Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
Drug Alcohol Depend. 2022 Sep 1;238:109584. doi: 10.1016/j.drugalcdep.2022.109584. Epub 2022 Jul 22.
Benzodiazepines and opioids are used alone or in conjunction in certain care settings, but each have the potential for misuse.
This longitudinal observational study evaluated substance use and mental health outcomes associated with providing opioids with or without benzodiazepine to treat traumatic injury in the emergency department (ED) setting.
We analyzed a limited dataset obtained through the IBM Watson Health Explorys. Matched cohorts were defined for: 1) patients treated with opioids during the ED encounter (ED-Opioid) vs. neither opioid or benzodiazepine treatment (No medication) (n = 5372); 2) patients treated with opioids and benzodiazepines during the ED encounter (ED-Opioid+Benzodiazepines) vs. No Medication (n = 2454); and 3) ED-Opioid+Benzodiazepines vs. ED-Opioid (n = 2454). Patients consisted of adults with an emergency department encounter in the MetroHealth System (Cleveland, Ohio) with a chief complaint of traumatic injury and medical records for five years following the encounter. Control patients for each cohort were matched to the exposure patients on demographics, body mass index, and residential zip code median income. Outcomes were five-year incidence rates for alcohol, substance use, depression, and anxiety-related diagnoses.
Our results indicate that, although receiving opioids during the ED visit predicted a relatively lower likelihood of subsequent substance use and mental health diagnoses, the brief co-use of benzodiazepines was strongly associated with poorer outcomes.
Even brief exposure to co-prescribed opioids and benzodiazepines during emergency traumatic injury care may be associated with negative substance use and mental health consequences in the years following the event.
苯二氮䓬类药物和阿片类药物在某些医疗环境中单独或联合使用，但两者都有可能被滥用。
本纵向观察性研究评估了在急诊科（ED）环境中提供阿片类药物联合或不联合苯二氮䓬类药物治疗创伤性损伤与物质使用和心理健康结局的相关性。
我们分析了通过 IBM Watson Health Explorys 获取的有限数据集。为以下情况定义了匹配队列：1）在 ED 就诊期间接受阿片类药物治疗的患者（ED-阿片类药物）与未接受阿片类药物或苯二氮䓬类药物治疗的患者（无药物治疗）（n=5372）；2）在 ED 就诊期间接受阿片类药物和苯二氮䓬类药物治疗的患者（ED-阿片类药物+苯二氮䓬类药物）与无药物治疗的患者（n=2454）；3）ED-阿片类药物+苯二氮䓬类药物与 ED-阿片类药物（n=2454）。患者为在俄亥俄州克利夫兰市 MetroHealth 系统接受 ED 就诊且主诉为创伤性损伤的成年人，就诊后五年内有医疗记录。每个队列的对照患者均根据人口统计学、体重指数和居住邮政编码中位数收入与暴露患者相匹配。结局为五年内酒精、物质使用、抑郁和焦虑相关诊断的发生率。
我们的结果表明，尽管在 ED 就诊期间接受阿片类药物治疗预测随后物质使用和心理健康诊断的可能性相对较低，但苯二氮䓬类药物的短期联合使用与较差的结局密切相关。
即使在紧急创伤性损伤护理期间短暂接触联合开具的阿片类药物和苯二氮䓬类药物，也可能与事件发生后数年出现负面物质使用和心理健康后果相关。
