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Hung HY, Chien WC, Chung CH, Kao LT, Chow LH, Chen YH, Kotlińska JH, Silberring J, Huang EYK. Patients with alcohol use disorder increase pain and analgesics use: A nationwide population-based cohort study. Drug Alcohol Depend 2021; 229:109102. [PMID: 34634646 DOI: 10.1016/j.drugalcdep.2021.109102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol has dual effects on many systems, including the pain system. We will test whether and how chronic alcohol consumption enhances pain sensation to develop pain disorder. METHODS We conducted a retrospective matched cohort study using data from the National Health Insurance Research Database (NHIRD) in Taiwan, in patients with and without alcohol use disorder (AUD). This study enrolled 19,174 individuals with AUD as study cohort and 19,174 propensity score-matched individuals without AUD as comparison cohort. The outcome was the incidence of pain disorders and the need for analgesics. The hazard ratios of pain disorders and the need for analgesics were evaluated using Cox proportional hazard regression analysis after adjusting for age, sex, index year, comorbidities, urbanization, areas of residence, and insurance premium. RESULTS The 14 years of follow-up showed that AUD patients had a higher adjusted hazard ratio (aHR) for developing pain disorders than in non-AUD controls [aHR= 1.290, 95% confidence interval (CI): 1.045-1.591]. Besides, AUD patients had a higher risk of analgesic use (aHR = 1.081, 95% CI: 1.064-1.312), including opioids and non-opioid analgesics. Most importantly, AUD patients required more days of analgesic use, increased dose of analgesics, and higher costs of analgesics. Moreover, AUD patients had more anemia (aHR=2.772, 95% CI: 2.581-2.872), which could be a mediating factor. CONCLUSIONS AUD patients had higher risks of developing pain disorders and subsequently increased analgesic demand. These results suggest that AUD worsened pain, and pain syndrome is correlated with the duration of chronic alcohol exposure.
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Affiliation(s)
- Hao-Yuan Hung
- Department of Pharmacology, National Defense Medical Center, Taipei 11490, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan; Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan; School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
| | - Li-Ting Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan; School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; School of Pharmacy, National Defense Medical Center, Taipei 11490, Taiwan
| | - Lok-Hi Chow
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Anesthesiology, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 11221, Taiwan; Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yuan-Hao Chen
- Department of Pharmacology, National Defense Medical Center, Taipei 11490, Taiwan; Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Jolanta H Kotlińska
- Department of Pharmacology and Pharmacodynamics, Faculty of Pharmacy with Division of Medical Analytics, Medical University of Lublin, Lublin 20-093, Poland
| | - Jerzy Silberring
- Department of Biochemistry and Neurobiology, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Krakow 30-059, Poland
| | - Eagle Yi-Kung Huang
- Department of Pharmacology, National Defense Medical Center, Taipei 11490, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan.
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Men's decrease and women's increase in harmful alcohol use from the 2014 to 2018 national surveys in Taiwan: A harbinger for an emerging national trend in East Asia? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 99:103441. [PMID: 34503897 DOI: 10.1016/j.drugpo.2021.103441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Gender differences in alcohol use have narrowed in Western societies, but that in Asia has been less investigated. By comparing the 2014 and 2018 waves of the national survey in Taiwan, we aimed to examine the gender differences in population trends in past-month alcohol use, binge drinking, and harmful alcohol use. METHODS The national survey enrolled 17,837 participants in 2014 and 18,626 participants in 2018. Binge drinking was defined as having ≥5 drinks on one occasion in the past month, and harmful alcohol use as having an Alcohol Use Disorders Identification Test score of ≥8. RESULTS There were significant decreases from 2014 to 2018 in the population's prevalence of past-month alcohol use, binge drinking, and harmful alcohol use. However, males and females had different trends: males showed significant reductions in all three alcohol use behaviours (a decrease of 3.79%, 1.59%, and 2.60%, respectively), while females exhibited a significant rise in harmful alcohol use (from 1.32% to 1.72%), particularly among those aged 18-29 years. CONCLUSION There was gender convergence in alcohol use in Taiwan, mainly due to men's decrease and women's increase in harmful alcohol use. Our findings have important implications for the intervention and prevention of the problematic use of alcohol in East Asia.
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Huang YC, Chien WC, Chung CH, Chang HA, Kao YC, Wan FJ, Huang SH, Chung RJ, Wang RS, Wang BL, Tzeng NS, Sun CA. Risk of Psychiatric Disorders in Multiple Sclerosis: A Nationwide Cohort Study in an Asian Population. Neuropsychiatr Dis Treat 2021; 17:587-604. [PMID: 33654401 PMCID: PMC7910105 DOI: 10.2147/ndt.s268360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/18/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a demyelinating disease that can damage neurons in the brain and spinal cord and is associated with several psychiatric disorders. However, few studies have evaluated the risk of psychiatric disorders in patients with MS by using a nationwide database. This study investigated the association between MS and the risk of psychiatric disorders. METHODS Using data from the Taiwan National Health Insurance Research Database from 2000 to 2015, we identified 1066 patients with MS. After adjustment for confounding factors, Fine and Gray's competing risk model was used to compare the risk of psychiatric disorders during 15 years of follow-up. RESULTS Of the patients with MS, 531 (4622.86 per 105 person years) developed psychiatric disorders; by contrast, 891 of the 3198 controls (2485.31 per 105 person years) developed psychiatric disorders. Fine and Gray's competing risk model revealed an adjusted hazard ratio (HR) of 5.044 (95% confidence interval = 4.448-5.870, p < 0.001) after adjustment for all the covariates. MS was associated with depression, anxiety, bipolar disorder, sleep disorders, schizophrenia, schizophreniform disorder, and other psychotic disorders (adjusted HR: 12.464, 4.650, 6.987, 9.103, 2.552, 2.600, 2.441, and 2.574, respectively; all p < 0.001). Some disease-modifying drugs were associated with a lower risk of anxiety or depression. CONCLUSION Patients with MS were determined to have a higher risk of developing a wide range of psychiatric disorders.
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Affiliation(s)
- Yao-Ching Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Ren-Jei Chung
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Richard S Wang
- Program of Data Analytic and Business Computing, Stern School of Business, New York University, USA
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
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