School of Social Work, The University of Alabama, Tuscaloosa, AL, United States of America.
Institute on Aging, University of Wisconsin-Madison, Madison, WI, United States of America.
PLoS One. 2023 Sep 21;18(9):e0291752. doi: 10.1371/journal.pone.0291752. eCollection 2023.
Despite the rapid rise in opioid prescription medication usage, little research has examined the role of early life adversity, such as childhood abuse, particularly in the context of race, in opioid prescription usage in adulthood. Guided by the life course perspective, the current study investigates whether experiencing childhood abuse increases the risk of opioid prescription use in adulthood and whether this association varies by race. Data were sourced from the second wave of the Midlife in the United States (MIDUS) study (2004-2005). The analytic sample consisted of two groups: non-Hispanic Whites (n = 714) and non-Hispanic Blacks (n = 151). Opioid prescription use was identified from the participants' medication list using the MULTUM Lexicon Drug Database Classification System. Three types of childhood abuse-emotional, physical, and sexual-were assessed via summary scales derived from the Childhood Trauma Questionnaire. The results indicate a significant interaction between childhood physical abuse and race. Among non-Hispanic Whites, higher exposure to physical abuse during childhood was associated with greater odds of opioid prescription use in adulthood, even after adjusting for chronic pain, physical and mental health, and sociodemographic characteristics. However, the association between childhood physical abuse and opioid prescription use in adulthood was non-significant among non-Hispanic Black individuals. These findings underscore the long-term adverse health effects of physical abuse in childhood, particularly for non-Hispanic Whites, and suggest support for developing and implementing tailored intervention strategies.
尽管阿片类药物处方的使用迅速增加，但很少有研究探讨童年期逆境（如儿童期虐待）在成年期阿片类药物处方使用中的作用，尤其是在种族方面。本研究以生命历程理论为指导，调查了童年期虐待是否会增加成年后使用阿片类药物的风险，以及这种关联是否因种族而异。数据来自美国中年研究（MIDUS）的第二波调查（2004-2005 年）。分析样本包括两组：非西班牙裔白人（n=714）和非西班牙裔黑人（n=151）。阿片类药物处方的使用是根据参与者的用药清单，使用 MULTUM Lexicon 药物数据库分类系统确定的。通过童年期创伤问卷得出的综合量表评估了三种类型的童年期虐待，即情感虐待、身体虐待和性虐待。结果表明，童年期身体虐待与种族之间存在显著的交互作用。在非西班牙裔白人中，童年期身体虐待的暴露程度越高，成年后使用阿片类药物的几率就越大，即使在调整了慢性疼痛、身心健康和社会人口特征后也是如此。然而，在非西班牙裔黑人中，童年期身体虐待与成年后使用阿片类药物之间的关联并不显著。这些发现强调了童年期身体虐待对健康的长期不良影响，尤其是对非西班牙裔白人，这表明需要制定和实施有针对性的干预策略。
