{"title":"长期处方阿片类药物使用个体中物质使用障碍的发生率和决定因素：一项基于人群的队列研究。","authors":"Håkon Høydal Nestvold, Eirik Haarr, Aleksi Hamina, Vidar Hjellvik, Svetlana Skurtveit, Ingvild Odsbu","doi":"10.1002/pds.70212","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the incidence of substance use disorders (SUDs) after long-term prescription opioid use (LTOU) and to identify socioeconomic and clinical risk factors associated with SUD among individuals with LTOU.</p><p><strong>Methods: </strong>Cohort study using linked nationwide registers (2011-2019). We identified 114 916 individuals who used opioids for more than 3 months (LTOU) without previous LTOU or SUD diagnosis. Outcomes were any incident SUD diagnosed in primary or secondary care (ICPC-2: P15-P16, P18-P19; ICD-10: F10-F16, F18-F19) and opioid use-related disorders (OUD) diagnosed in secondary care (ICD-10: F11). We calculated age- and sex-stratified incidence rates (IR), incidence rate ratios (IRR) and age-standardized incidence rates (ASIR). Adjusted hazard ratios (aHR) were calculated using Cox proportional hazards regression.</p><p><strong>Results: </strong>In total, 5.3% (6069/114916) were diagnosed with SUD (ASIR = 28.7 per 1000 person-years), and males had higher IRs compared to females (IRR). Males had higher risk of SUD in both the younger (aHR = 1.59, 95% CI 1.47-1.72) and older (1.66, 1.54-1.78) age group. Low education (1.87, 1.66-2.11) and unemployment (1.26, 1.15-1.38) had the strongest association with SUD in the younger age group versus low income (1.37, 1.21-1.57) and living alone (1.53, 1.41-1.65) in the older age group. Previously diagnosed mental disorders and use of benzodiazepines- or benzodiazepine-related drugs (BZDRs) were associated with SUD in both age groups (1.85, 1.71-2.01; 2.37, 2.18-2.57). Being male and having used BZDRs were the covariates strongest associated with OUD.</p><p><strong>Conclusions: </strong>Being male, young, having low socioeconomic status, previous mental disorders or BZDR use were associated with SUD diagnosis among individuals with LTOU.</p>","PeriodicalId":19782,"journal":{"name":"Pharmacoepidemiology and Drug Safety","volume":"34 9","pages":"e70212"},"PeriodicalIF":2.4000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence of and Determinants for Substance Use Disorders Among Individuals With Long-Term Prescription Opioid Use: A Population-Based Cohort Study.\",\"authors\":\"Håkon Høydal Nestvold, Eirik Haarr, Aleksi Hamina, Vidar Hjellvik, Svetlana Skurtveit, Ingvild Odsbu\",\"doi\":\"10.1002/pds.70212\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the incidence of substance use disorders (SUDs) after long-term prescription opioid use (LTOU) and to identify socioeconomic and clinical risk factors associated with SUD among individuals with LTOU.</p><p><strong>Methods: </strong>Cohort study using linked nationwide registers (2011-2019). We identified 114 916 individuals who used opioids for more than 3 months (LTOU) without previous LTOU or SUD diagnosis. Outcomes were any incident SUD diagnosed in primary or secondary care (ICPC-2: P15-P16, P18-P19; ICD-10: F10-F16, F18-F19) and opioid use-related disorders (OUD) diagnosed in secondary care (ICD-10: F11). We calculated age- and sex-stratified incidence rates (IR), incidence rate ratios (IRR) and age-standardized incidence rates (ASIR). Adjusted hazard ratios (aHR) were calculated using Cox proportional hazards regression.</p><p><strong>Results: </strong>In total, 5.3% (6069/114916) were diagnosed with SUD (ASIR = 28.7 per 1000 person-years), and males had higher IRs compared to females (IRR). Males had higher risk of SUD in both the younger (aHR = 1.59, 95% CI 1.47-1.72) and older (1.66, 1.54-1.78) age group. Low education (1.87, 1.66-2.11) and unemployment (1.26, 1.15-1.38) had the strongest association with SUD in the younger age group versus low income (1.37, 1.21-1.57) and living alone (1.53, 1.41-1.65) in the older age group. Previously diagnosed mental disorders and use of benzodiazepines- or benzodiazepine-related drugs (BZDRs) were associated with SUD in both age groups (1.85, 1.71-2.01; 2.37, 2.18-2.57). Being male and having used BZDRs were the covariates strongest associated with OUD.</p><p><strong>Conclusions: </strong>Being male, young, having low socioeconomic status, previous mental disorders or BZDR use were associated with SUD diagnosis among individuals with LTOU.</p>\",\"PeriodicalId\":19782,\"journal\":{\"name\":\"Pharmacoepidemiology and Drug Safety\",\"volume\":\"34 9\",\"pages\":\"e70212\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pharmacoepidemiology and Drug Safety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/pds.70212\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pharmacoepidemiology and Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pds.70212","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Incidence of and Determinants for Substance Use Disorders Among Individuals With Long-Term Prescription Opioid Use: A Population-Based Cohort Study.
Purpose: To assess the incidence of substance use disorders (SUDs) after long-term prescription opioid use (LTOU) and to identify socioeconomic and clinical risk factors associated with SUD among individuals with LTOU.
Methods: Cohort study using linked nationwide registers (2011-2019). We identified 114 916 individuals who used opioids for more than 3 months (LTOU) without previous LTOU or SUD diagnosis. Outcomes were any incident SUD diagnosed in primary or secondary care (ICPC-2: P15-P16, P18-P19; ICD-10: F10-F16, F18-F19) and opioid use-related disorders (OUD) diagnosed in secondary care (ICD-10: F11). We calculated age- and sex-stratified incidence rates (IR), incidence rate ratios (IRR) and age-standardized incidence rates (ASIR). Adjusted hazard ratios (aHR) were calculated using Cox proportional hazards regression.
Results: In total, 5.3% (6069/114916) were diagnosed with SUD (ASIR = 28.7 per 1000 person-years), and males had higher IRs compared to females (IRR). Males had higher risk of SUD in both the younger (aHR = 1.59, 95% CI 1.47-1.72) and older (1.66, 1.54-1.78) age group. Low education (1.87, 1.66-2.11) and unemployment (1.26, 1.15-1.38) had the strongest association with SUD in the younger age group versus low income (1.37, 1.21-1.57) and living alone (1.53, 1.41-1.65) in the older age group. Previously diagnosed mental disorders and use of benzodiazepines- or benzodiazepine-related drugs (BZDRs) were associated with SUD in both age groups (1.85, 1.71-2.01; 2.37, 2.18-2.57). Being male and having used BZDRs were the covariates strongest associated with OUD.
Conclusions: Being male, young, having low socioeconomic status, previous mental disorders or BZDR use were associated with SUD diagnosis among individuals with LTOU.
期刊介绍：
The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report.
Particular areas of interest include:
design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology;
comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world;
methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology;
assessments of harm versus benefit in drug therapy;
patterns of drug utilization;
relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines;
evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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