Leung Janni, Stjepanovic Daniel, Vu Giang, Lim Carmen, Anandan Aathavan Shanmuga, Hall Wayne, Connor Jason, Chan Gary
National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia.
School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia.
Drug Alcohol Depend Rep. 2022 Nov 13;5:100118. doi: 10.1016/j.dadr.2022.100118. eCollection 2022 Dec.
Due to concerns over the public health impact of increasing opioid use, Australia up-scheduled codeine in 2018, requiring codeine-containing pharmaceuticals to be prescription-only. We examined pre-post changes in the prevalence and correlates of non-medical use of pharmaceutical opioids (NMUPO) and other illicit substance use (ISU).
We conducted a cross-sectional analysis of 45,463 participants aged 14 or above in the Australian National Drug Strategy Household Surveys (NDSHS) 2016 and 2019. Participants were categorized based on their past 12 months NMUPO and ISU patterns. Correlates examined included socio-demographic, psychological (Kessler 10), health and behavioral variables.
The overall prevalence of any NMUPO decreased from 3.56% in 2016 to 2.65% in 2019, and the prevalence of codeine use from 2.98% to 1.49%. No significant changes were observed in the use of other types of painkillers (e.g. oxycodone and fentanyl) between 2016 and 2019. The overall decrease in NMUPO primarily occurred among people who used NMUPO only and did not use other illicit drugs. Older adults were more likely to report NMUPO only. Younger age, higher psychological distress, risky alcohol use, and daily smoking were associated with both NMUPO and illicit drug use.
A comparison of cross-sectional data from two time-points showed that the prevalence of NMUPO use among people who used NMUPO exclusively was lower post-up-scheduling of codeine in Australia. However, NMUPO use did not reduce among people who used both NMUPO and other illicit drugs. Public health interventions are needed to reduce opioid-related harm in those who also used other illicit drugs.
由于担心阿片类药物使用增加对公众健康产生影响，澳大利亚于2018年提高了可待因的管控级别，要求含可待因的药品只能凭处方购买。我们研究了药用阿片类药物非医疗使用（NMUPO）和其他非法物质使用（ISU）的流行率及其相关因素在管控前后的变化。
我们对2016年和2019年澳大利亚国家药物战略家庭调查（NDSHS）中45463名14岁及以上的参与者进行了横断面分析。参与者根据其过去12个月的NMUPO和ISU模式进行分类。所研究的相关因素包括社会人口统计学、心理（凯斯勒10项量表）、健康和行为变量。
任何形式的NMUPO总体流行率从2016年的3.56%降至2019年的2.65%，可待因使用流行率从2.98%降至1.49%。2016年至2019年期间，其他类型止痛药（如羟考酮和芬太尼）的使用情况未观察到显著变化。NMUPO的总体下降主要发生在仅使用NMUPO且不使用其他非法药物的人群中。老年人更有可能仅报告NMUPO。年龄较小、心理困扰程度较高、危险饮酒和每日吸烟与NMUPO和非法药物使用均相关。
对两个时间点的横断面数据进行比较显示，在澳大利亚提高可待因管控级别后，仅使用NMUPO的人群中NMUPO的使用流行率较低。然而，在同时使用NMUPO和其他非法药物的人群中，NMUPO的使用并未减少。需要采取公共卫生干预措施，以减少同时使用其他非法药物人群中的阿片类药物相关危害。
