Self-Reported Prescription Opioid Use Among Participants with Chronic Spinal Cord Injury

J S Krause, N. DiPiro, Clara E. Dismuke-Greer
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Abstract

Individuals with spinal cord injuries (SCI) experience high rates of prescription opioid use, yet there is limited data on frequency of opioid use and specific medications being taken. To examine the frequency of self-reported prescription opioid use among participants with SCI and the relationship with demographic, injury, and socioeconomic characteristics. A cohort study of 918 adults with SCI of at least 1-year duration completed a self-report assessment (SRA) that indicated frequency of specific prescription opioid use based on the National Survey on Drug Use and Health (NSDUH). Forty-seven percent of the participants used at least one prescription opioid over the last year; the most frequently used was hydrocodone (22.1%). Nearly 30% used a minimum of one opioid at least weekly. Lower odds of use of at least one opioid over the past year was observed for Veterans (odds ratio [OR] = 0.60, 95% CI = 0.38, 0.96) and those with a bachelor's degree or higher (OR = 0.63, 95% CI = 0.44, 0.91). When restricting the analysis to use of at least one substance daily or weekly, lower odds of use was observed for those with a bachelor's degree or higher and those with income ranging from $25,000 to $75,000+. None of the demographic or SCI variables were significantly related to prescription opioid use. Despite the widely established risks, prescription opioids were used daily or weekly by more than 28% of the participants. Usage was only related to Veteran status and socioeconomic status indicators, which were protective of use. Alternative treatments are needed for those with the heaviest, most regular usage.
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慢性脊髓损伤参与者自述的阿片类药物处方使用情况
脊髓损伤(SCI)患者使用处方阿片类药物的比例很高,但有关阿片类药物使用频率和服用的特定药物的数据却很有限。 目的:研究脊髓损伤患者自我报告的处方阿片类药物使用频率以及与人口、损伤和社会经济特征之间的关系。 一项针对 918 名至少患有 1 年 SCI 的成年人的队列研究完成了一项自我报告评估 (SRA),该评估根据全国药物使用和健康调查 (NSDUH) 显示了特定处方阿片类药物的使用频率。 47% 的参与者在过去一年中至少使用过一种处方类阿片;使用频率最高的是氢可酮(22.1%)。近 30% 的人每周至少使用一种阿片类药物。据观察,退伍军人(几率比 [OR] = 0.60,95% CI = 0.38,0.96)和拥有学士学位或更高学历的人在过去一年中使用至少一种阿片类药物的几率较低(OR = 0.63,95% CI = 0.44,0.91)。如果将分析范围限制在每天或每周至少使用一种药物,则可以观察到拥有学士学位或更高学历的人群以及收入在 25,000 美元至 75,000 美元以上的人群使用药物的几率较低。人口统计学变量或 SCI 变量均与处方阿片类药物的使用无明显关系。 尽管处方类阿片存在广泛的风险,但仍有超过 28% 的参与者每天或每周使用处方类阿片。使用情况仅与退伍军人状况和社会经济状况指标有关,这些指标对使用具有保护作用。对于那些使用最频繁、最经常的人,需要采取替代治疗方法。
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