Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pain Med. 2011 May;12(5):747-54. doi: 10.1111/j.1526-4637.2011.01062.x. Epub 2011 Feb 18.
Drug overdoses resulting from the abuse of prescription opioid analgesics and other controlled substances have increased in number as the volume of such drugs prescribed in the United States has grown. State prescription drug monitoring programs (PDMPs) are designed to prevent the abuse of such drugs. This study quantifies the relation of PDMPs to rates of death from drug overdose and quantities of opioid drugs distributed at the state level.
Observational study of the United States during 1999-2005.
Rates of drug overdose mortality, opioid overdose mortality, and opioid consumption by state.
PDMPs were not significantly associated with lower rates of drug overdose or opioid overdose mortality or lower rates of consumption of opioid drugs. PDMP states consumed significantly greater amounts of hydrocodone (Schedule III) and nonsignificantly lower amounts of Schedule II opioids. The increases in overdose mortality rates and use of prescription opioid drugs during 1999-2005 were significantly lower in three PDMP states (California, New York, and Texas) that required use of special prescription forms.
While PDMPs are potentially an important tool to prevent the nonmedical use of prescribed controlled substances, their impact is not reflected in drug overdose mortality rates. Their effect on overall consumption of opioids appears to be minimal. PDMP managers need to develop and test ways to improve the use of their data to affect the problem of prescription drug overdoses.
随着美国开出的处方类阿片类镇痛药和其他受控物质数量的增加,因滥用这些药物而导致的药物过量服用的情况也有所增加。州级处方药物监测项目旨在预防此类药物的滥用。本研究定量分析了州级处方药物监测项目与药物过量死亡率以及州级阿片类药物分发数量之间的关系。
对 1999 年至 2005 年期间的美国进行观察性研究。
药物过量死亡率、阿片类药物过量死亡率以及各州的阿片类药物使用量。
州级处方药物监测项目与较低的药物过量或阿片类药物过量死亡率或较低的阿片类药物使用量之间并无显著相关性。州级处方药物监测项目实施州使用的氢可酮(附表 III)数量明显增加,附表 II 类阿片类药物的使用量则无明显减少。在 1999 年至 2005 年期间,加利福尼亚州、纽约州和德克萨斯州这三个要求使用特殊处方形式的州的过量死亡率和处方类阿片类药物使用量的增长率明显较低。
虽然州级处方药物监测项目是预防非医疗使用处方受控物质的潜在重要工具,但它们对药物过量死亡率的影响并未得到体现。它们对阿片类药物总使用量的影响似乎很小。州级处方药物监测项目管理者需要制定并测试提高其数据使用效果的方法,以解决处方类药物过量的问题。