Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study
Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study
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DOI：
10.1111/j.1360-0443.2007.02015.x
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发表时间：
2007-12-01
期刊：
影响因子：
6
通讯作者：
Boyd, Carol J.
中科院分区：
文献类型：
--
作者：
McCabe, Sean E.;West, Brady T.;Boyd, Carol J.
本研究旨在探讨美国早期非医疗类处方药(NMUPD)(即镇静剂、镇静剂、阿片类药物、兴奋剂)与处方药滥用和依赖发展之间的关系。设计数据来自使用国家酒精滥用和酒精中毒研究所(NIAAA)酒精使用障碍和相关残疾访谈时间表：诊断和统计手册第四版(DSM-IV)的结构化诊断访谈。根据2001-2002年全国酒精及相关疾病流行病学调查(NESARC，n=43093)得出全国患病率估计值。参与者美国18岁或以上的非制度化平民成年人的全国代表性横断面样本，其中52%是女性，71%是白人，12%是西班牙裔，11%是非裔美国人，4%是亚裔，2%是土著美国人或其他种族背景。结果发现，与那些在21岁或之后开始使用处方药的人相比，在13岁或之前开始使用处方药的人被发现出现处方药滥用和依赖的比例更高。多因素Logistic回归分析显示，在控制相关协变量的情况下，非医疗吸毒者发生终生处方药滥用的几率随非医疗用药时间的推迟而降低约5%[调整后的优势比(AOR)=0.95，95%CI=0.94，0.97]，发生终生处方药依赖的几率随起病时间的推迟而降低约2%(AOR=0.98，95%CI=0.96，1.00)。结论NMUPD的早期发病是处方药滥用和依赖的重要预测因素。这些发现加强了开展预防工作的重要性，以减少儿童和青少年中的NMUPD和处方药的转移。
Aims The present study examined the associations between early onset of non-medical use of prescription drugs (NMUPD) (i.e. sedatives, tranquilizers, opioids, stimulants) and the development of prescription drug abuse and dependence in the United States. Design Data were collected from structured diagnostic interviews using the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Use Disorder and Associated Disabilities Interview Schedule: Diagnostic and Statistical Manual version IV (DSM-IV). Setting National prevalence estimates were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n = 43 093). Participants A nationally representative cross-sectional sample of civilian non-institutionalized adults aged 18 years or older in the United States, of whom 52% were women, 71% white, 12% Hispanic, 11% African American, 4% Asian and 2% Native American or of other racial background. Findings A higher percentage of individuals who began using prescription drugs non-medically at or before 13 years of age were found to have developed prescription drug abuse and dependence versus those individuals who began using at or after 21 years of age. Multivariate logistic regression analyses indicated that the odds of developing any life-time prescription drug abuse among non-medical users was reduced by approximately 5% with each year non-medical use was delayed [adjusted odds ratio (AOR) = 0.95, 95% CI = 0.94, 0.97], and that the odds of developing any life-time prescription drug dependence were reduced by about 2% with each year onset was delayed (AOR = 0.98, 95% CI = 0.96, 1.00) when controlling for relevant covariates. Conclusions The results of this study indicate that early onset of NMUPD was a significant predictor of prescription drug abuse and dependence. These findings reinforce the importance of developing prevention efforts to reduce NMUPD and diversion of prescription drugs among children and adolescents.