Division of Health Sciences, Utah Valley University, Orem; Department of Surgery, University of Utah Health, Salt Lake City; Department of Public Health, Brigham Young University, Provo, Utah. ORCID: https://orcid.org/0000-0002-5484-5303.
Utah Valley University, Orem, Utah.
J Opioid Manag. 2024 May-Jun;20(3):255-259. doi: 10.5055/jom.0843.
The ravaging effects of the opioid epidemic have affected our communities locally and nationally and are multifaceted in their cause and treatment. It is imperative to locate multiple modalities of treatment options and care for patients with opioid use disorder (OUD) including developing healthy nutrition habits and addressing mental health concerns. Understanding patient perceptions of their personal nutrition habits and mental health status is imperative to providing holistic care in the OUD patient population.
An anonymous 31-question Likert-scale and multiple-choice survey was administered to patients with an International Classification of Disease (ICD-10) code in their electronic medical record of OUD (N = 124). χ and Fisher's exact test where appropriate were performed to determine the demographics of survey participants who acknowledged history of OUD compared to those who did not acknowledge a history of OUD. Log-binomial models were used to generate adjusted prevalence ratios.
Of the 117 patients identified using ICD-10 codes from their medical records as having OUD, only 63 patients acknowledged having a history of OUD, while 54 patients did not. A univariate analysis showed differences in marital status for patients with a self-identified history of OUD. They were also more likely to not be married (divorced or single) (p < 0.01). Patients also tended to be younger than 50 years of age (p < 0.01) and non-White (p < 0.01). There were no differences seen for patients with a history of OUD in the categories of employment (p = 0.31) status or sex (p = 0.51). Patients who acknowledged a history of OUD were significantly more likely to understand the relationship between a healthy diet and reducing the intensity of opioid cravings (p = 0.01) and more likely to consider using nutrition to help combat opioid cravings (p = 0.01). There were no significant differences in overall health or the use of supplements as a part of opioid use treatment. Significant differences were found between those acknowledging a history of OUD having higher rates of depression (p = 0.02) and anxiety (p = 0.02) treatment, despite there not being differences in condition rates for these two conditions (depression, p = 0.08; anxiety, p = 0.27) between the groups. Patients with patient-confirmed OUD were more likely to receive medication treatment (p = 0.03) than those without this acknowledgment.
A similar disease burden of anxiety and depression existed for patients acknowledging OUD as opposed to patients denying OUD. However, significant differences existed between these groups in medication treatment, with those acknowledging OUD having higher rates of being treated for both depression and anxiety. Understanding a patient's mental health condition(s) can be impactful for the treatment of OUD. Multifaceted treatment options should include addressing nutritional deficiencies that impact cravings and long-term healing for patients.
Nutrition and mental health are key parts of a multifaceted treatment modality for patients dealing with OUD. Assisting patients in treatment for depression and anxiety as well as nutrition can change the trajectory of a patient's opioid use recovery.
阿片类药物流行的肆虐影响了我们当地和全国的社区,其原因和治疗方法具有多方面的特点。为患有阿片类药物使用障碍(OUD)的患者寻找多种治疗选择和护理方式至关重要,包括养成健康的营养习惯和解决心理健康问题。了解患者对自身营养习惯和心理健康状况的看法对于为 OUD 患者提供整体护理至关重要。
对电子病历中有阿片类药物使用障碍(ICD-10 编码)的患者进行了一项匿名的 31 个问题李克特量表和多项选择题调查(N = 124)。进行 χ 和 Fisher 确切检验,以确定在电子病历中承认有 OUD 病史的调查参与者的人口统计学特征与不承认有 OUD 病史的调查参与者的人口统计学特征。使用对数二项式模型生成调整后的患病率比。
在使用电子病历中的 ICD-10 编码识别出的 117 名患有 OUD 的患者中,只有 63 名患者承认有 OUD 病史,而 54 名患者没有。单变量分析显示,有自我报告 OUD 病史的患者在婚姻状况方面存在差异。他们更有可能未婚(离婚或单身)(p < 0.01)。患者也倾向于年龄在 50 岁以下(p < 0.01)和非白人(p < 0.01)。在有 OUD 病史的患者中,在就业状况(p = 0.31)或性别(p = 0.51)类别中没有发现差异。承认有 OUD 病史的患者更有可能理解健康饮食与减少阿片类药物渴望强度之间的关系(p = 0.01),并且更有可能考虑使用营养来帮助对抗阿片类药物的渴望(p = 0.01)。在整体健康状况或作为阿片类药物使用治疗一部分使用补充剂方面,没有显著差异。尽管这两种情况(抑郁,p = 0.08;焦虑,p = 0.27)的疾病发生率在两组之间没有差异,但在承认有 OUD 病史的患者中发现了更高的抑郁(p = 0.02)和焦虑(p = 0.02)治疗率之间存在显著差异。与没有这种认识的患者相比,经患者确认患有 OUD 的患者更有可能接受药物治疗(p = 0.03)。
承认 OUD 的患者与否认 OUD 的患者的焦虑和抑郁的疾病负担相似。然而,这两组患者在药物治疗方面存在显著差异,承认 OUD 的患者接受抑郁和焦虑治疗的比例更高。了解患者的心理健康状况对 OUD 的治疗有影响。多方面的治疗选择应包括解决影响渴望和患者长期康复的营养缺陷。
营养和心理健康是治疗患有 OUD 的患者的多方面治疗方法的关键部分。帮助患者治疗抑郁和焦虑以及营养问题可以改变患者阿片类药物使用康复的轨迹。