Mental Health Disorders and Long-term Opioid Use Among Adolescents and Young Adults With Chronic Pain
Mental Health Disorders and Long-term Opioid Use Among Adolescents and Young Adults With Chronic Pain
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DOI：
10.1016/j.jadohealth.2011.11.011
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发表时间：
2012-06-01
影响因子：
7.6
通讯作者：
Sullivan, Mark
中科院分区：
文献类型：
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作者：
Richardson, Laura P.;Russo, Joan E.;Sullivan, Mark
目的：本研究的目的是检查患有常见慢性疼痛的青少年和年轻人的心理健康障碍与随后长期使用阿片类药物的风险之间的关系（背痛、颈痛、头痛和关节炎/关节痛）。使用2001年1月1日至2008年6月30日的索赔数据，我们对13-24岁出现新的慢性疼痛发作的受试者进行了阿片类药物使用模式的纵向分析。长期阿片类药物使用定义为在6个月内接受> 90天的阿片类药物，在首次合格的疼痛诊断后的18个月内没有> 30天的阿片类药物使用间隔。精神健康障碍被确定为索赔前6个月的第一个合格的疼痛diagnosis.Results：五万九千七十七青年符合标准的慢性疼痛的新发作。在这些青少年中，321人（0.5%）符合长期使用阿片类药物的标准，16，172人（27.4%）使用阿片类药物。在控制了人口统计学和临床因素后，与没有阿片类药物相比，先前存在精神健康诊断的青年随后接受长期阿片类药物的风险增加了2.4倍（比值比= 2.36，95%置信区间= 1.73-3.23），与某些阿片类药物相比，接受长期阿片类药物的可能性增加1.8倍（比值比= 1.83，95%可信区间= 1.34-2.50）。结论：青少年和初显年轻人中，精神健康障碍与长期使用阿片类药物的风险增加相关。进一步的研究是必要的，以检查在这一人群中长期使用阿片类药物的风险和益处。(C)2012年青少年健康和医学协会。All rights reserved.
Purpose: The purpose of this study was to examine the association between mental health disorders and subsequent risk for long-term opioid use among adolescents and young adults presenting with common chronic pain complaints (back pain, neck pain, headache, and arthritis/joint pain).Methods: Using claims data from January 1, 2001 to June 30, 2008, we conducted a longitudinal analysis of opioid use patterns among 13-24-year-old subjects presenting with a new episode of chronic pain. Longterm opioid use was defined as receiving > 90 days of opioids within a 6-month period with no gap of > 30 days in use of opioids in the 18 months after the first qualifying pain diagnosis. Mental health disorders were identified from claims in the 6 months before the first qualifying pain diagnosis.Results: Fifty-nine thousand seventy-seven youth met criteria for a new episode of chronic pain. Among these youth, 321 (.5%) met criteria for long-term opioid use, and 16,172 (27.4%) had some opioid use. After controlling for demographic and clinical factors, youth with preexisting mental health diagnoses had a 2.4-fold increased risk of subsequently receiving long-term opioids versus no opioids (odds ratio = 2.36, 95% confidence interval = 1.73-3.23) and a 1.8-fold increased likelihood of receiving long-term opioids versus some opioids (odds ratio = 1.83, 95% confidence interval = 1.34-2.50).Conclusions: Mental health disorders are associated with increased risk for long-term opioid use among adolescents and emerging young adults. Further study is warranted to examine risks and benefits of long-term opioid use in this population. (C) 2012 Society for Adolescent Health and Medicine. All rights reserved.