PDF(Pubmed)
Abstract：
Persons with HIV (PWH) experience high levels of pain. We examined the relationship of pain severity with use of cannabis and prescription opioids among PWH. This cross-sectional study evaluated associations between self-reported pain (moderate/severe vs mild/none) and cannabis and prescription opioid use in a primary care sample of PWH enrolled in an alcohol use treatment study at Kaiser Permanente, San Francisco. Prevalence ratios (PR) for moderate/severe pain associated with cannabis, opioid use, or both in the prior 30 days were obtained from Poisson regression models. Adjusted models included race/ethnicity, education, employment, HIV ribonucleic acid levels, depression, and anxiety. Overall, 614 PWH completed baseline questionnaires from May 2013 to May 2015, among whom 182/614 (29.6%) reported moderate/severe pain. The prevalence of moderate/severe pain varied by substances: 19.1% moderate/severe pain among study participants who reported neither cannabis or opioids, 30.2% for cannabis alone, 41.2% for opioids alone, and 60.9% for those reporting both substances. In adjusted models, compared with PWH who reported neither substance (reference), prevalence of moderate/severe pain was higher for those using cannabis alone (PR 1.54; 95% CI 1.13-2.09), opioids alone (PR 1.96; 95% CI 1.31-2.94), and those reporting both (PR 2.66; 95% CI 1.91-3.70). PWH who reported opioid and/or cannabis use were more likely to report moderate/severe pain compared with PWH who did not report use of these substances. To improve patient care, it is vital to assess patients\' approaches to pain management including substance use and target appropriate interventions to reduce pain in PWH.
摘要：
患有HIV（PWH）的人经历高水平的疼痛。我们研究了PWH中疼痛严重程度与使用大麻和处方阿片类药物的关系。这项横断面研究评估了在KaiserPermanente进行的酒精使用治疗研究的PWH初级保健样本中，自我报告的疼痛（中度/重度与轻度/无）与大麻和处方阿片类药物使用之间的关联。旧金山.与大麻相关的中度/重度疼痛的患病率比（PR），阿片类药物的使用，或两者均在前30天内从泊松回归模型获得。调整后的模型包括种族/民族，教育,employment,HIV核糖核酸水平，抑郁症,和焦虑。总的来说,从2013年5月至2015年5月，有614份PWH完成了基线调查问卷，其中182/614（29.6%）报告了中度/重度疼痛。中度/重度疼痛的患病率因物质而异：在既未报告大麻也未报告阿片类药物的研究参与者中，有19.1％的中度/重度疼痛。仅大麻就占30.2%，仅阿片类药物占41.2%，报告这两种物质的占60.9%。在调整后的模型中，与未报告任何物质的PWH(参考)相比，仅使用大麻的患者的中度/重度疼痛患病率更高（PR1.54;95％CI1.13-2.09），单独使用阿片类药物（PR1.96；95%CI1.31-2.94），和同时报告的人（PR2.66；95%CI1.91-3.70）。与未报告使用这些物质的PWH相比，报告使用阿片类药物和/或大麻的PWH更有可能报告中度/重度疼痛。为了改善病人护理，评估患者的疼痛管理方法,包括药物使用和针对适当的干预措施以减轻PWH疼痛至关重要.
