Reported lifetime aberrant drug-taking behaviors are predictive of current substance use and mental health problems in primary care patients.
Reported lifetime aberrant drug-taking behaviors are predictive of current substance use and mental health problems in primary care patients.
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据报道，终身异常吸毒行为可预测初级保健患者当前的药物使用和心理健康问题。
DOI：
10.1111/j.1526-4637.2008.00491.x
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发表时间：
2008-11
期刊：
影响因子：
--
通讯作者：
Passik SD
中科院分区：
文献类型：
--
作者：
Fleming MF;Davis J;Passik SD
The aim of this report is to determine the frequency of aberrant drug behaviors and their relationship substance abuse disorders in a large primary sample of patients receiving opioids for chronic pain. The data utilized for this report was obtained from 904 chronic pain patients receiving opioid therapy from their primary care physician. A questionnaire was developed based on 12 aberrant drug behaviors reported in the clinical literature. The diagnosis of a current substance use disorder was determined using DSM-IV criteria. The average duration of chronic pain in the sample was 16 years, and for opioid therapy 6.4 years. 80.5% of the sample reported one or more lifetime aberrant drug behaviors. The most frequent behaviors reported included early refills (41.7%), increase dose without physician consent (35.7%) and felt intoxicated from opioids (32.2%). Only 1.1% of subjects with 1-3 aberrant behaviors (n=464, 51.2%) met DSM-IV criteria for current opioid dependence compared to 9.9% of patients with 4 or more behaviors (n=264, 29.3%). Persons with a positive urine toxicology tests for cocaine were 14 times more likely to report 4 or more behaviors than no behaviors (14.1% v.s.1.1%). A logistic model found that subjects who reported four or more aberrant behaviors were more likely to have a current substance use disorder (OR 10.14; 3.72, 27.64), a positive test for cocaine (OR 3.01; 1.74, 15.4), an ASI psychiatric composite score >0.5 (OR 2.38; 1.65, 3.44), male gender (OR 2.08: 1.48, 2.92) and older age (OR 0.69; 0.59, 0.81) compared to subjects with three or fewer behaviors. Pain levels, employment status and morphine equivalent dose do not enter the model. Patients who report 4 or more aberrant drug behaviors are associated with a current substance use disorder and illicit drug use, whereas subjects with up to 3 aberrant behaviors have a very low probability of a current substance abuse disorder. Four behaviors - over sedated oneself, felt intoxicated, early refills, increase dose on own – appear useful as a screening questions to predict patients at greatest risk for a current substance use disorders.
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影响因子：
4.7
作者：
Akbik, Hammam;Butler, Stephen F.;Jamison, Robert N.
通讯作者：
Jamison, Robert N.
影响因子：
3.2
作者：
Passik, SD;Kirsh, KL;Schein, JR
通讯作者：
Schein, JR
影响因子：
2.1
作者：
Todd, KH
通讯作者：
Todd, KH
影响因子：
--
作者：
Fleming, Sara;Rabago, David P;Mundt, Marlon P;Fleming, Michael F
通讯作者：
Fleming, Michael F
影响因子：
3.7
作者：
Schnoll, SH;Weaver, MF
通讯作者：
Weaver, MF