Co-morbid pain and psychopathology in males and females admitted to treatment for opioid analgesic abuse
Co-morbid pain and psychopathology in males and females admitted to treatment for opioid analgesic abuse
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DOI：
10.1016/j.pain.2008.03.021
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发表时间：
2008-09-30
期刊：
影响因子：
7.4
通讯作者：
Surratt, Hilary L.
中科院分区：
文献类型：
--
作者：
Cicero, Theodore J.;Lynskey, Michael;Surratt, Hilary L.
本研究的目的是确定进入阿片类药物滥用治疗的男性和女性的全国样本（N = 1408）中的共病。我们的样本主要是白色，居住在小城市，郊区或农村地区（80%），受过良好教育。慢性疼痛是所有受试者中超过60%的症状特征。此外，79%的男性和85%的女性处方阿片类药物滥用者表示，他们第一次接触阿片类药物是合法的止痛处方，随后导致60-70%的滥用者吸毒。我们的数据还表明，使用处方阿片类药物来获得高代表了药物滥用连续体的结束阶段，从很小的年龄开始。处方阿片类药物滥用者/滥用者首次使用酒精、醉酒、吸烟、使用大麻、兴奋剂和其他非阿片类处方药或非法药物的年龄很早（13-19岁），他们首次使用阿片类药物平均要到22岁。最后，大多数抽样者在完成调查的治疗入院之前曾因药物滥用寻求过3次或3次以上的治疗。男性和女性处方阿片类药物滥用者的身心健康状况都很差，但女性在所有身体领域，特别是情感领域的疾病和功能障碍比男性更多。我们的研究结果表明，少数“处于危险中”的阿片类药物初治疼痛患者，他们可能滥用其治疗上适当的阿片类镇痛药，可以通过评估前和共病药物滥用和显着的精神病理学。2008年国际疼痛研究协会（International Association for the Study of Pain）Elsevier B. V.出版，保留所有权利。
The purpose of this study was to identify co-morbidity in a national sample (N = 1408) of males and females entering treatment for opioid abuse. Our sample was primarily white, lived in small urban, suburban or rural locations (80%,), and was well-educated. Chronic pain was a symptomatic feature in over 60% of all Subjects. Furthermore, 79% of male and 85% of female prescription opioid abusers indicated that their first exposure to an opioid was a legitimate prescription for pain which Subsequently led 60-70% to misuse to get high. Our data also indicate that the use of prescription opioids to get high represents the end stage on a continuum of substance abuse, beginning at a very early age. The age of first alcohol use, getting drunk, smoking, use of marijuana, stimulants and other non-opioid prescription or illicit drugs occurred very early (13-19) in prescription opioid misusers/abusers, whose first use of opioids did not occur, on average, until age 22. Finally, most of the sample had sought treatment 3 or more times for substance abuse prior to the treatment admission in which the survey was completed. Physical and mental health were very poor in both male and female prescription opioid abusers, but females were more ill and dysfunctional than males in all physical and particularly emotional domains. Our results suggest that a small number of "at risk" opioid naive pain patients, who might abuse their therapeutically appropriate opioid analgesics, can be identified by assessing pre- and co-morbid substance abuse and significant psychopathology. (C)2008 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.