A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City.
A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City.
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DOI：
10.1371/journal.pone.0179054
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Elliott L
中科院分区：
文献类型：
--
作者：
Bennett AS;Golub A;Elliott L
根据自我报告的阿片类药物过量风险行为来确定使用阿片类药物的退伍军人的有意义类别。
该研究在纽约市地区招募了218名退伍军人作为样本，这些人在2001年9月11日之后从现役退役，并报告在上个月使用过阿片类药物。使用潜在类别分析（LCA）对包括心理健康、社会压力源、物质使用以及与阿片类药物相关的过量风险行为等测量指标的调查数据进行了分析。
一个五组解决方案具有极佳的拟合分数和可解释性。因子分析证实存在两个主要的变异维度：不依从和海洛因使用。这五个组包括低风险的处方阿片类药物使用者、不依从的处方阿片类药物使用者和海洛因使用者。不依从的处方阿片类药物使用者和海洛因使用者类别都进一步细分为“偶尔”和“经常”使用类别。除了认可更多的过量风险行为外，经常使用类别的使用者更有可能在酒精和物质使用障碍筛查中呈阳性，报告更多为缓解焦虑而自行使用阿片类药物的情况，报告更多身体疼痛问题，更有可能接受过心理健康、酒精和药物治疗，并且更不可能就业或上学。海洛因使用者也更不可能报告有稳定的住房。
研究结果表明，阿片类药物过量风险类别基于与心理、生理和社会适应痛苦及困境经历相关的背景因素，在针对阿片类药物使用者独特的风险行为和共病情况进行定制干预时应考虑这些因素。
To identify meaningful classes of opioid-using military veterans in terms of self-reported opioid overdose risk behaviors. The study recruited a sample of 218 military veterans in the NYC area who were discharged from active duty service after September 11, 2001 and reported past-month opioid use. Survey data including measures of mental health, social stressors, substance use, and opioid-related overdose risk behaviors were analyzed using Latent Class Analysis (LCA). A five group solution had excellent fit scores and interpretability. Factor analysis confirmed the existence of two major dimensions of variation: non-adherence and heroin use. The five groups included lower-risk prescription opioid users, non-adherent prescription opioid users and heroin users. The non-adherent prescription opioid users and heroin user classes were both further subdivided into “occasional” and “regular” use categories. In addition to endorsing a greater number of overdose risk behaviors, users in the regular use classes were more likely to screen positive for alcohol and substance use disorders, reported greater self-medicating opioid use to relieve anxiety, reported greater problems with physical pain, were more likely to have had mental health, alcohol and drug treatment, and were less likely to be employed or in school. Heroin users also were less likely to report stable housing. Findings indicate that opioid overdose risk classes are grounded in contextual factors related to experiences of psychological, physiological, and social adjustment pain and distress which should be addressed in tailored interventions targeting opioid users’ unique constellations of risk behaviors and comorbid conditions.