农村地区、未满足的治疗需求与成人慢性疼痛患者使用大麻的交集

Hannah Appleseth, Desiree R. Azizoddin, Amy Cohn
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摘要

目的:与城市居民相比,农村居民的慢性疼痛发病率更高,而且农村居民在社会经济方面处于更不利的地位,医疗保险覆盖率低或没有医疗保险,治疗需求得不到满足。医用大麻在俄克拉荷马州是合法的。俄克拉荷马州有 40% 的人口居住在农村地区,近 17% 的人口没有医疗保险,因此大麻医疗合法化可能是一种方便且成本相对较低的替代治疗方法,尤其是对慢性疼痛患者而言。本研究调查了生活在俄克拉荷马州的慢性疼痛患者和非慢性疼痛患者在农村(与城市)身份和未满足(与已满足)治疗需求方面使用大麻的差异。方法:参与者必须年满 18 周岁,居住在俄克拉荷马州,能够读写英语调查问卷。结果:样本(N = 3622)主要由非西班牙裔白人(70.4%)和中年女性(53.8%)组成(M = 41.80,SD = 16.88),有全职或兼职工作(53.8%),拥有大专/技校学历(37.2%)或学士学位(28.5%)。近五分之一的样本(18.2%)表示患有慢性疼痛,而患有慢性疼痛的人报告过去 30 天内吸食大麻的可能性是其他样本的八倍。仅对农村(与城市居住地)进行调查时,未发现差异。在患有慢性疼痛的成年人中,与居住在城市且治疗需求未得到满足的慢性疼痛成年人相比,居住在农村且报告治疗需求未得到满足的慢性疼痛成年人报告过去 30 天使用大麻的可能性几乎高出两倍。结论:在俄克拉荷马州,农村地区未满足治疗需求的慢性疼痛成年人可能会受益于更多的慢性疼痛治疗,以及关于大麻使用和减少伤害策略的教育,从而为医疗决策提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Intersection of Rurality, Unmet Treatment Need, and Cannabis Use for Adults with Chronic Pain
Objective: Rates of chronic pain are higher among rural versus urban individuals and rural individuals experience higher levels of socioeconomic disadvantage, poor or no health insurance coverage, and unmet treatment need. Medical cannabis is legal in Oklahoma. With 40% of Oklahoma’s population living in rural areas, and nearly 17% uninsured, the medical legalization of cannabis may present as an accessible and relatively low-cost alternative treatment, particularly for those with chronic pain. This study investigated differences in cannabis use by rural (vs. urban) status and unmet (vs. met) treatment need among adults with and without chronic pain living in Oklahoma. Method: To be eligible, participants had to be 18 years or older, reside in Oklahoma, and be able to read and write English-language surveys. Results: The sample (N = 3622) was primarily made up of non-Hispanic White (70.4%) females (53.8%) in their early middle age (M = 41.80, SD = 16.88), employed full-time or part-time (53.8%), with some college/technical school (37.2%) or a bachelor’s degree (28.5%). Nearly one-fifth of the sample (18.2%) endorsed chronic pain, and individuals with chronic pain were eight times more likely to report past 30-day cannabis use. No difference was detected when only rurality (vs. urban residence) was examined. Among adults with chronic pain, those who were rural dwelling and who reported unmet treatment need were almost two times more likely to report past 30-day cannabis use, compared to urban dwelling chronic pain adults with unmet treatment need. Conclusions: In Oklahoma, adults in rural areas with unmet treatment need and chronic pain may benefit from increasing access to chronic pain treatment, as well as education on cannabis use and harm reduction strategies to inform healthcare decision-making.
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