Bryant W K, Galea S, Tracy M, Markham Piper T, Tardiff K J, Vlahov D
Center for Urban Epidemiologic Studies, New York Academy of Medicine, Columbia University Mailman School of Public Health, New York, NY, USA.
Addiction. 2004 Jul;99(7):846-54. doi: 10.1111/j.1360-0443.2004.00693.x.
Methadone treatment has been shown to be an effective intervention that can lower the risk of heroin-induced overdose death. Recent reports have suggested increases in methadone-induced overdose deaths in several locations in the USA and in Europe. This study investigated the role of methadone and opiates in accidental overdose deaths in New York City.
We analysed data from the Office of the Chief Medical Examiner to examine all accidental drug overdose deaths in New York City between 1990 and 1998.
Of 7451 total overdose deaths during this period, there were 1024 methadone-induced overdose deaths, 4627 heroin-induced overdose deaths and 408 overdose deaths attributed to both methadone and heroin. Fewer than a third as many accidental overdose deaths were attributed to methadone than were attributed to heroin during this period. The proportion of accidental overdose deaths attributed to methadone did not change appreciably (12.6-15.8% of total overdose mortality), while the proportion of overdose deaths attributed to heroin increased significantly (53.5-64.2%) during the period of study.
There was no appreciable increase in methadone-induced overdose mortality in New York City during the 1990s. Both heroin-induced overdose mortality and prescriptions of methadone increased during the same interval.
美沙酮治疗已被证明是一种有效的干预措施，可降低海洛因所致过量用药死亡的风险。近期报告显示，美国和欧洲的几个地区美沙酮所致过量用药死亡有所增加。本研究调查了美沙酮和阿片类药物在纽约市意外过量用药死亡中的作用。
我们分析了首席法医办公室的数据，以检查1990年至1998年间纽约市所有意外药物过量用药死亡情况。
在此期间的7451例总过量用药死亡中，有1024例为美沙酮所致过量用药死亡，4627例为海洛因所致过量用药死亡，408例为美沙酮和海洛因两者所致过量用药死亡。在此期间，归因于美沙酮的意外过量用药死亡人数不到归因于海洛因的三分之一。归因于美沙酮的意外过量用药死亡比例没有明显变化（占总过量用药死亡率的12.6 - 15.8%），而在此研究期间，归因于海洛因的过量用药死亡比例显著增加（从53.5%增至64.2%）。
在20世纪90年代，纽约市美沙酮所致过量用药死亡率没有明显增加。在同一时期，海洛因所致过量用药死亡率和美沙酮处方量均有所增加。
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