Trends in Opioid Misuse Among Individuals Aged 12 to 21 Years in the US.
Trends in Opioid Misuse Among Individuals Aged 12 to 21 Years in the US.
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DOI：
10.1001/jamanetworkopen.2023.16276
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发表时间：
2023-06-01
影响因子：
13.8
通讯作者：
Bobashev, Georgiy
中科院分区：
文献类型：
--
作者：
Warren, Lauren Klein;Adams, Joella;Bobashev, Georgiy
从2002年到2019年，美国出生队列的青年和年轻人阿片类药物滥用流行率轨迹如何变化？在这项涉及114412名参与者的横断面研究中，基于2002年，2005年，2008年，2011年和2014年开始的横断面伪队列，青少年和年轻人阿片类药物滥用的轨迹有所改善。最值得注意的是，在高中期间，后来的伪队列有较低的起始患病率，并且随着年龄的增长，患病率的上升幅度较小。这些研究结果描述了阿片类药物滥用的伪队列患病率，包括最近伪队列中高中时期阿片类药物滥用的减少，可以深入了解影响美国家庭人口中青少年和年轻人药物使用趋势的行为。这项横断面研究使用全国药物使用和健康调查数据，以确定2002年至2019年美国青少年和年轻人滥用阿片类药物的趋势。尽管近年来美国青少年滥用阿片类药物的情况有所减少，但目前尚不清楚是什么导致了这一趋势，以及这一趋势如何随年龄组和性别而变化。确定不同年龄、出生队列和性别的青少年和年轻人滥用阿片类药物的趋势。横断面全国药物使用和健康调查（NSDUH）的公共使用文件被用来产生全国代表性的伪队列。调查人群包括美国50个州和华盛顿特区的平民。没有固定地址的个人和被收容的个人被排除在外。NSDUH的受访者是使用分层聚类设计选择的基于人口的样本。对于分析的年份（2002年1月1日至2019年12月31日）和年龄（12-21岁），样本量从1607到3239名受访者不等。分析了2022年1月1日至2023年4月12日的数据，按年龄、性别和伪队列分析了主要结局。受访者被问及他们在过去一年中是否滥用处方阿片类药物或使用海洛因。在数据收集后，制定并检验了分析假设。在总共5个伪队列中，分析了114412名年龄在12至21岁之间的受访者的数据;男性（补充为女性）的未加权分布范围为47.7%至52.6%（平均值[SD]，50.6% [1.1%]）。应答率范围为45.8%至71.3%。与早期相比，高中年龄的青年和年轻人在后期伪队列中阿片类药物滥用率明显较低。2002年，16岁人群的误用率比2008年高2.80%（95% CI，1.06%-4.54%）; 2002年，18岁人群的误用率比2008年高4.36%（95% CI，1.85%-6.87%）。同样，2008年16岁人群的滥用率比2014年高3.93%（95%CI，2.15%-5.71%）; 2008年17岁人群的滥用率高3.41%（95%CI，1.94%-4.88%）。按性别观察到类似的模式。在早期队列中，年轻女性参与者的阿片类药物滥用率高于男性参与者，老年男性参与者的阿片类药物滥用率高于女性参与者。性别差异在后来的队列中减少。这项针对美国青少年和年轻人的横断面研究的结果表明，高中年龄的人在后来的伪队列中总体和性别滥用阿片类药物的情况一直较少。阿片类药物使用率的性别差异在后来的伪队列中也有所减少。药物供应的减少和阿片类药物使用危害的普遍暴露可能有助于这些发现。未来计划使用这种伪队列方法的研究将检查多种物质的使用，并评估物质使用如何与其他社会人口特征不同。
How have opioid misuse prevalence trajectories changed for youths and young adults by birth cohorts in the US from 2002 to 2019? In this cross-sectional study of 114 412 participants, the trajectories of opioid misuse in youths and young adults improved based on cross-sectional pseudocohorts beginning in 2002, 2005, 2008, 2011, and 2014. Most notably, during high school years, later pseudocohorts had lower starting prevalence rates, and the rates increased less sharply with age. These findings describing pseudocohort prevalence rates for opioid misuse, including a decrease in opioid misuse in high school years in recent pseudocohorts, may provide insight into behaviors that affect drug use trends among youths and young adults in the US household population. This cross-sectional study uses National Survey on Drug Use and Health data to identify trends in opioid misuse among US youths and young adults from 2002 to 2019. Although opioid misuse has been decreasing among US youths and adolescents in recent years, it is unclear what has contributed to this trend and how this trend differs by age group and sex over time. To identify trends in opioid misuse among youths and young adults across and between ages, birth cohorts, and sexes. Cross-sectional National Survey on Drug Use and Health (NSDUH) public-use files were used to produce nationally representative pseudocohorts. The survey population includes the civilian US population in the 50 states and Washington, DC. Individuals without a fixed address and institutionalized individuals were excluded. Respondents to the NSDUH are a population-based sample selected using a stratified cluster design. For the years (January 1, 2002, to December 31, 2019) and ages (12-21 years) analyzed, the sample sizes ranged from 1607 to 3239 respondents. Data were analyzed from January 1, 2022, to April 12, 2023, for the main outcome by age, sex, and pseudocohort. Respondents were asked whether they misused prescription opioids or used heroin in the past year. The analysis hypotheses were formulated and tested after data collection. In a total of 5 pseudocohorts, data from 114 412 respondents aged 12 to 21 years were analyzed; the unweighted distribution of male sex (complement was female) ranged from 47.7% to 52.6% (mean [SD], 50.6% [1.1%]). Response rates ranged from 45.8% to 71.3%. High school–aged youths and young adults had distinctly lower rates of opioid misuse in later pseudocohorts compared with earlier ones. Rates of misuse among individuals aged 16 years were 2.80% (95% CI, 1.06%-4.54%) higher in 2002 vs 2008; among those aged 18 years, rates were 4.36% (95% CI, 1.85%-6.87%) higher in 2002. Similarly, rates of misuse among individuals aged 16 years were 3.93% (95% CI, 2.15%-5.71%) higher in 2008 vs 2014; among those aged 17 years, rates were 3.41% (95% CI, 1.94%-4.88%) higher in 2008. Similar patterns were observed by sex. In earlier cohorts, younger female participants had higher rates of opioid misuse than their male counterparts and older male participants had higher rates than their female counterparts. Sex differences decreased in later cohorts. The findings of this cross-sectional study of US youths and young adults suggest that high school–aged individuals consistently misused fewer opioids in later pseudocohorts overall and by sex. Sex differences in opioid rates also diminished in later pseudocohorts. A decrease in drug availability and general exposure to the harms of opioid use could be contributing to these findings. Future planned research using this pseudocohort approach will examine polysubstance use and evaluate how substance use differs by other sociodemographic characteristics.
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影响因子：
--
作者：
Swendsen, Joel;Burstein, Marcy;Case, Brady;Conway, Kevin P.;Dierker, Lisa;He, Jianping;Merikangas, Kathleen R.
通讯作者：
Merikangas, Kathleen R.
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Martins, Silvia S.
DOI：
10.3390/ijerph19148883
发表时间：
2022-07-21
影响因子：
--
作者：
Vo, Anh Truc;Patton, Thomas;Peacock, Amy;Larney, Sarah;Borquez, Annick
通讯作者：
Borquez, Annick
影响因子：
8
作者：
Miech, Richard;Johnston, Lloyd;Heard, Kennon
通讯作者：
Heard, Kennon