背景:Kratom是联邦不受管制的,尽管证据有限和已知的负面影响,但仍作为阿片类药物替代品上市。阿片类药物和kratom使用之间的联系差异可能部分归因于种族/民族和性取向,使用动机,和开药者的做法。
方法:数据:2021年全国代表性的18岁以上人群药物使用和健康调查。我们使用加权逻辑回归分析来评估种族/民族和性取向,作为过去一年阿片类药物(1)使用(总样本,n=44,877)和(2)滥用和使用障碍(在过去一年使用阿片类药物的人群中,n=10,398)和kratom使用的结果(寿命,过去一年)。
结果:26.76%报告了过去一年的阿片类药物使用情况,其中,12.20%和7.54%报告了过去一年的阿片类药物滥用和使用障碍,分别有1.72%和0.67%的人使用过kratom,分别。阿片类药物使用与终生(aOR=2.69,95CI=1.98,3.66)和过去一年(aOR=3.84,95CI=2.50,5.92)kratom使用呈正相关;非西班牙裔黑人和西班牙裔之间的关联(vs.非西班牙裔白人)参与者较弱(p<0.01)。在报告过去一年阿片类药物使用的参与者中,滥用和使用障碍与寿命呈正相关(aORmisuse=2.46,95CI=1.60,3.78;aORuse障碍=5.58,95CI=2.82,11.04)和过去一年(aORuse滥用=2.40,95CI=1.26,4.59;aORuse障碍=3.08,95CI=1.48,6.41)kratom使用;在双性恋中(vs.异性恋)参与者,阿片类药物使用障碍与终生使用kratom的概率较低相关(p<0.01)。
结论:我们观察到阿片类药物和kratom使用之间存在正相关,某些种族/族裔和性取向群体之间存在潜在差异。研究应检查导致这些差异的机制,为预防和干预工作提供信息。
BACKGROUND: Kratom is federally unregulated and is marketed as an opioid alternative despite limited evidence and known negative effects. Disparities in associations between opioid and kratom use may be partly attributed to race/ethnicity and sexual orientation given differences in marketing, use motives, and prescriber practices.
METHODS: Data: 2021 nationally representative National Survey on Drug Use and Health among individuals aged 18 + . We used weighted logistic regression analyses to assess race/ethnicity and sexual orientation as moderators of associations between past-year opioid (1) use (total sample, n = 44,877) and (2) misuse and use disorder (among those with past-year opioid use, n = 10,398) and the outcome of kratom use (lifetime, past year).
RESULTS: 26.76% reported past-year opioid use, and among those, 12.20% and 7.54% reported past-year opioid misuse and use disorder, respectively; 1.72% and 0.67% had lifetime and past-year kratom use, respectively. Opioid use was positively associated with lifetime (aOR = 2.69, 95%CI = 1.98, 3.66) and past-year (aOR = 3.84, 95%CI = 2.50, 5.92) kratom use; associations among non-Hispanic Black and Hispanic (vs. non-Hispanic White) participants were weaker (p < 0.01). Among participants reporting past-year opioid use, misuse and use disorder were positively associated with lifetime (aORmisuse = 2.46, 95%CI = 1.60, 3.78; aORuse disorder = 5.58, 95%CI = 2.82, 11.04) and past-year (aORmisuse = 2.40, 95%CI = 1.26, 4.59; aORuse disorder = 3.08, 95%CI = 1.48, 6.41) kratom use; among bisexual (vs. heterosexual) participants, opioid use disorder was associated with a lower probability of lifetime kratom use (p < 0.01).
CONCLUSIONS: We observed positive associations between opioid and kratom use, with potential disparities among certain racial/ethnic and sexual orientation groups. Research should examine the mechanisms contributing to these differences to inform prevention and intervention efforts.