Alcohol use disorder and motives for prescription opioid misuse: A latent class analysis
Alcohol use disorder and motives for prescription opioid misuse: A latent class analysis
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DOI：
10.1080/10826084.2019.1594904
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发表时间：
2019-05-04
影响因子：
2
通讯作者：
Witkiewitz, Katie
中科院分区：
文献类型：
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作者：
Votaw, Victoria R.;McHugh, R. Kathryn;Witkiewitz, Katie
简介：在滥用处方阿片类药物的患者中，酒精使用障碍（AUD）与阿片类药物使用障碍的进展、过量用药的风险和不良治疗结局相关。然而，对同时发生的AUD和处方阿片类药物滥用知之甚少。物质使用的动机或原因是物质使用开始和维持的重要因素;描述共同的动机可以帮助告知治疗目标。本研究的目的是（1）确定处方阿片类药物滥用的动机模式，（2）检查AUD和动机之间的关联。方法：数据来自2015年全国药物使用和健康调查。分析包括过去一年处方阿片类药物滥用的成年受访者（N = 2，627），其中24.2%的人同时患有AUD。潜在类别分析用于识别处方阿片类药物滥用的动机模式。AUD作为类别成员资格的预测因子。结果：我们确定了三类：（1）疼痛缓解（56.1%的样本），（2）娱乐（例如，获得高; 29.3%），和（3）混合动机（例如，应对、缓解疼痛、娱乐; 14.6%）。与疼痛缓解类相比，AUD与娱乐类（OR = 2.05，95% CI = 1.36，3.10，p = 0.001）和混合动机类（OR = 2.11，95% CI = 1.21，3.67，p = 0.008）成员资格的几率更大相关。结果：在有和没有AUD的患者中，疼痛缓解是阿片类药物滥用最常见的认可动机。这些结果强调了改善滥用处方阿片类药物的患者疼痛管理的必要性。合并AUD的患者也可能受益于针对负面影响和/或积极结局预期的干预措施。
Introduction: Among those who misuse prescription opioids, alcohol use disorder (AUD) is associated with progression to opioid use disorder, risk of overdose, and poor treatment outcomes. However, little is known about co-occurring AUD and prescription opioid misuse. Motives, or reasons, for substance use are important factors in substance use initiation and maintenance; characterizing common motives can help inform treatment targets. The aims of the present study were to (1) identify patterns of motives for prescription opioid misuse, and (2) examine the association between AUD and motives. Methods: Data were extracted from the 2015 National Survey on Drug Use and Health. Analyses included adult respondents with past-year prescription opioid misuse (N = 2,627), of which 24.2% had a co-occurring AUD. Latent class analysis was utilized to identify patterns of motives for prescription opioid misuse. AUD was included as a predictor of class membership. Results: We identified three classes: (1) pain relief (56.1% of the sample), (2) recreational (e.g., to get high; 29.3%), and (3) mixed motives (e.g., coping, pain relief, recreational; 14.6%). AUD was associated with greater odds of membership in the recreational (OR = 2.05, 95% CI = 1.36, 3.10, p = .001) and mixed motives (OR = 2.11, 95% CI = 1.21, 3.67, p = .008) classes, as compared to the pain relief class. Results: Pain relief was the most commonly endorsed motive for opioid misuse among those with and without AUD. These results underscore the need to improve pain management among those who misuse prescription opioids. Those with co-occurring AUD might also benefit from interventions targeting negative affect and/or positive outcome expectancies.