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Toward a Comprehensive Developmental Model of Prescription Opioid Use Disorder
Abstract
Objective To develop a comprehensive etiologic model of DSM-5 prescription opioid use disorder (POUD) based on Kendler and colleagues' development model for major depressive disorder. Methods Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013). Risk factors were divided into 4 developmental tiers (childhood/early adolescence, late adolescence, adulthood, past year). Hierarchical logistic regression models were used to examine the independent contribution of each risk factor. Separate models were built to predict 12-month nonmedical use of prescription opioids and risk of POUD among those with 12-month nonmedical use. Results After adjustment for other risk factors, the odds of past 12-month nonmedical use of prescription opioids were increased by history of trauma, social deviance, and use of drugs other than opioids in adulthood and by past-year pain, alcohol use disorder (AUD), tobacco use disorder, any Axis I disorder other than SUD, and number of stressful events. History of POUD in adulthood and pain, AUD, tobacco use disorder, and any Axis I disorder other than substance use disorders (SUD) in the past year increased the odds of 12-month POUD. History of SUD other than POUD in adulthood was associated with lower odds of POUD. For both outcomes, the effect of earlier development tiers was mediated by more proximal ones. Conclusions A modification of Kendler and colleagues' model for major depressive disorder provides a…
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Substance use and SUDs are multidetermined, with different risk factors playing varying roles at different life stages, from the prenatal period and childhood to early and late adulthood.
“Substance use and SUDs are multidetermined, with the differ ent risk factors playing varying roles at different life stages, from the prenatal period and childhood to early and late adulthood 78,79,164 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [79]
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Metadata
- Authors
- Blanco, C., Wall, M. M., Liu, S.-M., & Olfson, M.
- Affiliations
- National Institutes of Health (US)
- New York State Psychiatric Institute (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2019-12-03
- Volume
- 81
- Issue
- 1
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W2993499517
- Cited by
- 15
- References
- 0
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 3
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- prescription opioid use disorder, developmental model, etiology, nonmedical opioid use, childhood trauma, social deviance, polydrug use, pain, alcoholism, tobacco use disorder, life events, comorbid substance use disorders, risk factors
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Models, Psychological, Opioid-Related Disorders, Risk Factors, Substance-Related Disorders, Young Adult
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