患有精神疾病者中阿片类物质使用障碍的患病率及阿片类物质过量使用率
Prevalence of Opioid Use Disorder and Opioid Overdose Rates Among People With Mental Illness.
作者信息
Chen Qingxian, Gopaldas Manesh, Castillo Felipe, Leckman-Westin Emily, Nunes Edward V, Levin Frances R, Finnerty Molly T
机构信息
New York State Office of Mental Health, Albany (Chen, Leckman-Westin, Finnerty); Division of Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Gopaldas, Castillo, Nunes, Levin); School of Public Health, State University of New York at Albany, Albany (Leckman-Westin); Department of Child and Adolescent Psychiatry, New York University, New York City (Finnerty).
出版信息
Psychiatr Serv. 2024 Oct 1;75(10):953-960. doi: 10.1176/appi.ps.20230338. Epub 2024 Apr 23.
OBJECTIVE
The authors examined the prevalence and correlates of co-occurring opioid use disorder and opioid overdose among individuals receiving psychiatric services.
METHODS
This was a cross-sectional study of adults with continuous enrollment in New York State Medicaid who received at least one psychiatric service in 2020 (N=523,885). Logistic regression models were used to examine the correlates of both opioid use disorder and overdose.
RESULTS
In the study sample, the prevalence rate of opioid use disorder was 8.1%; within this group, 7.7% experienced an opioid overdose in the study year. Opioid use disorder rates were lower among younger (18-24 years; 2.0%) and older (≥65 years; 3.1%) adults and higher among men (11.1%) and among those residing in rural areas (9.9%). Compared with Whites (9.4%), opioid use disorder rates were lower for Asian Americans (2.0%, adjusted odds ratio [AOR]=0.22) and Blacks (6.8%, AOR=0.76) and higher for American Indians (13.2%, AOR=1.43) and Hispanics (9.6%, AOR=1.29). Individuals with any substance use (24.9%, AOR=5.20), posttraumatic stress (15.7%, AOR=2.34), bipolar (14.9%, AOR=2.29), or anxiety (11.3%, AOR=2.18) disorders were more likely to have co-occurring opioid use disorder; those with conduct (4.5%, AOR=0.51), adjustment (7.4%, AOR=0.88), or schizophrenia spectrum (7.4%, AOR=0.87) disorders were less likely to have opioid use disorder. Those with suicidality (23.9%, AOR=3.83) or economic instability (23.7%, AOR=3.35) had higher odds of having opioid use disorder. Overdose odds were higher among individuals with suicidality (34.0%, AOR=6.82) and economic instability (16.0%, AOR=2.57).
CONCLUSIONS
These findings underscore the importance of providing opioid use disorder screening and treatment for patients receiving psychiatric services.
目的
作者研究了接受精神科服务的个体中同时存在阿片类物质使用障碍和阿片类药物过量的患病率及其相关因素。
方法
这是一项对2020年持续参加纽约州医疗补助计划且至少接受过一次精神科服务的成年人进行的横断面研究（N = 523,885）。采用逻辑回归模型研究阿片类物质使用障碍和过量使用的相关因素。
结果
在研究样本中，阿片类物质使用障碍的患病率为8.1%；在该组中，7.7%的人在研究年度经历过阿片类药物过量。阿片类物质使用障碍在较年轻（18 - 24岁；2.0%）和较年长（≥65岁；3.1%）的成年人中发生率较低，在男性（11.1%）和居住在农村地区的人群（9.9%）中发生率较高。与白人（9.4%）相比，亚裔美国人（2.0%，调整优势比[AOR]=0.22）和黑人（6.8%，AOR = 0.76）的阿片类物质使用障碍发生率较低，而美国印第安人（13.2%，AOR = 1.43）和西班牙裔（9.6%，AOR = 1.29）的发生率较高。患有任何物质使用障碍（24.9%，AOR = 5.20）、创伤后应激障碍（15.7%，AOR = 2.34）、双相情感障碍（14.9%，AOR = 2.29）或焦虑障碍（11.3%，AOR = 2.18）的个体更有可能同时患有阿片类物质使用障碍；患有品行障碍（4.5%，AOR = 0.51）、适应障碍（7.4%，AOR = 0.88）或精神分裂症谱系障碍（7.4%，AOR = 0.87）的个体患阿片类物质使用障碍的可能性较小。有自杀倾向（23.9%，AOR = 3.83）或经济不稳定（23.7%，AOR = 3.35）的个体患阿片类物质使用障碍的几率更高。有自杀倾向（34.0%，AOR = 6.82）和经济不稳定（16.0%，AOR = 2.57）的个体过量使用阿片类药物的几率更高。
结论
这些发现强调了为接受精神科服务的患者提供阿片类物质使用障碍筛查和治疗的重要性。
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