在滥用阿片类药物的人群中,阿片类药物使用障碍 (OUD) 和阿片类问题治疗在OUD症状亚型中
Emily A Miller1, Angela M DeVeaugh-Geiss2, Howard D Chilcoat2,3
1Virginia Commonwealth University School of Pharmacy, 410 N 12th St, Richmond, VA 23298, USA.
Drug and alcohol dependence reports
|February 28, 2024
概括
阿片类药物使用障碍 (OUD) 呈现出多样化的症状模式,而不是单一的实体. 识别这些亚型对于改善针对性物质使用障碍的治疗和干预对于受阿片类药物滥用影响的数百万人来说至关重要.
科学领域:
- 药物使用障碍 药物使用障碍
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 滥用阿片类药物影响全球和美国的数百万人,阿片类药物使用障碍 (OUD) 的治疗缺口很大.
- OUD通常被视为单一的,但可能存在不同的症状亚型,超出目前的诊断标准.
- 了解这些亚型对于定制有效的治疗和干预策略至关重要.
研究的目的:
- 识别和描述阿片类药物使用障碍 (OUD) 基于症状的不同亚型.
- 检查已识别的OUD亚型与接受物质使用障碍治疗之间的关系.
- 探索OUD亚型成员资格和治疗准入的人口统计和临床相关性.
主要方法:
- 隐性类别分析应用于美国大型国家调查数据集 (2015-2018年国家药物使用和健康调查) 的个人滥用处方阿片类药物或海洛因 (n=10,928).
- 用回归分析来调查潜伏类成员资格和接受治疗之间的关联.
- 与OUD亚型相比,分析了人口特征和并发性疾病.
主要成果:
- 确定了五个不同的OUD症状类别:无症状 (71.6%),耐受性/时间 (14.5%),失去控制/药理 (LOC/Pharmacol) (5.7%),社会障碍 (2.6%),和普遍 (5.6%).
- 高严重性类 (LOC/Pharmacol,社会障碍,普遍) 显示近乎普遍的OUD诊断 (98-100%),但在过去一年接受治疗 (28-49%) 方面有显著差异.
- 接受治疗与年龄,种族,教育,保险状况和犯罪活动有关.
结论:
- 在阿片类药物使用障碍中存在显著的异质性,其特点是明显的症状模式.
- 这些发现突出了OUD患者中大量未满足的物质使用障碍治疗需求.
- 识别OUD亚型可以为开发更个性化和更有效的治疗计划提供信息.
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