Transitions in Illicit Drug Use Status Over 3 Years: A Prospective Analysis of a General Population Sample
Transitions in Illicit Drug Use Status Over 3 Years: A Prospective Analysis of a General Population Sample
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DOI：
10.1176/appi.ajp.2012.12060737
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发表时间：
2013-06-01
影响因子：
17.7
通讯作者：
Grant, Bridget F.
中科院分区：
文献类型：
--
作者：
Compton, Wilson M.;Dawson, Deborah A.;Grant, Bridget F.
目的：作者研究了美国成年人在一般家庭人口中不使用、无症状使用和问题使用非法药物之间的3年过渡。方法：数据来自具有全国代表性的全国酒精和相关疾病流行病学调查，该研究对34，653名成年人进行了两次访谈，间隔3.5年。受访者被分为三个相互排斥的基线药物状态类别：过去一年的非使用者（N= 32，675），过去一年的无症状吸毒者（N=861）和过去一年的有症状吸毒者（N= 1，117）。症状性药物使用或问题使用定义为存在一种或多种符合DSM-IV药物滥用和依赖标准的症状。作者评估了社会人口统计学，健康，物质使用和精神病学协变量与3年的过渡到不同的状态category.Results：在基线的非用户，95.4%继续在后续的非用户，2.1%成为无症状的用户，和2.5%开发的问题使用。在基线无症状使用者中，66.6%在随访时已停止使用药物，14.3%继续为无症状使用者，19.1%出现问题使用。在基线时有问题使用的患者中，近一半（49.0%）在随访时停止使用药物，10.9%转为无症状使用，40.1%继续有问题使用。年龄较小、男性、白色种族和未婚与从不使用到使用或问题使用的进展相关，酒精和烟草使用和障碍、重度抑郁症、典型性、边缘性和自恋型人格障碍也是如此。惊恐障碍和回避型人格障碍与进展较少有关。结论：药物使用状态的转变是常见的。酒精和烟草的变量和共同发生的精神病理学是重要的过渡相关的发现表明，在患者评估和治疗计划中解决所有共同发生的疾病和物质使用的价值，以防止不利的过渡，促进积极的过渡。
Objective: The authors examined 3-year transitions among nonuse, asymptomatic use, and problem use of illicit drugs for U.S. adults in the general household population.Method: Data were from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, a study of 34,653 adults interviewed twice, 3.years apart. Respondents were categorized on three mutually exclusive categories of baseline drug status: past-year nonusers (N=32,675), past-year asymptomatic drug users (N=861), and past-year symptomatic drug users (N=1,117). Symptomatic drug use, or problem use, was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. The authors assessed sociodemographic, health, substance use, and psychiatric covariates for association with 3-year transitions to different status categories.Results: Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed problem use. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users, and 19.1% had developed problem use. Nearly half (49.0%) of those with problem use at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use, and 40.1% continued to have problem use. Younger age, male sex, white race, and not being married were associated with progression from nonuse to use or problem use, as were alcohol and tobacco use and disorders, major depression, and schizotypal, borderline, and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with, less progression.Conclusions: Transitions in drug use status are common. The finding that alcohol and tobacco variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both to prevent adverse transitions and to promote positive transitions.