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美国阿片类药物使用障碍的治疗差距是否缩小了?2010 年至 2019 年的年度评估。

Has the treatment gap for opioid use disorder narrowed in the U.S.?: A yearly assessment from 2010 to 2019".

机构信息

Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States.

Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States.

出版信息

Int J Drug Policy. 2022 Dec;110:103786. doi: 10.1016/j.drugpo.2022.103786. Epub 2022 Aug 4.

Abstract

BACKGROUND

The United States overdose crisis continues unabated. Despite efforts to increase capacity for treating opioid use disorder (OUD) in the U.S., how actual treatment receipt compares to need remains unclear. In this cross-sectional study, we estimate progress in addressing the gap between OUD prevalence and OUD treatment receipt at the national and state levels from 2010 to 2019.

METHODS

We estimated past-year OUD prevalence rates based on the U.S. National Survey on Drug Use and Health (NSDUH), using adjustment methods that attempt to account for OUD underestimation in national household surveys. We used data from specialty substance use treatment records and outpatient pharmacy claims to estimate the gap between OUD prevalence and number of persons receiving medications for opioid use disorder (MOUD) during the past decade.

RESULTS

Adjusted estimates suggest past-year OUD affected 7,631,804 individuals in the U.S. in (2,773 per 100,000 adults 12+), relative to only 1,023,959 individuals who received MOUD (365 per 100,000 adults 12+). This implies approximately 86.6% of individuals with OUD nationwide who may benefit from MOUD treatment do not receive it. MOUD receipt increased across states over the past decade, but most regions still experience wide gaps between OUD prevalence and MOUD receipt.

CONCLUSIONS

Despite some progress in expanding access to MOUD, a substantial gap between OUD prevalence and treatment receipt highlights the critical need to increase access to evidence-based services.

摘要

背景

美国的药物过量危机仍在加剧。尽管美国一直在努力增加治疗阿片类药物使用障碍(OUD)的能力,但实际的治疗接受情况与需求相比仍不清楚。在这项横断面研究中,我们评估了 2010 年至 2019 年期间,全美和各州在解决 OUD 患病率与 OUD 治疗接受率之间差距方面的进展。

方法

我们根据美国国家药物使用与健康调查(NSDUH)的数据,采用试图解释全国家庭调查中 OUD 低估的调整方法,估算了过去一年 OUD 的患病率。我们使用专门的物质使用治疗记录和门诊药房理赔数据来估算过去十年 OUD 患病率与接受阿片类药物使用障碍药物治疗(MOUD)的人数之间的差距。

结果

调整后的估计表明,过去一年美国有 7631804 人患有 OUD(每 10 万成年人中有 2773 人),而仅 1023959 人接受了 MOUD(每 10 万成年人中有 365 人)。这意味着全国范围内约有 86.6%的 OUD 患者可能受益于 MOUD 治疗,但他们并未接受治疗。过去十年,各州接受 MOUD 的人数有所增加,但大多数地区的 OUD 患病率与 MOUD 接受率之间仍存在较大差距。

结论

尽管在扩大 MOUD 治疗机会方面取得了一些进展,但 OUD 患病率与治疗接受率之间存在巨大差距,这突出表明迫切需要增加获得循证服务的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e6/10976290/1fb2d7556ea1/nihms-1964811-f0001.jpg

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