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Physical Pain Common Psychiatric and Substance Use Disorders and the Non-Medical Use of Prescription Analgesics in the United States

机译：在美国身体上的疼痛常见的精神病和药物使用障碍以及处方药的非医疗用途

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This study investigated the link between physical pain and non-medical prescription analgesic use (NMPAU), as well as the degree to which this association may vary by the presence of psychiatric and substance use disorders. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative, in-person probability sample of adults (n=43,093) aged 18 or older in the United States (2001–2002). Face-to-face interviews were used to gather information on past-year levels of physical pain (i.e., low, medium, high), in addition to DSM-IV classifications for mood, anxiety, substance use problems (i.e., abuse and/or dependence), and personality disorders. Within the analytic sample of those with valid data (n=42,734), the past-year rate of NMPAU was 1.8%, of which 20% met the DSM-IV criteria for abuse/dependence. Among past-year NMPAUs, 53% was incidental (e.g., less than monthly), but daily use was substantial (13% of NMPAUs). Accounting for our target confounding factors, pain was positively associated (p<.05) with an increased probability of non-disordered (i.e., no abuse and/or dependence) and disordered (i.e., abuse and/or dependence) NMPAU in the past year. Within each level of pain, the odds of past-year non-disordered and disordered NMPAU were significantly higher (p<.05) for those with disordered alcohol use compared with non-disordered users. This pattern was similar for illicit drugs, although marginally significant (p=.060) and specific to disordered NMPAU. In contrast, psychiatric disorders increased the probability of both types of NMPAU, but these associations did not differ by levels of pain. These findings suggest that pain is an independent risk factor for non-disordered and disordered NMPAU, yet its effects are substantially modified by patterns of substance use.
机译：这项研究调查了身体疼痛与非医学处方镇痛药（NMPAU）之间的联系，以及这种关联因精神病和药物滥用障碍的存在而可能发生变化的程度。数据来自全国酒精和相关疾病流行病学调查（NESARC），这是全国有代表性的，年龄在18岁以上（2001-2002年）的成年人（n = 43,093）的成年概率样本。除了DSM-IV针对情绪，焦虑，物质使用问题（例如虐待和/或虐待）的分类之外，还使用面对面访谈来收集有关过去一年的身体疼痛程度（即低，中，高）的信息。或依赖性）和人格障碍。在具有有效数据的分析样本中（n = 42,734），NMPAU的过去一年比率为1.8％，其中20％符合DSM-IV的滥用/依赖性标准。在过去一年的NMPAU中，有53％是偶然的（例如，少于每月一次），但日常使用量却很大（占NMPAU的13％）。考虑到我们的目标混杂因素，在过去，疼痛与无障碍（即没有滥用和/或依赖）和无序（即滥用和/或依赖）NMPAU的可能性正相关（p <.05）年。在每种疼痛程度内，与无障碍使用者相比，无序饮酒者的过去一年无障碍和无序NMPAU的几率显着更高（p <.05）。对于非法药物，这种模式是相似的，尽管只具有轻微的意义（p = .060），并且对无序的NMPAU具有特异性。相反，精神疾病增加了两种类型的NMPAU的可能性，但是这些关联在疼痛程度上没有差异。这些发现表明，疼痛是非紊乱和无序NMPAU的独立危险因素，但其痛苦因药物的使用方式而大大改变。

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