Incidence and antecedents of nonmedical prescription opioid use in four US communities - The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study
Incidence and antecedents of nonmedical prescription opioid use in four US communities - The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study
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DOI：
10.1016/j.drugalcdep.2006.04.011
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发表时间：
2006-11-08
影响因子：
4.2
通讯作者：
Hulley, Stephen B.
中科院分区：
文献类型：
--
作者：
Pletcher, Mark J.;Kertesz, Stefan G.;Hulley, Stephen B.
背景：在过去的十年里，处方阿片类药物的非医疗使用已经成为一个主要的公共卫生问题，但缺乏对发病率和诱因的直接测量。方法：我们在青年冠状动脉风险发展研究中前瞻性地测量了28-40岁的非洲裔和欧洲裔美国男性和女性的非医疗类阿片类药物使用的发生率和前置因素，这些人以前没有非医疗类阿片类药物的使用史。结果：在3163名参与者中，23人报告了2000-2001年新的非药物处方阿片类药物使用(5年发生率0.7%；95%可信区间：0.4%-1.0%)。所有23人之前都曾报告使用过大麻(P<；0.001)。在欧洲裔美国男性(OR=3.3；95%CI：1.3-8.3)以及报告苯丙胺使用史(OR=24；95%CI：6.9-83)或医用阿片类药物治疗疼痛(OR=8.6；95%CI：2.5-30)的参与者中，5年发病率显著更高。当在大麻使用者中进行检查并根据人口统计、社会因素和其他既往物质使用情况进行调整后，这些关联仍然很强。安非他明的使用是预测未来非医疗使用的最好单一因素(敏感度87%，特异度79%)。结论：在28-40岁的成年人中，非医疗处方阿片类药物的开始使用通常很少见，但观察到更常见的是有药物滥用史和医生通过处方合法获得阿片类药物的情况。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Nonmedical use of prescription opioids has emerged as a major public health problem during the last decade, but direct measures of incidence and predisposing factors are lacking.Methods: We prospectively measured incidence and antecedents of nonmedical prescription opioid use in The Coronary Artery Risk Development in Young Adults study among 28-40-year-old African- and European-American men and women with no prior history of nonmedical opioid use. Results: Among 3163 participants, 23 reported new nonmedical prescription opioid use in 2000-2001 (5-year incidence 0.7%; 95%CI: 0.4-1.0%). All 23 had previously reported marijuana use (p < 0.001). Five-year incidence was significantly higher among European-American men (OR=3.3; 95%CI: 1.3-8.3), and among participants reporting a history of amphetamine use (OR=24; 95%Cl: 6.9-83) or medical opioid use for treatment of pain (OR=8.6; 95%Cl: 2.5-30). These associations remained strong when examined among marijuana users and after adjusting for demographics, social factors, and other antecedent substance use. Amphetamine use was the best single predictor of future nonmedical use (sensitivity 87%, specificity 79%).Conclusions: Initiation of nonmedical prescription opioid use is generally rare in 28-40-year-old adults, but is observed to be more common with a previous history of substance abuse and legal access to opioids through prescription by a physician. (c) 2006 Elsevier Ireland Ltd. All rights reserved.