Racial/ethnic differences in prescription opioid misuse and heroin use among a national sample, 1999-2018.
Racial/ethnic differences in prescription opioid misuse and heroin use among a national sample, 1999-2018.
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DOI：
10.1016/j.drugalcdep.2021.108588
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发表时间：
2021-04-01
影响因子：
4.2
通讯作者：
Wong EC
中科院分区：
文献类型：
--
作者：
Schuler MS;Schell TL;Wong EC
为了说明过去一年处方阿片类药物滥用和海洛因使用的种族/族裔差异，对1,117,086名12岁及以上个人的数据来自1999-2018年全国药物使用与健康调查。我们比较了6个种族/民族的处方阿片类药物滥用分析和4个种族/民族的海洛因分析的相对患病率。报告了5个时期(1999-2002年、2003-2006年、2007-2010年、2011-2014年、2015-2018年)未经调整和经性别和年龄调整的患病率。使用具有稳健方差的调查加权泊松回归模型来估计按种族/民族划分的风险比，并检验时间趋势。在所有时期，非西班牙裔白人个人的处方阿片类药物滥用明显高于黑人、西班牙裔和亚洲人，但在每个时期美国原住民中最高。白人与西班牙裔和亚裔个体之间的相对差异随着时间的推移显著扩大，而黑人和白人个体之间的差距显著缩小。在研究的早期，海洛因的使用率在黑人和西班牙裔个人中最高。白人个人的海洛因使用量在2007-2010年首次超过所有其他群体，并继续稳步增长，从1999-2002年到2015-2018年翻了一番以上。虽然海洛因在所有种族/族裔群体中的使用率都有所上升，但在过去20年中，海洛因使用的人口结构发生了显著变化，以至于现在白人中的流行率最高。阿片类药物预防和治疗举措既应了解海洛因使用人口结构的变化情况，又应设法减少与阿片类药物有关的危害，并公平地扩大所有种族/族裔群体的治疗机会。
To characterize racial/ethnic differences in past-year prescription opioid misuse and heroin use Data on 1,117,086 individuals age 12 and older were from the 1999–2018 National Survey on Drug Use and Health. We compared relative prevalences across 6 racial/ethnic groups for prescription opioid misuse analyses and 4 racial/ethnic groups for heroin analyses. Unadjusted and gender- and age-adjusted prevalences are reported for 5 time periods (1999–2002, 2003–2006, 2007–2010, 2011–2014, 2015–2018). Survey-weighted Poisson regression models with robust variance were used to estimate risk ratios by race/ethnicity and to test for time trends. Prescription opioid misuse was significantly higher among non-Hispanic White individuals than among Black, Hispanic, and Asian individuals across all time periods, yet was highest among Native American individuals in every time period. The relative difference between White and both Hispanic and Asian individuals significantly widened over time, whereas the gap between Black and White individuals significantly decreased. Early in the study period, heroin use was highest among Black and Hispanic individuals. Heroin use among White individuals first surpassed all other groups in 2007–2010 and continued to steadily increase, more than doubling from 1999–2002 to 2015–2018. While heroin use has risen among all racial/ethnic groups, the demographics of heroin use have changed significantly in the past two decades such that prevalence is now highest among White individuals. Opioid prevention and treatment initiatives should both be informed by the changing demographics of heroin use and seek to reduce opioid-related harms and expand treatment access equitably for all racial/ethnic groups.
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