社区药房处方阿片类药物患者的抑郁症状升高与药物使用、处方阿片类药物滥用、用药过量史、疼痛和一般健康状况之间的关系。

IF 2.8 3区医学 Q2 SUBSTANCE ABUSE

Substance abuse Pub Date : 2022-01-01 DOI:10.1080/08897077.2022.2060450

Jennifer L Brown, Gerald Cochran, M Aryana Bryan, Elizabeth Charron, T John Winhusen

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引用次数: 0

摘要

背景：处方阿片类药物的疼痛患者合并抑郁症的比例很高。本研究旨在分析在社区药房开阿片类处方的患者的疼痛、药物使用和健康状况与抑郁症状水平的关系。研究方法参加处方药监测指标验证研究的阿片类处方配药者（N = 1268）完成了一项在线调查，调查内容包括社会人口统计学、抑郁症状、药物使用、处方阿片类药物滥用、用药过量史、一般健康状况以及疼痛的严重程度和干扰。调查结果显示约五分之一（19.3%）的抑郁症筛查结果呈阳性。在协变量调整后的逻辑回归分析中，抑郁筛查结果呈阳性的人更有可能在处方类阿片（调整赔率 [AOR] = 2.06；95% 置信区间 [CI]，1.51-2.79）、街头类阿片（AOR = 7.18; 95% CI, 2.57-20.01); 大麻 (AOR = 2.00; 95% CI, 1.34-3.00); 可卡因 (AOR = 3.46; 95% CI, 1.46-8.22); 烟草 (AOR = 1.59; 95% CI, 1.18-2.15）；甲基苯丙胺（AOR = 7.59；95% CI，2.58-22.35）；处方兴奋剂（AOR = 2.95；95% CI，1.59-5.49）；以及镇静剂（AOR = 3.41；95% CI，2.43-4.79）。抑郁筛查结果呈阳性的人更有可能滥用处方阿片类药物（AOR = 3.46；95% CI，2.33-5.15）、曾用药过量（AOR = 2.69；95% CI，1.76-4.11）、总体健康状况较差（AOR = 2.95；95% CI，1.59-5.49）。11），报告的一般健康状况较差（AOR = 0.25，95% CI，0.18-0.35），报告的疼痛严重程度为中度/重度（AOR = 4.36，95% CI，2.80-6.77）和干扰（AOR = 6.47，95% CI，4.08-10.26）。结论被处方阿片类药物且抑郁加重的人更有可能报告使用其他药物、滥用处方阿片类药物、用药过量、疼痛加剧和健康状况较差。

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Associations between elevated depressive symptoms and substance use, prescription opioid misuse, overdose history, pain, and general health among community pharmacy patients prescribed opioids.

Background: Individuals with pain prescribed opioids experience high rates of comorbid depression. The aim of this study was to characterize pain, substance use, and health status as a function of depressive symptom level in individuals filling an opioid prescription at a community pharmacy. Methods: Participants (N = 1268) filling an opioid prescription enrolled in a study validating a prescription drug monitoring metric completed an online survey assessing sociodemographics, depressive symptoms, substance use, prescription opioid misuse, overdose history, general health, and pain severity and interference. Results: Approximately one-fifth (19.3%) had a positive depression screen result. In covariate-adjusted logistic regression analyses, individuals with a positive depression screen result were more likely to have moderate/high substance use risk scores for prescription opioids (adjusted odds ratio [AOR] = 2.06; 95% confidence interval [CI], 1.51-2.79); street opioids (AOR = 7.18; 95% CI, 2.57-20.01); cannabis (AOR = 2.00; 95% CI, 1.34-3.00); cocaine (AOR = 3.46; 95% CI, 1.46-8.22); tobacco (AOR = 1.59; 95% CI, 1.18-2.15); methamphetamine (AOR = 7.59; 95% CI, 2.58-22.35); prescription stimulants (AOR = 2.95; 95% CI, 1.59-5.49); and sedatives (AOR = 3.41; 95% CI, 2.43-4.79). Individuals with a positive depression screen were more likely to misuse prescription opioids (AOR = 3.46; 95% CI, 2.33-5.15), experience a prior overdose (AOR = 2.69; 95% CI, 1.76-4.11), report poorer general health (AOR = 0.25, 95% CI, 0.18-0.35), and report moderate/severe pain severity (AOR = 4.36, 95% CI, 2.80-6.77) and interference (AOR = 6.47, 95% CI, 4.08-10.26). Conclusions: Individuals prescribed opioids with heightened depression were more likely to report other substance use, prescription opioid misuse, prior overdose, greater pain, and poorer health.

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来源期刊

Substance abuse SUBSTANCE ABUSE-

CiteScore

5.90

自引率

2.90%

发文量

审稿时长

>12 weeks

期刊介绍： Now in its 4th decade of publication, Substance Abuse journal is a peer-reviewed journal that serves as the official publication of Association for Medical Education and Research in Substance Abuse (AMERSA) in association with The International Society of Addiction Medicine (ISAM) and the International Coalition for Addiction Studies in Education (INCASE). Substance Abuse journal offers wide-ranging coverage for healthcare professionals, addiction specialists and others engaged in research, education, clinical care, and service delivery and evaluation. It features articles on a variety of topics, including: Interdisciplinary addiction research, education, and treatment Clinical trial, epidemiology, health services, and translation addiction research Implementation science related to addiction Innovations and subsequent outcomes in addiction education Addiction policy and opinion International addiction topics Clinical care regarding addictions.