A hidden aspect of the US opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder
A hidden aspect of the US opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder
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DOI：
10.1016/j.drugalcdep.2018.10.002
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发表时间：
2018-12-01
影响因子：
4.2
通讯作者：
Dunn, Kelly E.
中科院分区：
文献类型：
--
作者：
Huhn, Andrew S.;Strain, Eric C.;Dunn, Kelly E.
背景：患有阿片类药物使用障碍（OUD）的老年人是一个医学上复杂的人群。目前的研究评估了寻求OUD治疗的老年人的趋势，重点是主要海洛因与处方阿片类药物的使用。这项研究还比较了老年人与OUD年轻OUD人口的人口统计学和药物使用behaviors.Methods：公开可用的数据，从国家认证的成瘾治疗中心收集通过治疗事件数据集-招生（TEDS-A）2004-2015年之间。本研究利用Joinpoint回归对55岁及以上成人（老年人; n = 400，421）与55岁以下成人（n = 7，795，839）首次接受OUD治疗的趋势进行了横断面纵向分析。鉴于2013-2015年间寻求OUD治疗的老年人迅速增加，次要结局包括2012年人口统计学和药物使用的变化结果：2004-2013年间，寻求OUD治疗的老年人比例稳步上升（增加41.2%; p趋势= 0.046），然后在2013-2015年期间迅速增加（增加53.5%; p趋势= 0.009）。2012-2015年间，主要使用海洛因的老年人比例增加了一倍多（p < 0.001）;这些人越来越多地是男性（p < 0.001），非裔美国人（p < 0.001），并通过鼻内给药途径使用结论：最近寻求治疗OUD的老年人激增，特别是那些主要使用海洛因的人。迫切需要为这一人群提供专业的治疗选择，如果这些趋势继续下去，则需要增加量身定制的老年护理OUD治疗的能力。
Background: Older adults with opioid use disorder (OUD) are a medically complex population. The current study evaluated trends in older adults seeking treatment for OUD, with a focus on primary heroin versus prescription opioid use. This study also compared older adults with OUD to the younger OUD population on demographics and drug use behaviors.Methods: Publicly available data from state-certified addiction treatment centers were collected via the Treatment Episode Data Set - Admissions (TEDS-A) between 2004-2015. This study utilized Joinpoint Regression to conduct a cross-sectional, longitudinal analysis of trends in first-time treatment admissions for OUD in adults 55 and older (older adults; n = 400,421) versus adults under the age of 55 (n = 7,795,839). Given the rapid increase in older adults seeking treatment for OUD between 2013-2015, secondary outcomes include changes in demographics and drug use between 2012 (as a baseline year) and 2015.Results: The proportion of older adults seeking treatment for OUD rose steadily between 2004-2013 (41.2% increase; p-trend = 0.046), then rapidly between 2013-2015 (53.5% increase; p-trend = 0.009). The proportion of older adults with primary heroin use more than doubled between 2012-2015 (p < 0.001); these individuals were increasingly male (p < 0.001), African American (p < 0.001), and using via the intranasal route of administration (p < 0.001).Conclusions: There has been a recent surge in older adults seeking treatment for OUD, particularly those with primary heroin use. Specialized treatment options for this population are critically needed, and capacity for tailored elder care OUD treatments will need to increase if these trends continue.