Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants
Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants
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DOI：
10.4088/jcp.14m09291
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发表时间：
2016-03-01
影响因子：
5.3
通讯作者：
Mojtabai, Ramin
中科院分区：
文献类型：
--
作者：
Chen, Lian-Yu;Crum, Rosa M.;Mojtabai, Ramin
目的：对于美国涉及处方兴奋剂的处方、非医疗使用和急诊科 (ED) 就诊的时间趋势知之甚少。我们的目的是研究成人和青少年中涉及右旋苯丙胺-苯丙胺和哌醋甲酯的这 3 个国家趋势。方法：使用了 2006 年至 2011 年期间进行的三项全国调查：国家疾病和治疗指数，一项基于办公室实践的调查；全国药物使用与健康调查，药物使用人口调查；药物滥用警告网络，对急诊室就诊的调查。使用普通最小二乘回归来检查随时间的时间变化以及三种趋势之间的关联。结果：在青少年中，涉及右旋苯丙胺-苯丙胺和哌醋甲酯的治疗就诊次数随着时间的推移而减少；非医疗右旋苯丙胺-苯丙胺使用量保持稳定，而非医疗哌甲酯使用量在 6 年内下降了 54.4%。涉及这两种药物的急诊就诊保持稳定。在成人中，涉及右旋苯丙胺的治疗就诊次数保持不变，而非医疗用途增加了 67.1%，急诊就诊次数增加了 155.9%。这3个涉及哌醋甲酯的趋势保持不变。在各个年龄段中，这两种药物非医疗用途的主要来源是朋友或亲戚；这些朋友和亲戚中有三分之二是从医生那里获得药物的。结论：兴奋剂处方的趋势与非医疗使用和急诊就诊报告的趋势并不相符。非医疗兴奋剂使用的增加可能不仅仅归因于处方趋势的增加。未来的研究应侧重于更深入地了解药物转移的比例、风险因素和动机。 (C) 版权所有 2016 Physicians Postgraduate Press, Inc.
Objective: Little is known regarding the temporal trends in prescriptions, nonmedical use, and emergency department (ED) visits involving prescription stimulants in the United States. Our aim was to examine these 3 national trends involving dextroamphetamine-amphetamine and methylphenidate in adults and adolescents.Method: Three national surveys conducted between 2006-2011 were used: National Disease and Therapeutic Index, a survey of office-based practices; National Survey on Drug Use and Health, a population survey of substance use; and Drug Abuse Warning Network, a survey of ED visits. Ordinary least squares regression was used to examine temporal changes over time and the associations between the 3 trends.Results: In adolescents, treatment visits involving dextroamphetamine-amphetamine and methylphenidate decreased over time; nonmedical dextroamphetamine-amphetamine use remained stable, while nonmedical methylphenidate use declined by 54.4% in 6 years. ED visits involving either medication remained stable. In adults, treatment visits involving dextroamphetamine-amphetamine remained unchanged, while nonmedical use went up by 67.1% and ED visits went up by 155.9%. These 3 trends involving methylphenidate remained unchanged. Across age groups, the major source for nonmedical use of both medications was a friend or relative; two-thirds of these friends and relatives had obtained the medication from a physician.Conclusions: Trends in prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits. Increased nonmedical stimulant use may not be simply attributed to increased prescribing trends. Future studies should focus on deeper understanding of the proportion of, risk factors for, and motivations for drug diversions. (C) Copyright 2016 Physicians Postgraduate Press, Inc.