The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence - An assessment of demographic and substance use trends, United States, 2003-2014
The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence - An assessment of demographic and substance use trends, United States, 2003-2014
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DOI：
10.1016/j.addbeh.2016.08.027
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发表时间：
2017-02-01
影响因子：
4.4
通讯作者：
Jones, Christopher M.
中科院分区：
文献类型：
--
作者：
Jones, Christopher M.
背景：与阿片类镇痛药的非医疗使用相关的危害已经影响美国十多年了。研究不同人口统计学和药物使用群体中非医疗使用、滥用和依赖的趋势可以为预防和治疗活动提供重要的见解。使用全国药物使用和健康调查的数据评估2003-2005年、2006-2008年、2009-2011年阿片类镇痛药非医疗使用、滥用和依赖的趋势，2012-2014年。多变量logistic回归用于识别与阿片类镇痛药滥用或依赖相关的特征。结果：过去一年阿片类镇痛药非医疗使用率从2003-2005年的每1000名12岁及以上人群中的48.4人下降至2012-2014年的43.3人。在大多数人口和药物使用群体中都出现了下降。相比之下，过去一年阿片类镇痛剂滥用或依赖率从2003-2005年的每1000人6.0人增加到2012-2014年的7.5人;大多数人口和药物使用群体都有增加。在2012-2014年，阿片类镇痛药滥用或依赖的几率是最高的镇静剂或镇静剂和海洛因滥用或dependence.Conclusions：这些研究结果表明，令人鼓舞的趋势，阿片类镇痛药的整体非医疗使用下降，许多人口和物质使用群体。然而，类阿片镇痛剂滥用率或依赖率的持续上升突出表明，必须继续努力减少不适当的类阿片处方，扩大努力，增加对类阿片使用障碍的药物辅助治疗和心理社会服务，并为个人提供纳洛酮以扭转类阿片过量。由爱思唯尔有限公司发布
Background: The harms related to nonmedical use of opioid analgesics have impacted the United States for more than a decade. Examining trends in nonmedical use, abuse, and dependence among various demographic and substance using groups can provide critical insight for prevention and treatment activities.Methods: Data from the National Survey on Drug Use and Health were used to assess trends in opioid analgesic nonmedical use, abuse, and dependence for 2003-2005, 2006-2008, 2009-2011, and 2012-2014. Multivariable logistic regression was used to identify characteristics associated with opioid analgesic abuse or dependence.Results: Rates of past-year opioid analgesic nonmedical use decreased from 48.4 per 1000 persons aged 12 years and older in 2003-2005 to 43.3 in 2012-2014. Declines were seen among most demographic and substance using groups. In contrast, rates of past-year opioid analgesic abuse or dependence increased from 6.0 per 1000 persons in 2003-2005 to 7.5 in 2012-2014; increases were seen among most demographic and substance using groups. In 2012-2014, odds of opioid analgesic abuse or dependence were highest among those with sedative or tranquilizer and heroin abuse or dependence.Conclusions: These findings indicate encouraging trends in overall nonmedical use of opioid analgesics which declined among many demographic and substance using groups. However, continued increases in rates of opioid analgesic abuse or dependence highlight the critical importance of maintaining efforts to drive down inappropriate opioid prescribing and expanding efforts to increase the provision of medication assisted treatment and psychosocial services for opioid use disorders and equipping individuals with naloxone to reverse opioid overdose. Published by Elsevier Ltd.