寻求药物滥用治疗者的多物质使用模式和临床合并症：一项观察性研究。
Patterns of polysubstance use and clinical comorbidity among persons seeking substance use treatment: An observational study.
机构信息
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
出版信息
J Subst Use Addict Treat. 2023 Mar;146:208932. doi: 10.1016/j.josat.2022.208932. Epub 2023 Jan 7.
INTRODUCTION
Polysubstance use is common among individuals seeking treatment for substance use disorders (SUD). However, we know less about patterns and correlates of polysubstance use among treatment-seeking populations. The current study aimed to identify latent patterns of polysubstance use and associated risk factors in persons entering SUD treatment.
METHODS
Patients (N = 28,526) being admitted for substance use treatment reported on their use of thirteen substances (e.g., alcohol, cannabis, cocaine, amphetamines, methamphetamines, other stimulants, heroin, other opioids, benzodiazepines, inhalants, synthetics, hallucinogens, and club drugs) in the month before treatment and prior to the month before treatment. Latent class analysis (LCA) determined the relationship between class membership and gender, age, employment status, unstable housing, self-harm, overdose, past treatment, depression, generalized anxiety disorder, and/or post-traumatic stress disorder (PTSD).
RESULTS
Identified classes included: 1) Alcohol primary, 2) Moderate probability of past-month alcohol, cannabis, and/or opioid use; 3) Alcohol primary, Lifetime cannabis and cocaine use; 4) Opioid primary, Lifetime use of alcohol, cannabis, hallucinogens, club drugs, amphetamines, and cocaine; 5) Moderate probability of past-month alcohol, cannabis, and/or opioid use, Lifetime use of various substances; 6) Alcohol and cannabis primary, Lifetime use of various substances; and 7) High past-month polysubstance use. Individuals who engaged in past-month polysubstance use attended to face elevated risk of screening positive for recent unstable housing, unemployment, depression, anxiety, PTSD, self-harm, and overdose.
CONCLUSIONS
Current polysubstance use is associated with significant clinical complexity. Tailored treatments that reduce harms resulting from polysubstance use and related psychiatric comorbidity may improve treatment outcomes in this population.
简介
在寻求治疗物质使用障碍（SUD）的个体中，多种物质使用较为常见。然而，我们对寻求治疗的人群中多种物质使用的模式和相关性知之甚少。本研究旨在确定进入 SUD 治疗的个体中多种物质使用的潜在模式和相关风险因素。
方法
接受物质使用治疗的患者（N=28526）报告了他们在治疗前一个月和治疗前一个月内使用的 13 种物质（例如，酒精、大麻、可卡因、苯丙胺、冰毒、其他兴奋剂、海洛因、其他阿片类药物、苯二氮䓬类药物、吸入剂、合成药物、迷幻剂和俱乐部药物）的使用情况。潜在类别分析（LCA）确定了类别成员身份与性别、年龄、就业状况、不稳定住房、自残、过量用药、既往治疗、抑郁、广泛性焦虑症和/或创伤后应激障碍（PTSD）之间的关系。
结果
确定的类别包括：1）酒精为主，2）过去一个月内有较高概率使用酒精、大麻和/或阿片类药物；3）酒精为主，终生使用大麻和可卡因；4）阿片类药物为主，终生使用酒精、大麻、迷幻剂、俱乐部药物、苯丙胺和可卡因；5）过去一个月内有较高概率使用酒精、大麻和/或阿片类药物，终生使用各种物质；6）酒精和大麻为主，终生使用各种物质；7）过去一个月内多种物质使用较高。过去一个月内使用多种物质的个体出现近期不稳定住房、失业、抑郁、焦虑、PTSD、自残和过量用药的风险较高。
结论
当前的多种物质使用与显著的临床复杂性相关。针对减少多种物质使用和相关精神共病造成的危害的个体化治疗可能会改善该人群的治疗结局。
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