Correlates of Opioid Use in Adults With Self-Reported Drug Use Recruited From Public Safety-Net Primary Care Clinics.
Correlates of Opioid Use in Adults With Self-Reported Drug Use Recruited From Public Safety-Net Primary Care Clinics.
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DOI：
10.1097/adm.0000000000000151
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发表时间：
2015-09
影响因子：
5.5
通讯作者：
Roy-Byrne P
中科院分区：
文献类型：
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作者：
Ries R;Krupski A;West II;Maynard C;Bumgardner K;Donovan D;Dunn C;Roy-Byrne P
本研究的目的是比较使用或不使用阿片类药物的药物使用安全网初级保健患者的人口统计学，临床和生存特征，并检查我们的研究结果的治疗意义。样本包括868名在研究入组前90天内报告非法药物使用的成年人，其中396人（45.6%）是阿片类药物使用者。多项措施表明，作为一个群体，类阿片使用者的身体和精神健康状况不如不赞同使用类阿片的吸毒者，并且是医疗服务的重度使用者（例如，急诊室、住院医院、门诊医疗），花费相当大的公共开支。在调整年龄后，他们在研究入组后1至5年内死亡的可能性是非阿片类药物使用者的2.61倍（CI，1.48-4.61），并且更有可能死于意外中毒。亚组分析表明，使用任何非处方阿片类药物的患者有更严重的药物问题，包括更多的静脉注射药物使用和更大的艾滋病毒风险比仅按规定使用阿片类药物的患者。类阿片的使用比在初级保健环境中出现的非法药物使用更加严重。阿片类药物使用者可能受益于纳入其初级保健环境的精神病和成瘾护理，纳洛酮过量预防套件以及清洁针头交换等预防工作。成瘾或初级保健提供者在促进这类患者的改变方面处于关键地位，特别是第三个或更多阿片类药物使用者，其目标是戒毒。
The purpose of this study was to compare demographic, clinical, and survival characteristics of drug-using safety-net primary care patients who used or did not use opioids, and to examine treatment implications of our findings. The sample consisted of 868 adults who reported illicit drug use in the 90 days prior to study enrollment, 396 (45.6%) of whom were opioid users. Multiple measures indicated that, as a group, opioid users were less physically and psychiatrically healthy than drug users who did not endorse using opioids, and were heavy users of medical services (e.g., emergency departments, inpatient hospitals, outpatient medical) at considerable public expense. After adjusting for age, they were 2.61 (CI, 1.48-4.61) times more likely to die in the 1 to 5 years after study enrollment and more likely to die from accidental poisoning than non-opioid users. Subgroup analyses suggested patients using any non-prescribed opioids had more serious drug problems including more intravenous drug use and greater HIV risk than patients using opioids only as prescribed. Use of opioids adds a dimension of severity over and above illicit drug use as it presents in the primary care setting. Opioid users may benefit from psychiatric and addiction care integrated into their primary care setting, naloxone overdose prevention kits, and prevention efforts such as clean needle exchanges. Addiction or primary care providers are in a key position to facilitate change among such patients, especially the third or more opioid users having a goal of abstinence from drugs.