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首页> 外文期刊>The clinical journal of pain >The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: The role of opioid prescription
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The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: The role of opioid prescription

机译：阿片类药物处方在慢性非癌性疼痛患者中阿片类药物滥用和依赖中的作用：阿片类药物处方的作用

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OBJECTIVE:: Increasing rates of opioid use disorders (OUDs) (abuse and dependence) among patients prescribed opioids are a significant public health concern. We investigated the association between exposure to prescription opioids and incident OUDs among individuals with a new episode of a chronic noncancer pain (CNCP) condition. METHODS:: We utilized claims data from the HealthCore Database for 2000 to 2005. The dataset included all individuals aged 18 and over with a new CNCP episode (no diagnosis in the prior 6 mo), and no opioid use or OUD in the prior 6 months (n=568,640). We constructed a single multinomial variable describing prescription on opioid days supply (none, acute, and chronic) and average daily dose (none, low dose, medium dose, and high dose), and examined the association between this variable and an incident OUD diagnosis. RESULTS:: Patients with CNCP prescribed opioids had significantly higher rates of OUDs compared with those not prescribed opioids. Effects varied by average daily dose and days supply: low dose, acute (odds ratio [OR]=3.03; 95% confidence interval [CI], 2.32, 3.95); low dose, chronic (OR=14.92; 95% CI, 10.38, 21.46); medium dose, acute (OR=2.80; 95% CI, 2.12, 3.71); medium dose, chronic (OR=28.69; 95% CI, 20.02, 41.13); high dose, acute (OR=3.10; 95% CI, 1.67, 5.77); and high dose, chronic (OR=122.45; 95% CI, 72.79, 205.99). CONCLUSIONS:: Among individuals with a new CNCP episode, prescription opioid exposure was a strong risk factor for incident OUDs; magnitudes of effects were large. Duration of opioid therapy was more important than daily dose in determining OUD risk.
机译：目的：在开处方的阿片类药物患者中，阿片类药物使用障碍（OUD）（滥用和依赖性）的发生率上升是一个重大的公共卫生问题。我们调查了患有慢性非癌性疼痛（CNCP）新发作的个体中处方类阿片暴露与事件性OUD之间的关联。方法：：我们使用了HealthCore数据库2000年至2005年的索赔数据。该数据集包括所有18岁以上且有新的CNCP发作的患者（之前6个月没有诊断），并且在之前6个月没有使用阿片类药物或OUD月（n = 568,640）。我们构建了一个单一的多项变量来描述关于阿片类药物的天数供应（无，急性和慢性）和平均日剂量（无，低剂量，中剂量和高剂量）的处方，并检查了该变量与OUD突发事件诊断之间的关联。结果：与非处方阿片类药物相比，CNCP处方阿片类药物的OUD发生率明显更高。效果随平均日剂量和日供应量的不同而变化：低剂量，急性（优势比[OR] = 3.03; 95％置信区间[CI]，2.32、3.95）;低剂量，慢性（OR = 14.92; 95％CI，10.38，21.46）;中等剂量，急性（OR = 2.80; 95％CI，2.12，3.71）;中剂量，慢性（OR = 28.69; 95％CI，20.02，41.13）;高剂量，急性（OR = 3.10; 95％CI，1.67，5.77）;高剂量，慢性（OR = 122.45; 95％CI，72.79，205.99）。结论：在发生新的CNCP发作的个体中，处方阿片类药物暴露是发生OUD的重要危险因素。影响的幅度很大。在确定OUD风险时，阿片类药物治疗的持续时间比每日剂量更重要。

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