Unintentional drug overdose: Is more frequent use of non-prescribed buprenorphine associated with lower risk of overdose?
Unintentional drug overdose: Is more frequent use of non-prescribed buprenorphine associated with lower risk of overdose?
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DOI：
10.1016/j.drugpo.2020.102722
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发表时间：
2020-04-17
影响因子：
4.4
通讯作者：
Martins, Silvia S.
中科院分区：
文献类型：
--
作者：
Carlson, Robert G.;Daniulaityte, Raminta;Silverstein, Sydney M.;Nahhas, Ramzi W.;Martins, Silvia S.
在美国，非故意药物过量已经达到流行水平。这项研究检验了一种假设，即在过去六个月内更频繁地使用非处方药丁丙诺啡的人在同一时期经历药物过量的可能性较小。18岁或18岁以上患有阿片类药物使用障碍的参与者是从俄亥俄州代顿地区招募的，他们报告在过去六个月中使用了非处方药丁丙诺啡，采用了靶向抽样和修改后的受访者驱动抽样相结合的方法。参与者在知情同意后完成了结构化访谈，包括六个月的时间线回访。采用Logistic回归分析非处方丁丙诺啡使用频率(对数转换)与前6个月过量用药之间的关系，调整了性别、无家可归、监禁、药物使用治疗、既往过量用药、海洛因/芬太尼注射、精神疾病和其他(非阿片类)药物使用(对数转换)频率。在356名参与者中，近89%的人是白人，50.3%的人是男性，78.1%的人受过高中或以上教育。超过27%(n=98)的人报告在过去六个月中经历过过量用药。调整混杂因素后，非处方丁丙诺啡使用频率越高，过量用药风险越低(AOR=0.81，95%CI=0.66，0.98；p=.0286)。多因素分析显示，6个月前服药过量(AOR=2.19，95%CI=1.24，3.97)、注射海洛因/芬太尼(AOR=2.49，95%CI=1.36，4.71)和甲基苯丙胺使用频度(AOR=1.13，95%CI=1.02，1.27)与近期服药过量的危险性显著相关。这些发现支持了我们的假设，即非处方药丁丙诺啡使用频率越高，药物过量的风险越低，药物过量是转移的潜在危害减少后果。迫切需要通过标准的物质使用障碍治疗、初级保健和其他创新方法来提高丁丙诺啡的可获得性。
Unintentional drug overdoses have reached epidemic levels in the U.S. This study tests the hypothesis that people who have used non-prescribed buprenorphine more frequently in the past six months were less likely to experience a drug overdose during that same time period. Participants age 18 years or older with opioid use disorder who reported use of non-prescribed buprenorphine in the last six months were recruited from the Dayton, Ohio, area using a combination of targeted and modified respondent-driven sampling. Participants completed a structured interview, including six-month timeline follow-back, after informed consent. Logistic regression was used to test the association between (log-transformed) frequency of non-prescribed buprenorphine use and overdose in the previous six months, adjusted for confounding due to sex, homelessness, incarceration, substance use treatment, previous overdose, heroin/fentanyl injection, psychiatric comorbidity, and (log-transformed) frequencies of other (non-opioid) drug use. Almost 89% of 356 participants were white, 50.3% were male, and 78.1% had high school or greater education. Over 27% (n=98) reported experiencing an overdose in the past six months. After adjusting for confounding, greater frequency of non-prescribed buprenorphine use was significantly associated with lower risk of overdose (AOR=0.81, 95% CI=0.66, 0.98; p=.0286). Experiencing an overdose more than six months ago (AOR=2.19, 95% CI=1.24, 3.97); injection as the most common route of administration of heroin/fentanyl (AOR=2.49, 95% CI=1.36, 4.71); and frequency of methamphetamine use (AOR=1.13, 95% CI=1.02, 1.27) were strongly associated with increased risk of recent overdose in multivariable analysis. The findings support our hypothesis that higher frequency of non-prescribed buprenorphine use is associated with lower risk of drug overdose, a potential harm reduction consequence of diversion. Improving the availability of buprenorphine though standard substance use disorder treatment, primary care, and other innovative methods is urgently needed.
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DOI：
10.15288/jsa.2004.65.774
发表时间：
2004-11-01
期刊：
JOURNAL OF STUDIES ON ALCOHOL
影响因子：
--
作者：
Carey, KB;Carey, MP;Henson, JM
通讯作者：
Henson, JM
影响因子：
4.2
作者：
Compton WM;Dawson DA;Goldstein RB;Grant BF
通讯作者：
Grant BF
影响因子：
4.2
作者：
Caudarella, Alexander;Dong, Huiru;Hayashi, Kanna
通讯作者：
Hayashi, Kanna
影响因子：
6
作者：
Coffin, PO;Galea, S;Tardiff, K
通讯作者：
Tardiff, K
影响因子：
5.5
作者：
Carroll, Jennifer J.;Rich, Josiah D.;Green, Traci C.
通讯作者：
Green, Traci C.