Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco
Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco
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DOI：
10.1016/j.drugalcdep.2018.11.011
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Wu, Li-Tzy
中科院分区：
文献类型：
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作者：
John, William S.;Zhu, He;Wu, Li-Tzy
背景：目前的数据表明，阿片类药物滥用或阿片类药物使用障碍（OUD）可能在烟草使用者中过度代表。然而，这种关联在初级保健机构中仍未得到充分研究。更好地了解吸烟的初级保健患者中阿片类药物滥用的异质性程度可能对改进初级保健筛查、预防和干预方法具有重要意义。方法：数据来自5个不同诊所的2000名成人（18岁）初级保健患者的样本。在过去一年的烟草使用者中（n = 882），我们通过社会人口学特征和过去一年的多物质使用来评估阿片类药物滥用和OUD的患病率。根据过去一年的多物质使用模式，使用潜在类分析（LCA）来确定烟草使用者的异质亚组。使用多项逻辑回归来检查与lca定义的类成员相关的变量。结果：报告过去一年阿片类药物滥用或OUD的参与者中，有80%报告了过去一年的烟草使用情况。在报告过去一年吸烟的人中，过去一年阿片类药物滥用和OUD的患病率分别为14.0%和9.5%。阿片类药物滥用或OUD的患病率在男性或失业的烟草使用者中最高。在烟草使用者中确定了三个lca定义的类别，包括烟草最小药物使用组（78.0%），烟草-大麻使用组（10.1%）和烟草-阿片类药物/多种药物使用组（11.9%）。阶级成员因社会人口学特征而异。结论：本研究的结果支持对使用烟草的初级保健患者，特别是男性、失业或多种药物使用者中阿片类药物滥用进行更全面的评估和/或监测的益处。
Background: Current data suggest that opioid misuse or opioid use disorder (OUD) may be over represented among tobacco users. However, this association remains understudied in primary care settings. A better understanding of the extent of heterogeneity in opioid misuse among primary care patients who use tobacco may have implications for improved primary care-based screening, prevention, and intervention approaches.Methods: Data were derived from a sample of 2000 adult (aged 18) primary care patients across 5 distinct clinics. Among past-year tobacco users (n = 882), we assessed the prevalence of opioid misuse and OUD by sociodemographic characteristics and past-year polysubstance use. Latent class analysis (LCA) was used to identify heterogeneous subgroups of tobacco users according to past-year polysubstance use patterns. Multinomial logistic regression was used to examine variables associated with LCA-defined class membership.Results: Past-year tobacco use was reported by > 84% of participants who reported past-year opioid misuse or OUD. Among those reporting past-year tobacco use, the prevalence of past-year opioid misuse and OUD was 14.0% and 9.5%, respectively. The prevalence of opioid misuse or OUD was highest among tobacco users who were male or unemployed. Three LCA-defined classes among tobacco users were identified including a tobacco-minimal drug use group (78.0%), a tobacco-cannabis use group (10.1%), and a tobacco-opioid/polydrug use group (11.9%). Class membership differed by sociodemographic characteristics.Conclusions: Results from this study support the benefit of more comprehensive assessment of and/or monitoring for opioid misuse among primary care patients who use tobacco, particularly for those who are male, unemployed, or polydrug users.