Measuring polysubstance use over the life course: implications for multilevel interventions.
Measuring polysubstance use over the life course: implications for multilevel interventions.
复制标题
测量生命过程中多物质的使用：对多层次干预的影响。
DOI：
10.1016/s2215-0366(19)30328-1
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Mauro,PiaM
中科院分区：
文献类型：
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作者：
Philbin,MorganM;Mauro,PiaM
自2000年以来，类阿片、兴奋剂和镇静剂或安定剂等处方药的非医疗使用大幅增加。1与美国其他年龄组相比，年轻人（18-25岁）报告过去一年非医疗使用处方药的患病率最高（15.3%），2过去一个月酗酒（36.9%），2或过去一个月非法使用药物（24.2%）。2过去一年中使用多种物质在年轻人中也很常见，3这增加了他们产生负面后果的风险，包括物质使用障碍和过量。4，5虽然测量多物质在方法上具有挑战性，但3种潜在变量方法提供了一个了解异质性使用模式的机会。Sean McCabe和同事6进行了一项潜在的个人资料分析，以探索年轻人非医疗使用处方药的轨迹的纵向模式和驱动因素，以及它们与生活中多种物质使用的关系。课程视角作者随访了一个年龄在18岁至35岁之间的美国队列（n= 51223），并根据处方药（处方镇静剂或安定剂、阿片类药物、兴奋剂或处方药的任何非医疗使用）的非医疗使用频率峰值的年龄确定了5个轨迹。6个轨迹包括“罕见滥用”，约占样本的75%，另外4个轨迹按高峰使用年龄从18岁到35岁进行区分。35岁时的结局包括物质使用障碍、酒精和大麻使用障碍以及阿片类药物或其他药物使用障碍，这些障碍包括除酒精和大麻外的所有物质使用障碍。处于非医疗使用处方药的四个轨迹中而不是“罕见误用”轨迹与35岁时报告两种或更多种物质使用障碍症状相关：最强的相关性发生在峰值较晚的个体中（例如，年龄27-28岁;校正比值比5.08 [95%CI 4.17 - 6.19]; p<0.0001）。与晚高峰年龄轨迹相关的因素包括物质使用（酒精，香烟和大麻使用），白色种族和未完成大学学业。
Non-medical use of prescription drugs, such as opioids, stimulants, and sedatives or tranquilisers, has increased substantially since 2000. 1 Compared to other age groups in the USA, young adults (aged 18–25 years) report the highest prevalence of non-medical use of prescription drugs in the past year (15· 3%), 2 binge drinking in the past month (36· 9%), 2 or illicit drug use in the past month (24· 2%). 2 Polysubstance use in the past year is also common in young adults, 3 which increases their risks for negative consequences, including substance use disorder and overdose. 4, 5 Although measuring polysubstance can be methodologically challenging, 3 latent variable approaches provide an opportunity to understand heterogeneous patterns of use.In their multicohort study in The Lancet Psychiatry, Sean McCabe and colleagues6 did a latent profile analysis to explore longitudinal patterns and drivers of young adults’ trajectories of non-medical use of prescription drugs and their relationship to polysubstance use from a life-course perspective. The authors followed up a US-based cohort (n= 51 223) from ages 18 years to 35 years and identified five trajectories based on the age of peak frequency of non-medical use of prescription drugs (prescription sedatives or tranquilisers, opioids, stimulants, or any non-medical use of prescription drugs). 6 Trajectories included “rare misuse”, which comprised approximately 75% of the sample, and four others differentiated by age of peak use from age 18 years to 35 years. Outcomes at age 35 years included substance use disorder, alcohol and cannabis use disorder, and opioid or other drug use disorders, which captured all substance use disorders besides alcohol and cannabis. Being in the four trajectories for non-medical use of prescription drugs other than the “rare misuse” trajectory was associated with reporting two or more substance use disorder symptoms at age 35 years: the strongest association was among individuals with later peaks (eg, ages 27–28 years; adjusted odds ratio 5· 08 [95% CI 4· 17–6· 19]; p< 0· 0001). Factors associated with a later peak age trajectory included substance use (alcohol, cigarettes, and cannabis use), white race, and not completing university.