年轻人和老年人阿片类药物滥用的差异模式——利用南卡罗来纳州处方药物监测计划的数据进行的回顾性观察研究。
Differential patterns of opioid misuse between younger and older adults - a retrospective observational study using data from South Carolina's prescription drug monitoring program.
机构信息
Daniel J. Epstein Department of Industrial & Systems Engineering, University of Southern California, Los Angeles, CA, USA.
Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
出版信息
Am J Drug Alcohol Abuse. 2022 Sep 3;48(5):618-628. doi: 10.1080/00952990.2022.2124380. Epub 2022 Oct 4.
Most research on opioid misuse focuses on younger adults, yet opioid-related mortality has risen fastest among older Americans over age 55. To assess whether there are differential patterns of opioid misuse over time between younger and older adults and whether South Carolina's mandatory Prescription Drug Monitoring Program (PDMP) affected opioid misuse differentially between the two groups. We used South Carolina's Reporting and Identification Prescription Tracking System from 2010 to 2018 to calculate an opioid misuse score for 193,073 patients (sex unknown) using days' supply, morphine milligram equivalents (MME), and the numbers of unique prescribers and dispensaries. Multivariable regression was used to assess differential opioid misuse patterns by age group over time and in response to implementation of South Carolina's mandatory PDMP in 2017. We found that between 2011 and 2018, older adults received 57% ( < .01) more in total MME and 25.4 days more ( < .01) in supply, but received prescriptions from fewer doctors (-0.063 doctors, < 01) and pharmacies (-0.11 pharmacies, < 01) per year versus younger adults. However, older adults had lower odds of receiving a high misuse score (OR 0.88, < .01). After the 2017 legislation, misuse scores fell among younger adults (OR 0.79, < .01) relative to 2011, but not among older adults. Older adults may misuse opioids differently compared to younger adults. Assessment of policies to reduce opioid misuse should take into account subgroup differences that may be masked at the population level.
大多数阿片类药物滥用研究都集中在年轻成年人身上，然而，55 岁以上的美国老年人中与阿片类药物相关的死亡率上升最快。为了评估年轻和老年成年人之间是否存在随时间推移而出现的不同模式的阿片类药物滥用情况，以及南卡罗来纳州的强制性处方药物监测计划（PDMP）是否对这两个群体的阿片类药物滥用产生了不同的影响。我们使用南卡罗来纳州的报告和识别处方跟踪系统（2010 年至 2018 年），使用天供应量、吗啡毫克当量（MME）、开处方医生数量和配药药店数量，为 193073 名（性别不详）患者计算阿片类药物滥用评分。多变量回归用于评估随时间推移以及在 2017 年南卡罗来纳州实施强制性 PDMP 后，两个年龄组之间的不同阿片类药物滥用模式。我们发现，2011 年至 2018 年，与年轻成年人相比，老年成年人接受的总 MME 多 57%（<0.01），供应量多 25.4 天（<0.01），但每年接受的医生处方（减少 0.063 名医生，<0.01）和药店处方（减少 0.11 家药店，<0.01）更少。然而，老年成年人接受高滥用评分的可能性较低（OR0.88，<0.01）。2017 年立法后，与 2011 年相比，年轻成年人的滥用评分下降（OR0.79，<0.01），但老年成年人的滥用评分没有下降。与年轻成年人相比，老年成年人可能会以不同的方式滥用阿片类药物。评估减少阿片类药物滥用的政策应考虑到可能在人群水平上被掩盖的亚组差异。
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