Prevalence, patterns, and correlates of multiple substance use disorders among adult primary care patients
Prevalence, patterns, and correlates of multiple substance use disorders among adult primary care patients
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DOI：
10.1016/j.drugalcdep.2018.01.035
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发表时间：
2018-06-01
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
背景资料：在基于初级保健的筛查和干预中解决多种物质使用障碍（SUD）可能会改善SUD治疗的可及性、参与度和结局。为了告知这些努力，研究是需要的患病率和模式的多SUD之间primary care patients.Methods：数据进行了分析，从一个样本的2000名成年人（年龄>= 18）的初级保健患者招募的多站点国家药物滥用治疗临床试验网络（CTN）研究（CTN-0059）。过去一年的DSM-5 SUD（烟草、酒精和药物）通过改良的复合国际诊断访谈进行评估。检查了多个SUD与单个SUD的患病率和相关性。潜类分析（LCA）被用来探索多个SUDs的模式。结果：多个SUDs被发现与SUD酒精，大麻，处方阿片类药物，可卡因和海洛因的大多数参与者之间。男性、年龄在26-34岁、受教育程度较低、失业的参与者与一个SUD相比，多个SUD的几率增加。多个SUD与烟草或酒精使用障碍的严重程度相关。样本的LCA确定了三个类别：第1类（83.7%）显示所有SUD的低患病率;第2类（12.0%）显示烟草、酒精和大麻的SUD的高-中度患病率;第3类（4.3%）显示烟草、阿片类药物和可卡因的SUD的高患病率。LCA定义的类区分性别，年龄，种族，教育和就业status.Conclusions：研究结果表明，初级保健医生应该知道多个SUD时，规划治疗，特别是在成年人谁是男性，年轻，教育程度较低，或失业。针对多个SUD的干预措施需要进一步研究。
Background: Addressing multiple substance use disorders (SUDs) in primary care-based screening and intervention may improve SUD treatment access, engagement, and outcomes. To inform such efforts, research is needed on the prevalence and patterns of multiple SUDs among primary care patients.Methods: Data were analyzed from a sample of 2000 adult (aged >= 18) primary care patients recruited for a multisite National Drug Abuse Treatment Clinical Trials Network (CTN) study (CTN-0059). Past-year DSM-5 SUDs (tobacco, alcohol, and drug) were assessed by the modified Composite International Diagnostic Interview. Prevalence and correlates of multiple versus single SUDs were examined. Latent class analysis (LCA) was used to explore patterns of multiple SUDs.Results: Multiple SUDs were found among the majority of participants with SUD for alcohol, cannabis, prescription opioids, cocaine, and heroin. Participants who were male, ages 26-34, less educated, and unemployed had increased odds of multiple SUDs compared to one SUD. Having multiple SUDs was associated with greater severity of tobacco or alcohol use disorder. LCA of the sample identified three classes: class 1 (83.7%) exhibited low prevalence of all SUDs; class 2 (12.0%) had high-moderate prevalence of SUDs for tobacco, alcohol, and cannabis; class 3 (4.3%) showed high prevalence of SUD for tobacco, opioids, and cocaine. LCA-defined classes were distinguished by sex, age, race, education, and employment status.Conclusions: Findings suggest that primary care physicians should be aware of multiple SUDs when planning treatment, especially among adults who are male, younger, less educated, or unemployed. Interventions that target multiple SUDs warrant future investigation.