Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: a national longitudinal study
Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: a national longitudinal study
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DOI：
10.1097/j.pain.0000000000000624
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发表时间：
2016-10-01
期刊：
影响因子：
7.4
通讯作者：
Schulenberg, John E.
中科院分区：
文献类型：
--
作者：
McCabe, Sean Esteban;Veliz, Philip;Schulenberg, John E.
本研究的目的是检查青春期处方阿片类药物暴露（即医疗或非医疗）的背景与随后35岁时非医疗使用处方阿片类药物（NMUPO）和物质使用障碍（SUD）症状的风险之间的关联。通过自填式问卷调查了美国高中毕业生（n = 4072）的全国代表性概率样本的多个队列，并从青春期（模态年龄18岁，毕业班1976-1996）到35岁（1993-2013）进行了纵向跟踪。主要结果指标是过去一年的NMUPO和SUD症状。青春期的医疗和NMUPO与35岁时的NMUPO显著相关。相对于无处方阿片类药物暴露，青春期无任何NMUPO病史的处方阿片类药物的医疗使用与35岁时的SUD症状无关。相比之下，与青春期无处方阿片类药物暴露相比，在青春期有处方阿片类药物和NMUPO医疗使用史的人群中，35岁时SUD症状相关的校正比值比（AOR）更大，AOR=1.49（95%CI =1.13-1.97），单用NMUPO者AOR=2.61（95%CI =1.88-3.61）。研究结果表明，在青春期没有任何NMUPO病史的处方阿片类药物的医疗使用与35岁时的SUD症状无关，而青春期的任何NMUPO预测35岁时的SUD症状。减少NMUPO和SUD的筛查工具和预防性干预计划必须考虑与青春期处方阿片类药物暴露相关的背景。
The objective of this study was to examine the association of context of prescription opioid exposure (ie, medical or nonmedical) in adolescence with the subsequent risk of nonmedical use of prescription opioids (NMUPO) and substance use disorder (SUD) symptoms at age 35. Multiple cohorts of nationally representative probability samples of U.S. high school seniors (n = 4072) were surveyed through self-administered questionnaires and followed longitudinally from adolescence (modal age 18, graduating classes 1976-1996) to age 35 (1993-2013). Main outcome measures were past-year NMUPO and SUD symptoms. The medical and NMUPO during adolescence was significantly associated with NMUPO at age 35. Relative to no prescription opioid exposure, medical use of prescription opioids without any history of NMUPO during adolescence was not associated with SUD symptoms at age 35. In contrast, compared with no prescription opioid exposure during adolescence, the adjusted odds ratios (AORs) associated with SUD symptoms at age 35 were greater among those with a history of both medical use of prescription opioids and NMUPO during adolescence, AOR=1.49 (95% CI=1.13-1.97); and among those who reportedNMUPOonly, AOR=2.61 (95% CI=1.88-3.61). The findings indicate medical use of prescription opioids without any history of NMUPO in adolescence is not associated with SUD symptoms at age 35, whereas any NMUPO in adolescence predicts SUD symptoms at age 35. Screening instruments and preventive intervention programs to reduce NMUPO and SUDs must account for the context associated with prescription opioid exposure during adolescence.