Abstinence Among Alcohol Use Disorder Patients During the COVID-19 Pandemic: Insights From Spain
Abstinence Among Alcohol Use Disorder Patients During the COVID-19 Pandemic: Insights From Spain
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DOI：
10.1111/acer.14555
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发表时间：
2021-03-05
期刊：
影响因子：
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通讯作者：
Manthey, Jakob
中科院分区：
文献类型：
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作者：
Barrio, Pablo;Baldaqui, Nuria;Manthey, Jakob
背景酒精使用障碍（AUD）患者可能遭受与COVID-19大流行和相关政策措施相关的不成比例的伤害。虽然已经进行了许多调查，但大多数调查都集中在普通人群的饮酒变化上，缺乏生物标记物的验证。方法：我们对参加尿液药物筛选项目的AUD患者进行了回顾性队列研究。使用混合效应logistic回归模型，我们根据患者的主要临床特征和分析时间（在西班牙实施封锁之前或之后）评估了葡萄糖醛酸乙酯筛查阳性的概率。结果362例患者共提供2040份尿样（封城前1295份，封城期间745份）。参与者的平均年龄为52.0岁（SD 12.6）， 69.2%为男性。在43%接受其他药物检测的患者中，22%呈阳性。在对所有协变量进行调整后，封城期间葡萄糖醛酸乙酯筛查阳性的几率几乎翻了一番（OR = 1.99, 95% CI 1.20至3.33,p = 0.008）。其他重要协变量包括其他药物检测呈阳性（OR = 10.79, 95% CI 4.60 ~ 26.97）和治疗时间（OR = 0.59, 95% CI 0.47 ~ 0.74）。我们的数据支持COVID-19导致的封锁与AUD患者饮酒增加之间的关联。因此，成瘾医疗保健系统可能面临重大挑战。鉴于这些发现，有必要前瞻性地评估AUD患者如何受到大流行的影响，以及卫生系统如何应对他们的需求。
Background Patients with alcohol use disorder (AUD) are likely to suffer disproportionate harms related to the COVID-19 pandemic and related policy measures. While many surveys have been conducted, most are focused on drinking changes in the general population and validation with biological markers is lacking.Method We performed a retrospective cohort study among patients with AUD attending a urine drug screening program. With mixed-effects logistic regression models, we assessed the probability of screening positive for ethyl glucuronide according to patients' main clinical characteristics and time of analysis (either prior to or after a lockdown was implemented in Spain).Results A total of 362 patients provided 2,040 urine samples (1,295 prior to lockdown, 745 during lockdown). The mean age of participants was 52.0 years (SD 12.6), and 69.2% were men. Of the 43% of patients tested for other drugs 22% screened positive. After adjusting for all covariates, the odds of screening positive for ethyl glucuronide during lockdown almost doubled (OR = 1.99, 95% CI 1.20 to 3.33, p = 0.008). Other significant covariates included testing positive for other drugs (OR = 10.79, 95% CI 4.60 to 26.97) and length of treatment (OR = 0.59, 95% CI 0.47 to 0.74).Conclusions Our data support an association between the lockdown due to COVID-19 and increased alcohol use in patients with AUD. Thus, addiction healthcare systems could face significant challenges ahead. In light of these findings, it is essential to evaluate prospectively how patients with AUD are affected by the pandemic and how health systems respond to their needs.