Promethazine misuse among methadone maintenance patients and community-based injection drug users.
Promethazine misuse among methadone maintenance patients and community-based injection drug users.
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DOI：
10.1097/adm.0b013e31827f9b43
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发表时间：
2013-03
影响因子：
5.5
通讯作者：
Kral AH
中科院分区：
文献类型：
--
作者：
Shapiro BJ;Lynch KL;Toochinda T;Lutnick A;Cheng HY;Kral AH
据报道，异丙嗪在多种情况下与阿片类药物一起被滥用。异丙嗪本身或与阿片类药物一起滥用可能会对健康产生严重的不良影响。迄今为止，尚未报告异丙嗪非医疗用途的流行率数据。本研究调查了美国加利福尼亚州旧金山两个不同人群中异丙嗪使用的流行率和相关性：美沙酮维持诊所患者和社区注射吸毒者 (IDU)。我们分析了尿液样本中是否存在异丙嗪，并审查了县美沙酮诊所 334 名美沙酮维持治疗患者的临床记录。另外，我们采用有针对性的抽样方法招募并调查了 139 名社区阿片类药物注射者使用异丙嗪的情况。我们通过双变量和多变量统计评估了与异丙嗪使用相关的患病率和因素。美沙酮维持治疗患者尿样异丙嗪阳性率为 26%。只有 15% 的异丙嗪阳性患者拥有有效的异丙嗪处方。在社区调查中报告注射阿片类药物的注射吸毒者中，17% 的人报告在过去一个月内使用过异丙嗪；据报告参加美沙酮治疗的注射吸毒者中，有 24% 的人在过去一个月内使用过异丙嗪。诊所或社区环境中招募的四分之一的美沙酮维持患者最近使用过异丙嗪，这一发现提供了令人信服的证据，证明异丙嗪在该患者群体中具有显着的非医疗用途。需要进一步研究以确定异丙嗪非医疗用途的程度和性质。
Promethazine has been reported to be misused in conjunction with opioids in several settings. Promethazine misuse by itself or in conjunction with opioids may have serious adverse health effects. To date, no prevalence data for the nonmedical use of promethazine has been reported. This study examines the prevalence and correlates of promethazine use in two different populations in San Francisco, California, USA: methadone maintenance clinic patients and community-based injection drug users (IDUs). We analyzed urine samples for the presence of promethazine and reviewed the clinical records for 334 methadone maintenance patients at the county methadone clinic. Separately, we used targeted sampling methods to recruit and survey 139 community-based opioid IDUs about their use of promethazine. We assessed prevalence and factors associated with promethazine use with bivariate and multivariate statistics. The prevalence of promethazine positive urine samples among the methadone maintenance patients was 26 percent. Only 15 percent of promethazine positive patients had an active prescription for promethazine. Among IDUs reporting injection of opiates in the community-based survey, 17 percent reported having used promethazine in the past month; 24 percent of the IDUs who reported being enrolled in methadone treatment reported using promethazine in the past month. The finding that one quarter of methadone maintenance patients in a clinic or recruited in community settings have recently used promethazine provides compelling evidence of significant nonmedical use of promethazine in this patient population. Further research is needed to establish the extent and nature of nonmedical use of promethazine.