有 binge drinking 行为，3580 万成年人报告过去一个月有非法使用药物或处方止痛药的行为；2040 万人在过去一年符合物质使用障碍的诊断标准（1）。大约 81000 人死于 2019 年 5 月至 2020 年 5 月的药物过量*；过量饮酒导致每年约有 95000 人死亡（2）。有物质使用障碍的人过量用药和相关伤害的风险更高（3）。为了研究过去 30 天物质使用模式的流行情况以及七个生物心理社会领域（酒精、药物、就业、家庭、法律、医疗和精神）的问题严重程度，CDC 使用了 2019 年国家成瘾警觉干预和预防计划（NAVIPPRO）成瘾严重程度指数多媒体版（ASI-MV）工具的数据（4）；这些数据来自美国寻求物质使用治疗的年龄在 18 岁及以上的成年人。在过去 30 天内，最常报告的物质使用是酒精（35.8%），其次是大麻（24.9%）、处方阿片类药物（滥用）（18.5%）、非法兴奋剂（14.0%）、海洛因（10.2%）、处方镇静剂或安定剂（滥用）（8.5%）、可卡因（7.4%）、非法芬太尼（4.9%）和处方兴奋剂（滥用）（1.8%）。过去 30 天内，32.6%的受访者报告了多种物质的使用。在所测量的生物心理社会领域中，45.4%的评估报告药物问题更严重；其他报告有精神疾病（35.2%）、法律问题（28.8%）、医疗问题（27.4%）、就业问题（25.0%）、酒精问题（24.2%）和家庭问题（22.8%）。这些发现强调了美国物质使用的复杂性，物质使用与精神疾病之间的相互作用，以及物质使用障碍患者在寻求治疗时面临的复杂挑战。需要采取行动加强综合物质使用项目，将多种物质使用和同时存在的精神健康问题纳入预防、治疗和应对策略，还需要扩大与服务的联系。CDC 提供数据和资源，为各州、领土和地方司法管辖区提供装备和信息，以帮助改善阿片类药物的处方实践，改善与治疗药物使用障碍的联系，并预防和逆转过量用药。
