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

摘要 2016年，有1180万12岁及以上的美国人报告滥用阿片类药物。超过4万人死于 2016年与阿片类药物相关的过量，从2001年到2016年增长了345%。处方类阿片在历史上一直被用作 向吸毒过量的高风险药物过渡，包括海洛因和高度有效的 可接近，芬太尼。引人注目的是，21%到29%的患者开出了阿片类药物来治疗慢性疼痛，滥用或 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是其他人的40倍 海洛因。在工作场所，用于止痛的处方阿片类药物平均占处方疼痛的85% 根据国家级工人索赔和受伤工人发放的阿片类药物 处方率是全国平均水平的三倍。建筑行业工人，95.9%以男性为主 在工人索赔和注册护士中，阿片类药物配药率最高 而由90%的女性组成的注册护士助理报告的与非致命工作相关的人数最多 受伤。到目前为止，还没有针对处方阿片类药物高风险行业的循证干预措施 根据伤害和处方率，存在滥用和/或过度使用。因此，迫切需要一种 采用可扩展的循证干预措施预防处方阿片类药物滥用和/或 在高危劳动力人群中过度使用，即建筑贸易工人和护理人员。 循证医疗干预是高危人群健康干预的有效手段 行为干预。这项拟议研究的目标是开发一种优化的、高效的、 旨在防止高危行业工人使用处方阿片类药物的移动健康干预措施 伤病和阿片类药物处方。在拟议的第二阶段项目中进行的研究和开发 将带来一个经过充分设计、优化和评估的面向市场的产品，将在高端 风险行业。本研究的具体目的是：1)开发剩下的两种全功能干预 针对与意向使用处方阿片类药物相关的激励因素的成分 2)对干预课程进行优化和评价。在完成建议的研究及 发展，我们的预期结果是第一次展示出科学和技术上的优点 预防处方阿片类药物滥用和/或过度使用的循证干预 风险行业。

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.