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阿片类物质使用障碍的城郊/远郊人群中的排毒、参加12步戒毒互助会及非致命性阿片类物质过量使用情况

Detoxification, 12-step meeting attendance, and non-fatal opioid overdoses among a suburban/exurban population with opioid use disorder.

作者信息

Clingan Sarah E, Woodruff Susan I, Gaines Tommi L, Davidson Peter J

机构信息

Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.

Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, CA, USA.

出版信息

J Addict Dis. 2023 Oct-Dec;41(4):266-273. doi: 10.1080/10550887.2022.2108287. Epub 2022 Aug 11.

Abstract

BACKGROUND

Drug overdoses are the leading cause of injury death in the United States with an estimated 105,752 individuals dying from an overdose in the United States in a 12-month period ending October 2021. Given that people who have opioid use disorder (OUD) are at an increased risk of death, it is crucial to assess risk factors associated with opioid overdose to improve interventions.

OBJECTIVES

We examine factors associated with non-fatal overdose among a suburban/exurban population with OUD in Southern California.

METHODS

Participants were recruited by convenience sampling (n = 355) and were interviewed between November 2017 to August 2018. Participants were eligible for the study if they had a history of pharmaceutical opioid use.

RESULTS

A total of 198 (55.8%) participants reported at least one overdose in their lifetime. A total of 229 participants identified as male, 124 identified as female, and 2 identified as non-binary. When controlling for demographic factors, non-oral opioid administration at first opioid use (AOR 2.82, 95% CI 1.52-5.22), having a history of methadone detoxification, (AOR 2.23, 95% CI 1.27-3.91), history of buprenorphine detoxification (AOR 1.77, 95% CI 1.02-3.07), and history of 12 step attendance (AOR 1.89, 95% CI 1.12-3.20) were found to be independently and positively associated with lifetime opioid overdose.

CONCLUSIONS

Detoxification with buprenorphine and methadone was found to be associated with having a non-fatal opioid overdose. Buprenorphine and methadone should not be prescribed as a detoxification medication as long-term use of medication for OUD results in better outcomes than medication that is used short-term.

摘要

背景

药物过量是美国伤害死亡的主要原因,在截至2021年10月的12个月期间,估计有105,752名美国人死于药物过量。鉴于患有阿片类药物使用障碍(OUD)的人死亡风险增加,评估与阿片类药物过量相关的风险因素对于改善干预措施至关重要。

目的

我们研究南加州郊区/远郊患有OUD的人群中与非致命性药物过量相关的因素。

方法

通过便利抽样招募参与者(n = 355),并在2017年11月至2018年8月期间进行访谈。如果参与者有使用阿片类药物的历史,则符合该研究的条件。

结果

共有198名(55.8%)参与者报告一生中至少有一次药物过量。共有229名参与者被认定为男性,124名被认定为女性,2名被认定为非二元性别。在控制人口统计学因素后,首次使用阿片类药物时非口服给药(调整后比值比[AOR] 2.82,95%置信区间[CI] 1.52 - 5.22)、有美沙酮脱毒史(AOR 2.23,95% CI 1.27 - 3.91)、丁丙诺啡脱毒史(AOR 1.77,95% CI 1.02 - 3.07)以及参加12步戒毒计划的历史(AOR 1.89,95% CI 1.12 - 3.20)被发现与一生中阿片类药物过量独立且呈正相关。

结论

发现丁丙诺啡和美沙酮脱毒与非致命性阿片类药物过量有关。丁丙诺啡和美沙酮不应作为脱毒药物处方,因为长期使用OUD药物比短期使用药物能产生更好的效果。

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