Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 4770 Buford Hwy, Mailstop F-62, Atlanta, GA 30341, United States.
Drug Alcohol Depend. 2013 Sep 1;132(1-2):81-6. doi: 10.1016/j.drugalcdep.2013.01.006. Epub 2013 Feb 8.
In the United States, fatal drug overdoses have tripled since 1991. This escalation in deaths is believed to be driven primarily by prescription opioid medications. This investigation compared trends and patterns in sales of opioids, opioid drug overdoses treated in emergency departments (EDs), and unintentional overdose deaths in North Carolina (NC).
Our ecological study compared rates of opioid sales, opioid related ED overdoses, and unintentional drug overdose deaths in NC. Annual sales data, provided by the Drug Enforcement Administration, for select opioids were converted into morphine equivalents and aggregated by zip code. These opioid drug sales rates were trended from 1997 to 2010. In addition, opioid sales were correlated and compared to opioid related ED visits, which came from a Centers for Disease Control and Prevention syndromic surveillance system, and unintentional overdose deaths, which came from NC Vital Statistics, from 2008 to 2010. Finally, spatial cluster analysis was performed and rates were mapped by zip code in 2010.
Opioid sales increased substantially from 1997 to 2010. From 2008 to 2010, the quarterly rates of opioid drug overdoses treated in EDs and opioid sales correlated (r=0.68, p=0.02). Specific regions of the state, particularly in the southern and western corners, had both high rates of prescription opioid sales and overdoses.
Temporal trends in sales of prescription opioids correlate with trends in opioid related ED visits. The spatial correlation of opioid sales with ED visit rates shows that opioid sales data may be a timely way to identify high-risk communities in the absence of timely ED data.
自 1991 年以来，美国的致命药物过量致死人数增加了两倍。据信，这种死亡人数的上升主要是由处方类阿片类药物推动的。本研究比较了北卡罗来纳州（NC）的阿片类药物销售、急诊科（ED）治疗的阿片类药物药物过量和意外药物过量死亡的趋势和模式。
我们的生态研究比较了 NC 的阿片类药物销售、阿片类药物相关 ED 药物过量和意外药物过量死亡的比率。毒品执法管理局提供的特定阿片类药物的年度销售数据被转换为吗啡当量，并按邮政编码进行汇总。这些阿片类药物销售数据从 1997 年到 2010 年呈上升趋势。此外，从疾病控制和预防中心的综合征监测系统获得了与阿片类药物相关的 ED 就诊数据，并从 NC 生命统计数据获得了意外药物过量死亡数据，对 2008 年至 2010 年的阿片类药物销售数据进行了相关性和比较。最后，进行了空间聚类分析，并按邮政编码在 2010 年绘制了费率图。
1997 年至 2010 年，阿片类药物销售大幅增加。从 2008 年到 2010 年，急诊科治疗的阿片类药物药物过量和阿片类药物销售的季度比率相关（r=0.68，p=0.02）。该州的特定地区，特别是南部和西部角落，处方类阿片类药物的销售和过量率都很高。
处方类阿片类药物销售的时间趋势与与 ED 就诊相关的阿片类药物趋势相关。阿片类药物销售与 ED 就诊率的空间相关性表明，在缺乏及时的 ED 数据的情况下，阿片类药物销售数据可能是一种及时识别高风险社区的方法。
