Edelman, E Jennifer; Li, Yu; Barry, Declan; Brennan Braden, Jennifer; Crystal, Stephen; Kerns, Robert D; Gaither, Julie R; Gordon, Kirsha S; Manhapra, Ajay; Merlin, Jessica S; +10 more... Moore, Brent A; Oldfield, Benjamin J; Park, Lesley S; Rentsch, Christopher T; Skanderson, Melissa; Williams, Emily C; Justice, Amy C; Tate, Janet P; Becker, William C; Marshall, Brandon DL; (2020) Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. JAIDS Journal of Acquired Immune Deficiency Syndromes, 84 (1). pp. 26-36. ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0000000000002310
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Abstract
BACKGROUND: No prior studies have characterized long-term patterns of opioid use regardless of source or reason for use among patients with HIV (PWH). We sought to identify trajectories of self-reported opioid use and their correlates among a national sample of PWH engaged in care. SETTING: Veterans Aging Cohort Study, a prospective cohort including PWH receiving care at 8 US Veterans Health Administration (VA) sites. METHODS: Between 2002 and 2018, we assessed past year opioid use frequency based on self-reported "prescription painkillers" and/or heroin use at baseline and follow-up. We used group-based trajectory models to identify opioid use trajectories and multinomial logistic regression to determine baseline factors independently associated with escalating opioid use compared to stable, infrequent use. RESULTS: Among 3702 PWH, we identified 4 opioid use trajectories: (1) no lifetime use (25%); (2) stable, infrequent use (58%); (3) escalating use (7%); and (4) de-escalating use (11%). In bivariate analysis, anxiety; pain interference; prescribed opioids, benzodiazepines and gabapentinoids; and marijuana use were associated with escalating opioid group membership compared to stable, infrequent use. In multivariable analysis, illness severity, pain interference, receipt of prescribed benzodiazepine medications, and marijuana use were associated with escalating opioid group membership compared to stable, infrequent use. CONCLUSION: Among PWH engaged in VA care, 1 in 15 reported escalating opioid use. Future research is needed to understand the impact of psychoactive medications and marijuana use on opioid use and whether enhanced uptake of evidence-based treatment of pain and psychiatric symptoms can prevent escalating use among PWH.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology |
Research Centre | EHR Research Group |
Elements ID | 144289 |
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