Co-occurring substance use and mental disorders among adults with opioid use disorder
Co-occurring substance use and mental disorders among adults with opioid use disorder
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DOI：
10.1016/j.drugalcdep.2018.12.030
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发表时间：
2019-04-01
影响因子：
4.2
通讯作者：
McCance-Katz, Elinore F.
中科院分区：
文献类型：
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作者：
Jones, Christopher M.;McCance-Katz, Elinore F.
背景：阿片类药物使用障碍（OUD）患者中同时发生的物质使用和精神障碍增加了发病率和死亡率的风险。解决这些并发症对于改善治疗和健康结果至关重要。有有限的共同发生的疾病的患病率，与共同发生的疾病的人口统计学特征，并接受心理健康和物质使用治疗服务的OUD之间的最近的研究。这限制了有针对性的和资源的政策和临床interventions.Methods的发展：使用2015-2017年全国药物使用和健康调查数据，同时发生的物质使用和精神障碍的患病率和接受精神健康和物质使用治疗服务的估计为18-64岁的成人OUD。多变量Logistic回归评估人口统计学和物质使用的特点与过去一年的精神疾病（AMI）和严重精神疾病（SMI）成人OUD以及治疗recipient.Results：成人OUD，具体的共同发生的物质使用障碍的患病率范围从26.4%（95%CI：23.6%-29.4%）酒精10.6%（95%CI：8.6%-13.0%）甲基苯丙胺。AMI患病率为64.3%（95%CI：60.4%~ 67.9%），SMI患病率为26.9%（95%CI：24.2%~ 29.8%）。接受心理健康和物质使用治疗服务，在过去的一年中，24.5%（95%CI：21.5%-29.9%）的成人OUD和AMI和29.6%（95%CI：23.3%-36.7%）的成人OUD和SMI.Conclusions：共同发生的物质使用和精神障碍是常见的成人OUD。迫切需要扩大全面服务提供模式的覆盖面，以解决这一人群的药物使用和精神健康并发症。
Background: Co-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions.Methods: Using 2015-2017 National Survey on Drug Use and Health data, prevalence of co-occurring substance use and mental disorders and receipt of mental health and substance use treatment services was estimated for adults aged 18-64 with OUD. Multivariable logistic regression assessed demographic and substance use characteristics associated with past-year mental illness (AMI) and serious mental illness (SMI) among adults with OUD as well as treatment receipt.Results: Among adults with OUD, prevalence of specific co-occurring substance use disorders ranged from 26.4% (95% CI:23.6%-29.4%) for alcohol to 10.6% (95% CI:8.6%-13.0%) for methamphetamine. Prevalence of AMI was 64.3% (95% CI:60.4%-67.9%) and SMI was 26.9% (95% CI:24.2%-29.8%). Receiving both mental health and substance use treatment services in the past year was reported by 24.5% (95% CI:21.5%-29.9%) of adults with OUD and AMI and 29.6% (95% CI:23.3%-36.7%) of adults with OUD and SMI.Conclusions: Co-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.