Access to substance use treatment among young adults who use prescription opioids non-medically.
Access to substance use treatment among young adults who use prescription opioids non-medically.
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DOI：
10.1186/s13011-016-0082-1
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发表时间：
2016-11-29
期刊：
影响因子：
--
通讯作者：
Marshall BD
中科院分区：
文献类型：
--
作者：
Liebling EJ;Yedinak JL;Green TC;Hadland SE;Clark MA;Marshall BD
在美国，非医疗处方阿片类药物 (NMPO) 的使用是一个严重的公共卫生问题，每年新增 150 万人。 2013 年，只有 746,000 人接受了使用 NMPO 的治疗，这表明获得治疗的机会存在巨大差异。本研究旨在评估罗德岛州年轻成人 NMPO 使用者接受药物滥用治疗的相关性，该州深受 NMPO 使用和阿片类药物过量的影响。该分析使用的数据来自对 200 名年龄在 18 至 29 岁的罗德岛州居民的研究，他们报告了过去 30 天内 NMPO 的使用情况。我们比较了曾经成功参加药物滥用治疗计划且从未遇到障碍的个人、曾经尝试参加但无法参加的个人以及从未尝试参加的个人。我们使用多项逻辑回归来确定从未尝试和未成功尝试获得药物使用治疗的独立相关性。 200 名参与者中，平均年龄为 24.5 岁，其中 65.5% 为男性，61.5% 为白人。近一半 (45.5%) 的人从未尝试过参加药物滥用治疗，而 35.0% 的人在没有遇到障碍的情况下成功参加，19.5% 的人至少有一次尝试参加但未成功。在多变量模型中，与白人参与者相比，非白人参与者更有可能从未尝试过注册。曾被监禁、经历过医学界与毒品相关的歧视以及月收入为 501 - 1500 美元与从未尝试加入的可能性降低有关。有用药过量史和月收入为 501 - 1500 美元的人，获得治疗失败的可能性增加。最常见的获得治疗障碍是等候名单 (n = 23)、健康保险不批准注册 (n = 20) 和无力支付 (n = 16)。这项研究表明，报告使用 NMPO 的年轻人在获得治疗方面存在显着差异。研究表明，用药过量史与物质使用治疗利用障碍相关。需要采取干预措施来减少临床环境中与药物相关的歧视，并提供将年轻人（特别是有用药过量史）与循证治疗联系起来的机制。
Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days. We compared individuals who had ever successfully enrolled in a substance use treatment program without ever facing barriers, individuals who had ever attempted to enroll but were unable, and individuals who never attempted to enroll. We used multinomial logistic regression to determine the independent correlates of never attempting and unsuccessfully attempting to access substance use treatment. Among 200 participants, the mean age was 24.5, 65.5% were male, and 61.5% were white. Nearly half (45.5%) had never attempted to enroll in substance use treatment, while 35.0% had successfully enrolled without ever facing barriers and 19.5% were unsuccessful in at least one attempt to enroll. In multivariable models, non-white participants were more likely to never have attempted to enroll compared to white participants. Previous incarceration, experiencing drug-related discrimination by the medical community, and a monthly income of $501 - $1500 were associated with a decreased likelihood of never attempting to enroll. A history of overdose and a monthly income of $501 - $1500 were associated with an increased likelihood of unsuccessfully accessing treatment. The most commonly reported barriers to accessing treatment were waiting lists (n = 23), health insurance not approving enrollment (n = 20), and inability to pay (n = 16). This study demonstrates significant disparities in access to treatment among young adults who report NMPO use. A history of overdose was shown to correlate with experiencing barriers to substance use treatment utilization. Interventions are needed to reduce drug-related discrimination in clinical settings and to provide mechanisms that link young adults (particularly with a history of overdose) to evidence-based treatment.
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影响因子：
2.1
作者：
Davis, Corey;Webb, Damika;Burris, Scott
通讯作者：
Burris, Scott
影响因子：
5.1
作者：
Cerda, Magdalena;Santaella, Julian;Martins, Silvia S.
通讯作者：
Martins, Silvia S.
影响因子：
1.8
作者：
Harlow, Warren;Happell, Brenda;Browne, Matthew
通讯作者：
Browne, Matthew
影响因子：
5.7
作者：
Green, Alexander R.;Carney, Dana R.;Pallin, Daniel J.;Ngo, Long H.;Raymond, Kristal L.;Iezzoni, Lisa I.;Banaji, Mahzarin R.
通讯作者：
Banaji, Mahzarin R.
影响因子：
4.2
作者：
Haegerich TM;Paulozzi LJ;Manns BJ;Jones CM
通讯作者：
Jones CM