The Altshuler Center for Education and Research at Metrocare Services, Dallas, Texas, USA.
Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Dual Diagn. 2023 Oct-Dec;19(4):180-188. doi: 10.1080/15504263.2023.2260328. Epub 2023 Nov 1.
To study the New York City area population after the September 11, 2001, 9/11 attacks, focusing on tobacco and drug use and drug use disorders. An abundance of research has identified the important mental health sequelae stemming from exposure to disasters, especially vulnerability to the development of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). There also is a body of literature on the association of disaster exposure with alcohol use/misuse, but far less research on tobacco and other drug use/disorders.
A terrorism-affected sample ( = 379) was assessed nearly 3 years after the attacks using structured diagnostic interviews, providing predisaster and postdisaster prevalence and incidence of tobacco and drug use, changes in tobacco and drug use, and predisaster and postdisaster prevalence and incidence of drug use disorders in relation to the 9/11 attacks. criteria were fully assessed using structured diagnostic interviews for psychiatric disorders including PTSD, MDD, panic disorder, generalized anxiety disorder, and alcohol and drug use disorders.
Tobacco use did not increase significantly, and no predictors of increased tobacco use could be found for any subgroups, including disaster trauma exposures. Drug use (largely cannabis) increased initially but decreased by 3 years after the attacks. Drug use disorders, which were associated with other psychiatric disorders, were rare and primarily began prior to 9/11.
The overall lack of increase of tobacco use or predictors of increased use found after the disaster and the low rates of new drug use disorders suggest that universal screening for increased tobacco use and new drug use disorders by clinicians may have very low yield. Regardless, postdisaster settings provide suitable circumstances for general discussions about self-care including concern for increased tobacco use, avoiding drug use, and guidance on healthier means of managing stress than through substances. Additionally, because existing tobacco and drug use are endemic in populations, the postdisaster setting can serve as a reminder for clinicians to assess these problems generally and provide appropriate referrals when needed. Postdisaster circumstances offer opportunities to disseminate and promote public health messages and address issues of substance use and misuse.
研究 2001 年 9 月 11 日 9/11 袭击事件后纽约市的人口情况，重点关注烟草和药物使用以及药物使用障碍。大量研究已经确定了与灾害接触有关的重要心理健康后果，尤其是易患创伤后应激障碍（PTSD）和重度抑郁症（MDD）的风险。还有大量关于灾害暴露与酒精使用/滥用之间关联的文献，但关于烟草和其他药物使用/障碍的研究则少得多。
使用结构化诊断访谈，对近 3 年后遭受恐怖袭击的人群（ = 379）进行评估，提供了与 9/11 袭击有关的烟草和药物使用的发病前和发病后流行率和发病率、烟草和药物使用的变化、以及发病前和发病后药物使用障碍的流行率和发病率。使用结构化诊断访谈，对包括 PTSD、MDD、惊恐障碍、广泛性焦虑障碍和酒精和药物使用障碍在内的精神障碍的标准进行了全面评估。
烟草使用没有显著增加，并且无法为任何亚组找到与增加烟草使用相关的预测因素，包括灾害创伤暴露。最初药物使用（主要是大麻）有所增加，但在袭击发生 3 年后减少。药物使用障碍与其他精神障碍相关，较为罕见，主要发生在 9/11 之前。
在灾难后发现，总体上烟草使用没有增加，也没有增加使用的预测因素，以及新的药物使用障碍发生率较低，这表明临床医生普遍筛查增加的烟草使用和新的药物使用障碍的可能性非常低。无论如何，灾难后环境为临床医生提供了适当的机会，让他们可以就自我保健进行一般性讨论，包括关注增加的烟草使用、避免药物使用，以及指导通过非物质手段管理压力。此外，由于现有的烟草和药物使用在人群中普遍存在，灾难后环境可以提醒临床医生普遍评估这些问题，并在需要时提供适当的转介。灾难后情况提供了传播和推广公共卫生信息的机会，并解决了药物使用和滥用问题。
