Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study

被引:83
作者
Banerjee, Geetanjoli [1 ]
Edelman, E. Jennifer [2 ,3 ]
Barry, Declan T. [4 ,5 ]
Becker, William C. [6 ]
Cerda, Magdalena [7 ]
Crystal, Stephen [8 ]
Gaither, Julie R. [3 ,9 ]
Gordon, Adam J. [10 ,11 ,12 ]
Gordon, Kirsha S. [13 ]
Kerns, Robert D. [6 ,14 ,15 ,16 ]
Martins, Silvia S. [17 ]
Fiellin, David A. [2 ,3 ]
Marshall, Brandon D. L. [1 ]
机构
[1] Brown Sch Publ Hlth, Dept Epidemiol, Providence, RI USA
[2] Yale Univ, Yale Sch Med, Dept Internal Med, New Haven, CT USA
[3] Yale Univ, Yale Sch Publ Hlth, Yale Ctr Interdisciplinary Res AIDS, New Haven, CT USA
[4] Yale Univ, Sch Med, New Haven, CT USA
[5] APT Fdn Pain Treatment Serv, New Haven, CT USA
[6] VA Connecticut Healthcare Syst, PRIME Ctr, West Haven, CT USA
[7] Univ Calif Davis, Dept Emergency Med, Sacramento, CA 95817 USA
[8] Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, New Brunswick, NJ USA
[9] Yale Sch Med, Yale Ctr Med Informat, New Haven, CT USA
[10] VA Pittsburgh Healthcare Syst, CHERP, Pittsburgh, PA USA
[11] VA Pittsburgh Healthcare Syst, MIRECC, Pittsburgh, PA USA
[12] Univ Pittsburgh, Pittsburgh, PA USA
[13] VA Connecticut Healthcare Syst, West Haven, CT USA
[14] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA
[15] Yale Univ, Dept Neurol, New Haven, CT USA
[16] Yale Univ, Dept Psychol, New Haven, CT USA
[17] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA
关键词
Heroin; longitudinal study; non-medical prescription drug use; opioid-related disorders; polysubstance use; veterans; POSTTRAUMATIC-STRESS-DISORDER; UNITED-STATES; INVERSE PROBABILITY; THERAPEUTIC-USE; CHRONIC PAIN; MEDICAL USE; ALCOHOL-USE; DRUG-USERS; TRENDS; ABUSE;
D O I
10.1111/add.13491
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
AimsTo estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. DesignUsing a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use. SettingVeterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC. ParticipantsA total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012. MeasurementsThe primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use. FindingsUsing a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR)=5.43, 95% confidence interval (CI)=4.01, 7.35]. ConclusionsNew-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use.
引用
收藏
页码:2021 / 2031
页数:11
相关论文
共 57 条
[1]  
[Anonymous], 2014, Results from the 2012 National survey on drug use and health: mental health detailed tables
[2]  
[Anonymous], 2015, Trends in Heroin Use in the United States: 2002 to 2013
[3]   Nonmedical use of prescription opioids and pain in veterans with and without HIV [J].
Barry, Declan T. ;
Goulet, Joseph L. ;
Kerns, Robert K. ;
Becker, William C. ;
Gordon, Adam J. ;
Justice, Amy C. ;
Fiellin, David A. .
PAIN, 2011, 152 (05) :1133-1138
[4]   Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV [J].
Becker, William C. ;
Gordon, Kirsha ;
Edelman, E. Jennifer ;
Kerns, Robert D. ;
Crystal, Stephen ;
Dziura, James D. ;
Fiellin, Lynn E. ;
Gordon, Adam J. ;
Goulet, Joseph L. ;
Justice, Amy C. ;
Fiellin, David A. .
AIDS AND BEHAVIOR, 2016, 20 (03) :679-686
[5]   Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system [J].
Boscarino, Joseph A. ;
Rukstalis, Margaret ;
Hoffman, Stuart N. ;
Han, John J. ;
Erlich, Porat M. ;
Gerhard, Glenn S. ;
Stewart, Walter F. .
ADDICTION, 2010, 105 (10) :1776-1782
[6]   Adolescents' Nonmedical Use of Prescription Medications and Other Problem Behaviors [J].
Boyd, Carol J. ;
Young, Amy ;
Grey, Melissa ;
McCabe, Sean Esteban .
JOURNAL OF ADOLESCENT HEALTH, 2009, 45 (06) :543-550
[7]   Two brief alcohol-screening tests from the Alcohol Use Disorders Identification Test (AUDIT) - Validation in a female veterans affairs patient population [J].
Bradley, KA ;
Bush, KR ;
Epler, AJ ;
Dobie, DJ ;
Davis, TM ;
Sporleder, JL ;
Maynard, C ;
Burman, ML ;
Kivlahan, DR .
ARCHIVES OF INTERNAL MEDICINE, 2003, 163 (07) :821-829
[8]   Substance use trends among active duty military personnel: findings from the United States Department of Defense Health Related Behavior Surveys, 1980-2005 [J].
Bray, Robert M. ;
Hourani, Laurel L. .
ADDICTION, 2007, 102 (07) :1092-1101
[9]   Inverse probability-of-censoring weights for the correction of time-varying noncompliance in the effect of randomized highly active antiretroviral therapy on incident AIDS or death [J].
Cain, Lauren E. ;
Cole, Stephen R. .
STATISTICS IN MEDICINE, 2009, 28 (12) :1725-1738
[10]   MULTIVARIATE SURVIVAL ANALYSIS USING COX REGRESSION-MODEL [J].
CHRISTENSEN, E .
HEPATOLOGY, 1987, 7 (06) :1346-1358