Psychiatric symptoms and recent overdose among people who use heroin or other opioids: Results from a secondary analysis of an intervention study.
Psychiatric symptoms and recent overdose among people who use heroin or other opioids: Results from a secondary analysis of an intervention study.
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DOI：
10.1016/j.abrep.2019.100212
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发表时间：
2019-12-01
影响因子：
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通讯作者：
Hernandez-Meier, Jennifer
中科院分区：
文献类型：
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作者：
Fendrich, Michael;Becker, Jessica;Hernandez-Meier, Jennifer
背景：药物过量（OD）是美国意外死亡的主要原因，其中大多数死亡涉及阿片类药物。尽管有研究表明阿片类药物滥用与精神疾病有关，并且有证据表明大部分阿片类药物OD死亡是自杀，但OD预防策略很少考虑精神健康风险因素。我们检查了参加干预研究的海洛因或其他阿片类药物使用者的样本，以确定过量的患病率，过量自杀企图的患病率，以及与其他阿片类药物使用者相比，精神病学水平较高的人是否更有可能经历最近的OD。通过进行双变量分析和多变量logistic回归模型，控制多药物使用，刑事司法状况，年龄，种族，性别和教育，我们评估了严重抑郁症，严重焦虑症，创伤后应激障碍（PTSD）和精神病的关联和过去三个月的OD.RESULTS：刚刚超过12%（45/368）的最近阿片类药物使用者报告最近过量。最近的四名吸毒过量的受害者报告说，吸毒过量是自杀企图。多元Logistic回归分析显示，重度抑郁症（比值比2.46; 95% CI：1.24，4.89），PTSD（比值比：2.77; 95% CI：1.37-5.60）和精神病（比值比2.39; 95%CI：1.10-5.15）与OD比值升高显著相关。研究结果表明，系统的心理健康症状筛查和阿片类药物使用者的心理健康治疗的连接-特别是那些确定与OD-可能是OD预防的关键。
BACKGROUND: Drug overdose (OD) is the leading cause of accidental death in the United States and most of these deaths involve opioids. Despite research linking opioid abuse to mental illness, and evidence suggesting a large portion of opioid OD deaths are suicides, OD prevention strategies scarcely take into account mental health risk factors.METHODS: We examined a sample of heroin or other opioid users enrolled in an intervention study to determine the prevalence of overdose, the prevalence of suicide attempts in overdose, and whether those with higher levels of psychiatric symptomatology would be more likely to experience a recent OD compared to other opioid users. By performing bivariate analyses and multivariate logistic regression models that controlled for poly drug use, criminal justice status, age, race, gender, and education, we evaluated the association of severe depression, severe anxiety, posttraumatic stress disorder (PTSD) and, psychosis and past three-month OD.RESULTS: Just over 12% (45/368) of recent opioid users reported a recent overdose. Four of these recent overdose victims reported that the overdose was a suicide attempt. Multiple logistic regression analysis revealed that severe depression (odds ratio 2.46; 95% CI: 1.24, 4.89), PTSD (odds ratio: 2.77; 95% CI: 1.37-5.60) and psychosis (odds ratio 2.39; 95% CI: 1.10-5.15) were significantly associated with elevated odds for OD.CONCLUSIONS: Findings suggest systematic mental health symptom screening and connection to mental health treatment for opioid users-especially those identified with OD-may be critical for OD prevention.