Opioid-Involved Overdose Among Male Afghanistan/Iraq-Era U.S. Military Veterans: A Multidimensional Perspective.
Opioid-Involved Overdose Among Male Afghanistan/Iraq-Era U.S. Military Veterans: A Multidimensional Perspective.
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DOI：
10.1080/10826084.2017.1306563
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发表时间：
2017-11-10
影响因子：
2
通讯作者：
Guarino H
中科院分区：
文献类型：
--
作者：
Bennett AS;Elliott L;Golub A;Wolfson-Stofko B;Guarino H
与美国广泛人群中的全国性趋势相似，数量惊人的阿富汗/伊拉克战争时期的美国退伍军人经历了与阿片类药物相关的过量用药情况。越来越多的研究已经考察了可能导致过量用药的近端行为；而对于这些风险行为受到的更远端的生理、心理社会和结构影响，人们所知甚少。
本研究采用多维方法，以更好地了解美国退伍军人中与阿片类药物相关的过量用药情况，并不仅试图探究过量用药事件的近端行为诱因，还试图探究支撑过量用药事件的生理、心理和社会学影响的复杂关联。
这项定性研究基于对36名男性退伍军人的访谈数据，这些退伍军人在2001年9月之后退伍，并且在服役期间或退役后至少经历过一次与阿片类药物相关的过量用药。参与者于2014年在纽约市招募，分享他们过量用药的经历叙述。
退伍军人的叙述表明，诸如因社会和心理痛苦而自行用药、创伤、社会疏离和孤立以及非法药物使用史等背景经历，预先决定了导致过量用药的更直接的因素和行为（包括药物滥用、混合用药、对剂量的无知以及对生死的矛盾心理）。
研究结果表明，需要针对退伍军人的生理、心理和社会状况开展全面的药物安全和过量用药教育。对退伍军人及其他弱势群体所面临的远端和近端过量用药风险的多维理解，可能有助于为更具包容性/整体性的过量用药预防和教育方法奠定基础。
Mirroring nationwide trends in a broad range of U.S. populations, an alarming number of Afghanistan/Iraq-era U.S. Military veterans have experienced opioid-related overdoses. A growing body of research has examined the proximal behaviors that can precipitate an overdose; considerably less is known about more distal physiological, psychosocial and structural influences on these risk behaviors. This study adopts a multidimensional approach to better understand opioid-related overdose among U.S. Military veterans, and seeks to explore not only the proximal behavioral precipitants of overdose events, but also the complex nexus of physiological, psychological, and sociological influences that undergird overdose events. This qualitative examination is based on interview data from 36 male veterans who were discharged from the military after September 2001 and experienced at least one opioid-related overdose during or after military service. Participants were recruited in New York City during 2014 to share narrative accounts of their overdoses. Veterans’ accounts indicate that background experiences, such as self-medication for social and psychological pain, trauma, social alienation and isolation, and histories of illicit drug use, precondition the more immediate factors and behaviors that precipitate overdose (including bingeing on drugs, mixing drugs, naiveté about dosage, and ambivalence about life/death). Findings suggest the need for comprehensive drug safety and overdose education that is sensitive to veterans’ physiological, psychological, and sociological conditions. A multidimensional understanding of the distal and proximal overdose risks faced by veterans and other vulnerable groups may help lay a foundation for more inclusive/holistic approaches to overdose prevention and education.
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