Preventing prescription opioid misuse among employees working in high risk industries.

摘要 11.8 2016年，有100万12岁或以上的美国人报告了阿片类药物滥用。超过4万人死于 2016年阿片类药物相关过量，从2001年到2016年增加了345%。处方阿片类药物历来作为 一个登机坡道，以药物过量的高风险，包括海洛因和高度有效的， 芬太尼引人注目的是，21%至29%的患者因慢性疼痛而滥用阿片类药物， 过度使用它们，有处方阿片类药物滥用史的人滥用的可能性要高出40倍。 海洛因在工作场所，用于疼痛的处方阿片类药物平均占处方疼痛的85% 根据国家一级工人的赔偿要求， 是全国平均水平的三倍。建筑业工人，男性占95.9% 在工人赔偿索赔和注册护士中，阿片类药物配药率最高。 90%为女性的注册护士助理报告的非致命性工作相关死亡人数最多， 受伤到目前为止，没有针对处方阿片类药物高风险行业的循证干预措施 存在基于损伤和处方率的误用和/或过度使用。因此，迫切需要一个 参与、可扩展、循证干预，以预防处方阿片类药物滥用和/或 在高风险劳动力人群中，即建筑业工人和护理雇员中过度使用。 基于证据的移动健康干预措施是针对高危健康的有效干预提供方法 行为干预。这项研究的目的是开发一种优化的，高效的， 旨在预防高风险行业工人使用处方阿片类药物的移动健康干预措施 受伤和开阿片类药物在拟议的第二阶段项目中进行的研究和开发 将产生一个经过充分设计、优化和评估的市场就绪产品， 风险产业。本研究的具体目标是：1）开发其余两种功能齐全的干预措施 针对与使用处方阿片类药物的意图相关的动机因素的成分， 2）优化和评价干预课程。在完成拟议的研究和 发展，我们的预期成果是已经证明了科学和技术的优点，为第一 循证干预，以防止处方阿片类药物滥用和/或过度使用的工人之间的高- 风险产业。

Abstract 11.8 million Americans aged 12 or older reported opioid misuse in 2016. Over 40,000 people died due to opioid-related overdoses in 2016, up 345% from 2001 to 2016. Prescription opioids have historically served as an onboarding ramp to drugs with a high-risk of overdose, including heroin and the highly potent and accessible, fentanyl. Strikingly, 21 to 29 percent of patients prescribed opioids for chronic pain misuse or overuse them and individuals with a history of prescription opioid abuse are 40 times more likely to abuse heroin. In the workplace, prescription opioids for pain made up an average of 85% of prescribed pain medications according to state-level workers’ compensation claims, and injured workers are issued opioid prescriptions at a rate three times the national average. Construction trade workers, a 95.9% male-dominated industry, exhibit the highest rates of opioid dispensing in workers’ compensation claims and registered nurses and certified nursing assistants, made up of 90% women, report the greatest number of non-fatal work-related injuries. To date, no evidence-based interventions targeting industries with a high-risk for prescription opioid misuse and/or overuse, based on injury and prescribing rates, exist. Thus, there is a critical need for an engaging, scalable, evidence-based intervention for the prevention of prescription opioid misuse and/or overuse among high-risk workforce populations, namely, construction trade workers and employees in nursing. Evidence-based mHealth interventions are an effective intervention delivery method for high-risk health behavior interventions. The objective of this proposed research is to develop an optimized, highly effective, mHealth intervention designed to prevent prescription opioid use among workers in industries with a high risk for injury and opioid prescribing. The research and development performed in the proposed Phase II project will result in a fully designed, optimized, and evaluated, market-ready product to be implemented among high- risk industries. The specific aims of this study are to 1) Develop the remaining two fully functional intervention components targeting motivational factors associated with intentions to use prescription opioid medications for pain; 2) Optimize and evaluate the intervention lessons. At the completion of the proposed research and development, our expected outcome is to have demonstrated scientific and technical merit for the first evidence-based intervention for preventing prescription opioid misuse and/or overuse among workers of high- risk industries.