社会支持和创伤后应激障碍与长期使用处方阿片类药物的风险之间的联系
Mark D Sullivan1, Lauren Wilson2, Matthew Amick2
1Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States.
Pain
|June 4, 2024
概括
慢性疼痛患者的创伤后应激障碍 (PTSD) 与持续的阿片类药物使用有关,但高度的情绪支持可能会减轻这种关联. 改善情绪支持可以减少弱势个体持续使用阿片类药物.
科学领域:
- 疼痛医学 医学 疼痛医学
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 创伤后应激障碍 (PTSD) 在慢性疼痛患者中很普遍,对结果产生负面影响,并增加了阿片类药物的使用.
- 社会支持是影响PTSD和慢性疼痛轨迹的关键因素.
- 在非癌症疼痛中,PTSD,情绪支持和持续使用阿片类药物之间的相互作用需要进一步调查.
研究的目的:
- 调查情绪支持是否改变了非癌症疼痛患者中PTSD和持续使用阿片类药物之间的关联.
- 根据PTSD状态和情绪支持水平,确定患有持续阿片类药物使用风险较高的患者子组.
主要方法:
- 分析了808名成人患者的队列,他们开始为非癌症疼痛提供30至90天的处方阿片类药物疗程.
- 参与者被评估为可能的PTSD和情绪支持水平 (低与高).
- 在6个月的随访期间,评估了阿片类药物的使用情况,通过统计分析,包括两种类型的关联和调整的模型来评估相互作用效应.
主要成果:
- 17.2%的参与者可能患有PTSD;高情绪支持在这个群体中不太常见.
- 在6个月的随访期间,PTSD与处方阿片类药物的使用增加有关.
- 这种关联在具有高情绪支持的患者中被取消,但在情绪支持较低的患者中仍然显著.
结论:
- 情绪支持显著改变了PTSD和慢性疼痛患者持续使用阿片类药物之间的关系.
- 旨在增强情绪支持的干预措施可能对减少慢性疼痛和PTSD患者持续使用阿片类药物至关重要.
- 有针对性的支持策略可以改善疼痛管理,并减轻与阿片类药物相关的风险,在这个弱势群体.
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