在被诊断患有酒精相关疾病的分娩人群中使用药物治疗酒精使用障碍。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-09-04 DOI:10.1097/ADM.0000000000001372
Sarah Cm Roberts, Guodong Liu, Mishka Terplan
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引用次数: 0

摘要

目的:尽管成人用药治疗酒精使用障碍(AUD)的安全性和有效性已得到充分证实,但有关孕期用药的文献却十分有限。鉴于已知妊娠期酒精中毒性精神障碍未经治疗会产生不良影响,临床医生和研究人员最近开始呼吁重新考虑在妊娠期使用药物治疗酒精中毒性精神障碍。因此,我们试图估算出有酒精相关诊断并接受过与 AUD 治疗相关的药物处方的分娩者比例:数据来自 Meritive MarketScan(一个全国性的私人保险理赔数据库)。研究队列包括 2006 年至 2019 年期间在美国生育单胎并与婴儿匹配的 25-50 岁分娩者。变量包括出生后一年内与酒精相关的诊断和接受与 AUD 治疗相关的药物处方。我们计算了接受任何 AUD 药物治疗的酒精相关诊断比例以及每种药物类型的比例:在 1,432,979 个分娩者-婴儿二人组中,有 2517 人(0.18%)被诊断出与酒精有关。在接受酒精相关诊断的人群中,8.70%(n = 219)接受过任何药物治疗。最常见的药物是加巴喷丁(4.69%,n = 118),其次是用于戒酒的苯二氮卓类药物(2.19%,n = 55)。约 2% 的人服用纳曲酮(1.91%,n = 48)和/或双硫仑(1.39%,n = 35);0.56% 的人服用阿坎酸(n = 14)。没有人因酒精相关诊断而接受苯巴比妥治疗。几乎所有药物都是产后服用的:结论:被诊断为酒精相关疾病的孕妇/产后患者很少服用与 AUD 治疗相关的药物。需要进行研究,以确定孕期服用这些药物是否利大于弊。
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Medications for Alcohol Use Disorder among Birthing People with an Alcohol-related Diagnosis.

Objectives: Although safety and effectiveness of medications for alcohol use disorder (AUD) are well established for adults, literature on these medications in pregnancy is limited. Given known adverse effects of untreated AUD during pregnancy, clinicians and researchers have recently begun to call for reconsidering use of medications for AUD in pregnancy. Thus, we sought to estimate the proportion of birthing people with an alcohol-related diagnosis who received a prescription for medication related to AUD treatment.

Methods: Data were from Meritive MarketScan, a national private insurance claims database. The study cohort included birthing people aged 25-50 who gave birth to a singleton in the United States between 2006 and 2019 and were matched with an infant. Variables included an alcohol-related diagnosis within a year of birth and receiving a prescription for a medication related to AUD treatment. We calculated proportions with alcohol-related diagnoses who received any AUD medication and each medication type.

Results: Of 1,432,979 birthing person-infant dyads, 2517 (0.18%) had an alcohol-related diagnosis. Of those with an alcohol-related diagnosis, 8.70% (n = 219) received any medication. The most common was gabapentin (4.69%, n = 118), with benzodiazepines for withdrawal as the second most common (2.19%, n = 55). Approximately 2% received naltrexone (1.91%, n = 48) and/or disulfiram (1.39%, n = 35); 0.56% (n = 14) received acamprosate. No one with an alcohol-related diagnosis received phenobarbital. Almost all medications were received postpartum.

Conclusions: Very few pregnant/postpartum people with alcohol-related diagnoses are prescribed medications related to AUD treatment. Research is needed to examine whether benefits of these medications during pregnancy outweigh harms.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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