MMWR Morb Mortal Wkly Rep. 2012 Feb 17;61(6):101-5.
Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved . Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of these programs have provided the opioid antagonist naloxone hydrochloride, the treatment of choice to reverse the potentially fatal respiratory depression caused by overdose of heroin and other opioids. Naloxone has no effect on non-opioid overdoses (e.g., cocaine, benzodiazepines, or alcohol) . In October 2010, the Harm Reduction Coalition, a national advocacy and capacity-building organization, surveyed 50 programs known to distribute naloxone in the United States, to collect data on local program locations, naloxone distribution, and overdose reversals. This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.
自 1979 年以来,美国的药物过量致死率稳步上升。2008 年,共报告了 36450 例药物过量死亡(即非故意、故意[自杀或他杀]或意图不明),涉及的药物主要是处方类阿片类镇痛药(如羟考酮、氢可酮和美沙酮)、可卡因和海洛因。自 20 世纪 90 年代中期以来,社区为吸毒者及其家人、朋友和服务提供者提供了阿片类药物过量预防服务。自 1996 年以来,越来越多的这些项目提供了盐酸纳洛酮,作为逆转海洛因和其他阿片类药物过量引起的潜在致命呼吸抑制的首选治疗方法。纳洛酮对非阿片类药物过量(如可卡因、苯二氮䓬类或酒精)没有作用。2010 年 10 月,全国倡导和能力建设组织“减少危害联盟”对在美国分发纳洛酮的 50 个项目进行了调查,以收集有关当地项目地点、纳洛酮分发和过量逆转的资料。本报告总结了完成调查的 48 个项目和通过答复代表的 188 个地方项目的调查结果。自 1996 年第一个阿片类药物过量预防项目开始分发纳洛酮以来,被调查项目报告培训并向 53032 人分发了纳洛酮,并收到了 10171 例过量逆转的报告。向吸毒者和可能在阿片类药物过量时在场的人提供阿片类药物过量教育和纳洛酮,可以帮助降低阿片类药物过量死亡率,这是一个迅速增长的公共卫生问题。