Under Treatment of Pain: A Prescription for Opioid Misuse Among the Elderly?
Under Treatment of Pain: A Prescription for Opioid Misuse Among the Elderly?
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DOI：
10.1111/pme.12189
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发表时间：
2013-11-01
期刊：
影响因子：
3.1
通讯作者：
Buttram, Mance E.
中科院分区：
文献类型：
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作者：
Levi-Minzi, Maria A.;Surratt, Hilary L.;Buttram, Mance E.
目的研究老年处方阿片类药物滥用者的人口统计学、生理和心理健康特征;当前药物使用模式;使用动机;和转移来源。设计混合方法设计。设置研究现场办公室，或南佛罗里达的高级或社区中心办公室。受试者报告过去90天处方药物滥用的60岁及以上的个人;只有处方阿片类药物滥用者（N=88）被包括在最终分析中。一个子样本的老年人报告大量的处方药滥用被选为深入访谈（N=30）。50%的人报告曾接受过戒毒治疗;有几个人承认最近使用过非法药物：用途：粉末可卡因和/或快克（35.2%），大麻（30.7%），海洛因（14.8%）。大多数人报告去年严重的身体疼痛和不适（86.4%），以及滥用其主要阿片类药物治疗疼痛（80.7%）;超过一半（52.3%）的人从他们的常规医生那里获得主要阿片类药物。定性数据强调了由于未经治疗或治疗不足的疼痛而滥用处方阿片类药物。与主要阿片类药物滥用疼痛的参与者有超过12倍的几率从他们的常规医生获得药物（比值比[OR]=12.22，P=0.002），并有较低的几率使用经销商（OR=0.20，P=0.005）。这项研究强调了需要教育处方专业人员对老年人进行适当的疼痛管理，同时仍然对药物滥用和依赖问题敏感。
ObjectiveTo examine the demographic, physical, and mental health characteristics; current drug use patterns; motivations for use; and diversion sources among elderly prescription opioid misusers.DesignMixed methods design.SettingResearch field offices, or senior or community center offices in South Florida.SubjectsIndividuals aged 60 and over reporting past 90-day prescription medication misuse; only prescription opioid misusers (N=88) were included in the final analysis.MethodsThe Global Appraisal of Individual Needs was the main survey instrument. A subsample of elderly reporting substantial prescription drug misuse were chosen for the in-depth interview (N=30).ResultsThe mean age was 63.3. Fifty percent reported ever being admitted to a drug treatment program; several endorsed recent illicit drug use: powder cocaine and/or crack (35.2%), marijuana (30.7%), heroin (14.8%). The majority reported past year severe physical pain and discomfort (86.4%), and misuse of their primary opioid for pain (80.7%); over half (52.3%) obtained their primary opioid from their regular doctor. Qualitative data highlight the misuse of prescription opioids due to untreated or undertreated pain. Participants with primary opioid misuse for pain had over 12 times higher odds of obtaining the medication from their regular doctor (odds ratio [OR]=12.22, P=0.002) and had lower odds of using a dealer (OR=0.20, P=0.005).ConclusionsFindings suggest that this group of elderly participants often misuse their own prescriptions for pain management. This study highlights the need to educate prescribing professionals on appropriate pain management for older adults while still being sensitive to issues of substance abuse and dependence.