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影响美国进入阿片类药物使用障碍治疗等待时间的因素,特别关注潜在的生物性别差异。

Factors affecting waiting times to enter opioid use disorder treatment in the United States with a particular focus on potential biological sex disparity.

作者信息

Nkemjika Stanley, Oforeh Kenneth, Olwit Connie, Olayinka Olaniyi, Tumenta Terence

机构信息

Department of Psychiatry and Human Behavior Thomas Jefferson University Philadelphia Pennsylvania USA.

Department of Psychiatry University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA.

出版信息

PCN Rep. 2024 Dec 27;4(1):e70048. doi: 10.1002/pcn5.70048. eCollection 2025 Mar.

Abstract

AIM

Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility. We aim to explore biological sex differences in treatment disparities and its role in wait time to enter OUD treatment.

METHOD

Using the 2018 Treatment Episode Data Set Discharge, the national sample representative of OUD patients in the substance use disorder treatment facilities within the 50 states of the United States was 382,547. Univariate and multivariable logistic analysis of the independent variables and other covariates with the dependent variables were explored to estimate the adjusted odds relationship.

RESULTS

Medications for OUD (MOUD) use among males was significantly different, with waiting 1-7 days (adjusted odds ratio [AOR] = 1.300, 95% confidence interval [CI] = 1.208-1.399) and >7 days (AOR = 0.676, 95% CI = 0.600-0.763) to enter OUD treatment compared to waiting less than a day. For females, MOUD was significantly different, with waiting 1-7 days (AOR = 1.366, 95% CI = 1.244-1.499) and >7 days (AOR = 0.834, 95% CI = 0.721-0.965) to enter OUD treatment compared to waiting less than a day.

CONCLUSION

Both females and males who received MOUD had lower odds of waiting >7 days to enter treatment than those who received no MOUD. The findings of this study will ensure equity in allocating resources to both males and females.

摘要

目的

阿片类物质使用障碍(OUD)是对合法或非法阿片类物质的问题性使用。到目前为止,关于接受治疗时生物性别差异的文献很少。因此,我们假设生物性别对OUD治疗可及性具有调节作用。我们旨在探讨治疗差异中的生物性别差异及其在进入OUD治疗等待时间方面的作用。

方法

使用2018年治疗事件数据集出院数据,美国50个州物质使用障碍治疗设施中OUD患者的全国代表性样本为382,547例。对自变量和其他协变量与因变量进行单变量和多变量逻辑分析,以估计调整后的优势比关系。

结果

男性中使用阿片类物质使用障碍药物(MOUD)的情况有显著差异,与等待不到一天相比,等待1 - 7天(调整后的优势比[AOR]=1.300,95%置信区间[CI]=1.208 - 1.399)和超过7天(AOR = 0.676,95% CI = 0.600 - 0.763)进入OUD治疗。对于女性,MOUD情况也有显著差异,与等待不到一天相比,等待1 - 7天(AOR = 1.366,95% CI = 1.244 - 1.499)和超过7天(AOR = 0.834,95% CI = 0.721 - 0.965)进入OUD治疗。

结论

接受MOUD治疗的男性和女性等待超过7天进入治疗的几率均低于未接受MOUD治疗的人。本研究结果将确保在为男性和女性分配资源时的公平性。

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本文引用的文献

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Campbell Syst Rev. 2022 Jan 7;18(1):e1215. doi: 10.1002/cl2.1215. eCollection 2022 Mar.
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J Addict Dis. 2023 Oct-Dec;41(4):322-333. doi: 10.1080/10550887.2022.2116904. Epub 2022 Sep 9.
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