Opioid use disorder and overdose among youth following an initial opioid prescription.
Opioid use disorder and overdose among youth following an initial opioid prescription.
复制标题
DOI：
10.1111/add.15487
复制
发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Barocas JA
中科院分区：
文献类型：
--
作者：
Hadland SE;Bagley SM;Gai MJ;Earlywine JJ;Schoenberger SF;Morgan JR;Barocas JA
一些青少年和年轻人(称为“青年”)开出的阿片类药物会出现阿片类药物使用障碍或服药过量。这项研究的目的是确定患者和处方特征与阿片类药物首次分发后一年内随后发生阿片类药物使用障碍或过量的风险有关。回顾性队列研究。2006年至2016年，美国一个大型数据库中的商业健康保险索赔。年龄在11-25岁之间的年轻人，服用最初的阿片类药物处方。患者(社会人口学信息和身心健康诊断)和处方特征(阿片类药物配方、剂量和持续时间)。主要结果是在随后的12个月中出现了“阿片类药物相关并发症”(阿片类药物使用障碍或阿片类药物相关过量的诊断)。感兴趣的暴露是患者(社会人口学信息，以及身心健康诊断)和处方特征(阿片类药物配方、剂量和持续时间)。在最初服用阿片类药物处方的3,278,990名青年中，中位年龄为18岁(IQR，16-21)，其中56.1%是女性。在随后的12个月中，10,405名青年(0.3%)出现了与阿片类药物相关的并发症。与风险增加相关的情况包括情绪/焦虑障碍(ARR，4.45[95%CI，4.25-4.66])和药物使用(ARR，20.77[95%CI，19.74-21.84])。在经历阿片类药物相关并发症的年轻人中，72.8%存在共病物质使用障碍，包括酒精(33.4%)、大麻(33.0%)、尼古丁(43.2%)和其他物质使用障碍(75.5%)。与短效制剂和持续3天相比，长效阿片类药物(ARR，2.59[95%CI，2.18-3.09])和较长持续时间(7-14天：ARR，1.15[95%CI，1.08-1.22]；≥15天：ARR，1.96[95%CI，1.80-2.12])与风险增加相关(7-14天：ARR，1.15[95%CI，1.08-1.22]；≤15天：ARR，1.96[95%CI，1.80-2.12])。最初的阿片类药物处方后的并发症相对较少。在开处方前对精神健康状况和药物使用情况进行筛查，可能会发现青少年有吸毒过量的风险。临床医生可能会通过短期开出短效阿片类药物来降低风险。
Some adolescents and young adults (termed ‘youth’) prescribed an opioid will develop opioid use disorder or experience overdose. This study aimed to identify patient and prescription characteristics associated with subsequent risk of opioid use disorder or overdose during the year after an opioid is first dispensed. Retrospective cohort study. Commercial health insurance claims in a large US database from 2006 to 2016. Youth aged 11–25 years filling an initial opioid prescription. Patient (sociodemographic information, and physical and mental health diagnoses) and prescription characteristics (opioid formulation, dose, and duration). The primary outcome was development of an ‘opioid-related complication’ (a diagnosis of opioid use disorder or opioid-related overdose) during the subsequent 12 months. Exposures of interest were patient (sociodemographic information, and physical and mental health diagnoses) and prescription characteristics (opioid formulation, dose, and duration). Among 3,278,990 youth filling an initial opioid prescription, median age was 18 years (IQR, 16–21) and 56.1% were female. During the subsequent 12 months, 10,405 (0.3%) youth experienced an opioid-related complication. Conditions associated with increased risk included mood/anxiety disorders (aRR, 4.45 [95% CI, 4.25–4.66]) and substance use (aRR, 20.77 [95% CI, 19.74–21.84]). Comorbid substance use disorders were present among 72.8% of youth experiencing an opioid-related complication and included alcohol (33.4%), cannabis (33.0%), nicotine (43.2%), and other substance use disorders (75.5%). Long-acting opioids (aRR, 2.59 [95% CI, 2.18–3.09]) and longer durations were associated with increased risk (7–14 days: aRR, 1.15 [95% CI, 1.08–1.22]; ≥15 days: aRR, 1.96 [95% CI, 1.80–2.12]) compared to short-acting formulations and durations ≤3 days, respectively. Complications after an initial opioid prescription are relatively rare. Screening for mental health conditions and substance use before prescribing might identify youth at risk for OUD and overdose. Clinicians might mitigate the risk by prescribing short-acting opioids for short durations.
登录
查看更多内容
影响因子：
39.2
作者：
Dunn, Kate M.;Saunders, Kathleen W.;Von Korff, Michael
通讯作者：
Von Korff, Michael
影响因子：
5.1
作者：
Cerda, Magdalena;Santaella, Julian;Martins, Silvia S.
通讯作者：
Martins, Silvia S.
DOI：
10.1097/00004583-200503000-00013
发表时间：
2005-03-01
影响因子：
13.3
作者：
Hale, WW;Raaijmakers, Q;Meeus, W
通讯作者：
Meeus, W
影响因子：
4
作者：
Mayhew, Meghan;DeBar, Lynn L.;Von Korff, Michael
通讯作者：
Von Korff, Michael
影响因子：
39
作者：
Miller, Matthew;Barber, Catherine W.;Gagnon, David R.
通讯作者：
Gagnon, David R.