Associations Between Adolescent Chronic Pain and Prescription Opioid Misuse in Adulthood
Associations Between Adolescent Chronic Pain and Prescription Opioid Misuse in Adulthood
复制标题
DOI：
10.1016/j.jpain.2018.07.007
复制
发表时间：
2019-01-01
期刊：
影响因子：
4
通讯作者：
Palermo, Tonya M.
中科院分区：
文献类型：
--
作者：
Groenewald, Cornelius B.;Law, Emily F.;Palermo, Tonya M.
处方阿片类药物滥用是一个严重的公共卫生问题，但先决因素描述不清。使用国家青少年到成人健康纵向研究（N = 14，784）的数据，我们研究了青少年慢性疼痛史与成年期滥用处方阿片类药物的几率之间的纵向关系。主要预测变量是青春期的慢性疼痛状态。主要结果变量是成年早期和成年期的处方阿片类药物滥用。控制已知阿片类药物滥用风险因素的多变量模型，包括社会人口统计学（性别、种族和民族）、青少年心理健康症状（焦虑、抑郁）、青少年自我报告的身体健康状况、青少年物质使用/滥用、童年创伤和成人合法阿片类药物使用。我们发现，有青少年慢性疼痛史的成年人比没有慢性疼痛史的人更容易滥用阿片类药物，即使在控制了其他已知的风险因素之后。此外，我们发现，在有青少年慢性疼痛史的个体中，种族（白色）、其他物质使用和创伤暴露是后来阿片类药物滥用的风险因素。青少年慢性疼痛和随后的成人处方阿片类药物滥用之间的纵向关联突出了早期有针对性的筛查和预防工作，可能会减少以后的阿片类药物滥用的必要性。观点：使用一个大的，具有全国代表性的样本，我们发现，在青春期的慢性疼痛是一个独立的风险因素阿片类药物滥用在成年期，超过和其他已知的风险因素。此外，在患有青少年慢性疼痛的个体中，物质使用，创伤暴露和种族与阿片类药物滥用有关。(C)2018年美国疼痛协会
Prescription opioid misuse is a serious public health concern, yet antecedent factors are poorly described. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 14,784), we examined the longitudinal relationship between a history of adolescent chronic pain and the odds of misusing prescription opioids in adulthood. The primary predictor variable was chronic pain status during adolescence. The primary outcome variables were prescription opioid misuse during early adulthood and adulthood. Multivariate models controlled for known risk factors of opioid misuse, including sociodemo-graphics (sex, race, and ethnicity), adolescent mental health symptoms (anxiety, depression), adolescent self-reported physical health status, adolescent substance use/abuse, childhood trauma, and adult legitimate opioid use. We found that adults with a history of adolescent chronic pain were more likely to misuse opioids than those without history of chronic pain, even after controlling for other known risk factors. Further, we found that among individuals with history of adolescent chronic pain that race (white), other substance use, and exposure to trauma were risk factors for later opioid misuse. Longitudinal associations between adolescent chronic pain and subsequent adult prescription opioid misuse highlight the need for early targeted screening and prevention efforts that may reduce later opioid misuse.Perspective: Using a large, nationally representative sample, we found that chronic pain during adolescence was an independent risk factor for opioid misuse in adulthood, over and above other known risk factors. Furthermore, among those individuals with adolescent chronic pain, substance use, exposure to trauma, and race were associated with opioid misuse. (C) 2018 by the American Pain Society