背景:滥用的普遍性,分流,和基于网络的塔博他多背书(延长版本[ER],与其他处方阿片类药物相比,立即释放[IR])的特征是低。关于他喷他多非医疗使用(NMU)的个人经验知之甚少。
目的:本研究旨在试行基于网络的调查技术,以调查他汀多NMU的动机,采购来源,管理路线,篡改方法,使用的剂量,和他喷他多产品(Nucynta和NucyntaER)的印象。
方法:招募传单和横幅广告被放置在Bluelight网站[DragonByteTechnologiesLtd]上,链接到基于网络的调查(Qualtrics),旨在查询个人的一生tapentadolNMU。这项基于网络的调查之后是一个基于网络的交互式聊天(Cryptocat),与愿意联系的受访者进行。受访者被问及获得他喷他多的来源,使用动机,管理路线,篡改方法,联合使用的药物,片剂的强度和剂量,以及继续或停止使用的原因。对NMU的期望度和吸引力进行了评级。
结果:基于网络的招募成功吸引了难以找到的研究参与者。共有78名参与者报告他喷他多来自朋友和家人(ER11/30,37%;IR18/67,27%),互联网(ER11/30,37%;IR12/67,18%)或参与者拥有医生的处方(ER9/30,30%;IR17/67,25%)。它用于非医学缓解疼痛(ER18/30,60%;IR33/67,49%)和多种精神药物作用,包括弛豫(ER13/30,43%;IR29/67,43%),抑郁或焦虑减少(ER7/30,23%;IR30/67,45%),或变高(ER12/30,40%;IR33/67,49%)。他喷他多主要是吞咽(ER22/30,73%;IR55/67,82%),尽管也报告了鼻吸(ER2/30,7%;IR8/67,12%)和注射(ER2/30,7%;IR5/67,8%)。NMU的优选剂量为100mg(ER和IR)。参与者报告他喷他多与苯二氮卓类药物一起使用(ER12/21,57%;IR28/47,60%)。大多数参与者在调查完成时停止了他喷他多NMU(ER22/30,73%;IR55/67,82%)。停止ERNMU的原因包括副作用(10/22,46%)和缺乏有效治疗(10/22,46%)。终止IRNMU的原因包括缺乏访问权(26/55,47%)和更好的NMU选择(IR21/55,38%)。很少有人愿意在互动聊天中透露有关自己的识别信息(8/78,10%),展示了匿名的力量,基于网络的调查。互动聊天支持调查结果。一组参与者(4/78,5%)报告了高剂量的致幻副作用。
结论:基于网络的调查可以成功招募报告药物NMU和难以找到药物的人。TapentadolNMU似乎主要用于缓解疼痛及其精神作用。虽然有些人喜欢它,Tapentadol并未获得NMU的稳健认可。
BACKGROUND: The prevalence of abuse, diversion, and web-based endorsement of tapentadol (extended-release [ER], immediate-release [IR]) has been characterized as low compared with other prescription opioids. Little is known about individual experience with tapentadol nonmedical use (NMU).
OBJECTIVE: This study aims to pilot web-based survey technologies to investigate the motivation for tapentadol NMU, sources of procurement, routes of administration, tampering methods, doses used, and impressions of tapentadol products (Nucynta and Nucynta ER).
METHODS: Recruitment flyers and banner advertisements were placed on the Bluelight website [DragonByte Technologies Ltd] with a link to a web-based survey (Qualtrics) designed to query about individuals\' lifetime tapentadol NMU. This web-based survey was followed by an interactive web-based chat (Cryptocat) with respondents who were willing to be contacted. Respondents were queried about sources for obtaining tapentadol, motives for use, routes of administration, tampering methods, drugs used in combination, tablet strengths and dosages, and reasons for continued or discontinued use. Desirability and attractiveness for NMU was rated.
RESULTS: Web-based recruitment successfully attracted difficult-to-find study participants. A total of 78 participants reported that tapentadol was obtained from friends and family (ER 11/30, 37%; IR 18/67, 27%), the internet (ER 11/30, 37%; IR 12/67, 18%) or participants\' own prescriptions from a doctor (ER 9/30, 30%; IR 17/67, 25%). It was used nonmedically for pain relief (ER 18/30, 60%; IR 33/67, 49%) and multiple psychotropic effects, including relaxation (ER 13/30, 43%; IR 29/67, 43%), reduction in depression or anxiety (ER 7/30, 23%; IR 30/67, 45%), or getting high (ER 12/30, 40%; IR 33/67, 49%). Tapentadol was primarily swallowed (ER 22/30, 73%; IR 55/67, 82%), although snorting (ER 2/30, 7%; IR 8/67, 12%) and injection (ER 2/30, 7%; IR 5/67, 8%) were also reported. The preferred dose for NMU was 100 mg (both ER and IR). The participants reported tapentadol use with benzodiazepines (ER 12/21, 57%; IR 28/47, 60%). Most participants had discontinued tapentadol NMU at the time of survey completion (ER 22/30, 73%; IR 55/67, 82%). Reasons for discontinued ER NMU included side effects (10/22, 46%) and lack of effective treatment (10/22, 46%). Reasons for discontinued IR NMU included lack of access (26/55, 47%) and better NMU options (IR 21/55, 38%). Few individuals were willing to divulge identifying information about themselves for the interactive chat (8/78, 10%), demonstrating the strength of anonymous, web-based surveys. Interactive chat supported the survey findings. A subgroup of participants (4/78, 5%) reported hallucinogenic side effects with high doses.
CONCLUSIONS: Web-based surveys can successfully recruit individuals who report drug NMU and those who are difficult to find. Tapentadol NMU appears to occur primarily for pain relief and for its psychotropic effects. Although it was liked by some, tapentadol did not receive a robust pattern of endorsement for NMU.