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美国有终身癌症诊断的成年人中,止痛药物滥用、心理困扰与阿片类药物使用障碍之间的关联。

Association between pain medication misuse, psychological distress, and opioid use disorder among adults with lifetime cancer diagnosis in the United States.

作者信息

Owusu Derrick Nyantakyi, Brooks Bill, Ahuja Manik, Goodin Kate, Mensah Emmanuel Angmorteh

机构信息

Biostatistics and Epidemiology Department, College of Public Health, East Tennessee State University, Johnson City, TN, USA.

Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA.

出版信息

Support Care Cancer. 2025 Jun 28;33(7):638. doi: 10.1007/s00520-025-09713-1.

Abstract

PURPOSE

Opioid use disorder (OUD) is a critical public health concern in the United States, further complicated in cancer patients who often require opioids for pain management. This study aims to identify predictors of OUD among adults with lifetime cancer in the United States.

METHODS

A cross-sectional analysis was conducted using data from the 2022 National Survey on Drug Use and Health (NSDUH). A total of 1,948 cancer respondents were included. Multivariable logistic regression models were employed to examine the association between OUD and predictors such as pain medication misuse, psychological distress, and SUD history, while adjusting for socio-demographic factors.

RESULTS

The prevalence of OUD among cancer patients was 3.0%, with 9% reporting pain medication misuse. Respondents who misused pain medications were 11.3 times more likely to have an OUD (adjusted odds ratio [aOR]: 11.3, 95% CI: 4.07-31.3). High to very high psychological distress was associated with a significant increase in odds of OUD compared to low or no distress, [aOR] 10.8 (95% CI: 1.89-61.6). No significant association was observed between a history of SUD treatment and OUD.

CONCLUSION

Cancer patients remain at considerable risk for OUD, driven by pain medication misuse and psychological distress. These findings underscore the need for comprehensive strategies integrating opioid management, mental health support, and early identification of at-risk individuals. A multidisciplinary approach is essential to mitigate the dual challenges of effective cancer pain management and the prevention of OUD.

摘要

目的

阿片类药物使用障碍(OUD)是美国一个关键的公共卫生问题,对于经常需要使用阿片类药物进行疼痛管理的癌症患者而言,情况更为复杂。本研究旨在确定美国有终生癌症病史的成年人中OUD的预测因素。

方法

使用2022年全国药物使用和健康调查(NSDUH)的数据进行横断面分析。共纳入1948名癌症受访者。采用多变量逻辑回归模型,在调整社会人口统计学因素的同时,研究OUD与疼痛药物滥用、心理困扰和物质使用障碍(SUD)病史等预测因素之间的关联。

结果

癌症患者中OUD的患病率为3.0%,9%的患者报告有疼痛药物滥用情况。滥用疼痛药物的受访者患OUD的可能性高11.3倍(调整后的优势比[aOR]:11.3,95%置信区间[CI]:4.07 - 31.3)。与低或无心理困扰相比,高至非常高的心理困扰与OUD的患病几率显著增加相关,[aOR]为10.8(95% CI:1.89 - 61.6)。未观察到SUD治疗史与OUD之间存在显著关联。

结论

由于疼痛药物滥用和心理困扰,癌症患者仍然面临着相当大的OUD风险。这些发现强调了需要采取综合策略,整合阿片类药物管理、心理健康支持以及对高危个体的早期识别。多学科方法对于减轻有效癌症疼痛管理和预防OUD这两个双重挑战至关重要。

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