Characteristics and Receipt of Medication Treatment Among Young Adults Who Experience a Nonfatal Opioid-Related Overdose.
Characteristics and Receipt of Medication Treatment Among Young Adults Who Experience a Nonfatal Opioid-Related Overdose.
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DOI：
10.1016/j.annemergmed.2019.07.030
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发表时间：
2020-01
影响因子：
6.2
通讯作者：
Walley AY
中科院分区：
文献类型：
--
作者：
Bagley SM;Larochelle MR;Xuan Z;Wang N;Patel A;Bernson D;Silverstein M;Hadland SE;Land T;Samet JH;Walley AY
非致命的阿片类药物过量代表着让年轻人有机会接受阿片使用障碍(Moud)的药物治疗。我们试图：(1)描述经历非致命性过量服药的年轻人的特征，以及(2)估计年轻人相对于26-45岁(YO)的Moud比率和持续时间。我们使用来自马萨诸塞州政府机构的未识别的、个人层面的、相关的数据集，对2012-2014年间在马萨诸塞州因阿片类药物相关过量而幸存下来的15,281名年龄在18-45岁之间的人进行了一项队列研究。我们描述了按年龄(18-21岁、22-25岁和26-45岁)分层的患者特征，并评估了多变量Cox比例风险模型，以比较年龄、性别、精神健康障碍病史和成瘾治疗的Moud收受控制率。在第二年发生非致命性过量用药的4 268名青年中，28%(n=336/11013)的18-21岁的青年服用了任何Moud，36%(n=1097/3059)的22-25岁的青年服用了Moud，36%(n=3916/11013)的26-45岁的青年服用了Moud。18-21岁和22-25岁的患者，丁丙诺啡治疗的中位时间为4个月(IQR：1，7；1，8)，美沙酮治疗4个月(IQR：2，8；2，9)，纳曲酮治疗1个月(IQR：1，1)。与22-25岁和26-45岁相比，18-21岁的人接受美沙酮治疗的可能性较小(AHR为0.60[95%CI：0.45，0.70])。18~21YO和22~25YO均比26~45YO更有可能使用纳曲酮(AHR 1.65[95%CI：1.36，2.00]和1.41[95%CI：1.23，1.61])。三分之一的年轻人在服药过量后的12个月内接受了Moud的治疗。收到的Moud类型似乎与年龄有关。未来的研究应该集中在如何选择用药以及如何优化急诊科以应对非致命性过量用药后的Moud启动。
Nonfatal opioid overdose represents an opportunity to engage young adults into medication for opioid use disorder (MOUD). We seek to: (1) describe characteristics of young adults who experience nonfatal overdose and (2) estimate rates of and time to MOUD for young adults relative to 26–45 year olds (yo). We conducted a cohort study using retrospective administrative data of 15,281 individuals ages 18–45 who survived an opioid-related overdose in Massachusetts between 2012–2014 using de-identified, individual-level, linked datasets from Massachusetts government agencies. We described patient characteristics stratified by age (18–21, 22–25, and 26–45) and evaluated multivariable Cox proportional hazards models to compare rates of MOUD receipt controlling for age, gender, history of mental health disorders, and addiction treatment. Among 4268 young adults in the year following with nonfatal overdose, 28% (n=336/1209) of 18–21 yo received any MOUD, 36% (n=1097/3059) of 22–25 yo received MOUD, and 36% (n=3916/11013) of 26–45 yo received MOUD. For 18–21 yo and 22–25 yo, median time to buprenorphine treatment was 4 months (IQR 1,7; 1,8), 4 months (IQR: 2,8; 2,9) to methadone, and 1 month (IQR:1,1) to naltrexone. Eighteen-twenty one year olds were less likely (AHR 0.60 [95% CI: 0.45, 0.70]) to receive methadone than 22–25 and 26–45 yo. Both 18–21 yo and 22–25 yo were more likely to receive naltrexone (AHR 1.65 [95% CI:1.36, 2.00] and 1.41 [95% CI:1.23, 1.61]) than 26–45 yo. One in three young adults received MOUD in the 12 months after surviving an overdose. Type of MOUD received appeared to be age-associated. Future research should focus on how medication choice is made and how to optimize the emergency department for MOUD initiation after nonfatal overdose.
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影响因子：
33.9
作者：
Vivolo-Kantor, Alana M.;Seth, Puja;Coletta, Michael A.
通讯作者：
Coletta, Michael A.
DOI：
10.1136/bmj.e5945
发表时间：
2012-10-03
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
MacArthur GJ;Minozzi S;Martin N;Vickerman P;Deren S;Bruneau J;Degenhardt L;Hickman M
通讯作者：
Hickman M
影响因子：
5.7
作者：
D'Onofrio, Gail;Chawarski, Marek C.;Fiellin, David A.
通讯作者：
Fiellin, David A.
影响因子：
33.9
作者：
Rudd, Rose A.;Seth, Puja;Scholl, Lawrence
通讯作者：
Scholl, Lawrence
影响因子：
2.6
作者：
Green, Carla A.;Perrin, Nancy A.;Coplan, Paul M.
通讯作者：
Coplan, Paul M.