Division of General Internal Medicine, Department of Medicine, and Colorado Health Outcomes Program , University of Colorado School of Medicine, Aurora, CO 80045, USA.
Subst Abus. 2013;34(2):129-36. doi: 10.1080/08897077.2012.726959.
Increased methamphetamine use occurred during the last decade and little is known about factors associated with death. This study assesses trends in psychostimulant deaths in the United States.
Using the Centers for Disease Control and Prevention (CDC) Wonder Database, the authors searched deaths among 15- to 64-year-olds from 1999 to 2009 for decedents who died with "psychostimulants with abuse potential, excluding cocaine." The International Classification of Diseases (ICD) code T43.6 was used to identify methamphetamine-related deaths. Trends in death rates and the most common underlying causes of death were determined. For recent trends, age-adjusted death rates/100,000 person-years (p-y) and (95% confidence intervals [CIs]) among those who died with psychostimulants were calculated.
The rate of psychostimulant-related deaths increased 3-fold from 1999 (0.37/100,000 p-y; 95% CI: 0.354-0.39) to 2005 (1.05/100,000 p-y; 95% CI: 1.01-1.10). Deaths steadily declined from 2006 to 2008, but rose again in 2009 to 0.97/100,000 p-y (95% CI: 0.92-1.01). Across all age groups, men had a 2 to 3 times higher rate of death than women. American Indians/Alaska Natives were twice as likely to die a psychostimulant-related death as compared with non-Hispanic whites. The northwestern/western region of the US had the highest rates of psychostimulant-related deaths, whereas the northeastern region had the lowest death rates. "Accidental poisonings" (ICD-10: X40-49) was the most frequently listed cause of death among those who died with psychostimulants.
Psychostimulant-related deaths increased from 1999 to 2006, declined from 2006 to 2008, but rebounded in 2009. Interventions targeting those at highest risk of death must be implemented and studied to prevent increasing deaths.
在过去十年中，甲基苯丙胺的使用有所增加，但人们对与死亡相关的因素知之甚少。本研究评估了美国精神兴奋剂死亡的趋势。
作者使用疾病控制和预防中心（CDC）Wonder 数据库，从 1999 年至 2009 年期间，对 15 至 64 岁人群中因“具有滥用潜力的精神兴奋剂，不包括可卡因”而死亡的死者进行了搜索。国际疾病分类（ICD）代码 T43.6 用于识别与甲基苯丙胺相关的死亡。确定了死亡率趋势和最常见的根本死因。对于最近的趋势，计算了死于精神兴奋剂的人群中每 100,000 人年的年龄调整死亡率/100,000 人年（p-y）和（95%置信区间[CI]）。
从 1999 年（0.37/100,000 p-y；95%CI：0.354-0.39）到 2005 年（1.05/100,000 p-y；95%CI：1.01-1.10），与精神兴奋剂相关的死亡人数增加了 3 倍。从 2006 年到 2008 年，死亡人数稳步下降，但 2009 年再次上升至 0.97/100,000 p-y（95%CI：0.92-1.01）。在所有年龄组中，男性的死亡率是女性的 2 至 3 倍。与非西班牙裔白人相比，美国印第安人/阿拉斯加原住民死于与精神兴奋剂相关的死亡的可能性是其两倍。美国西北部/西部地区的精神兴奋剂相关死亡率最高，而东北部地区的死亡率最低。“意外中毒”（ICD-10：X40-49）是死于精神兴奋剂的人群中最常见的死因。
从 1999 年到 2006 年，与精神兴奋剂相关的死亡人数增加，从 2006 年到 2008 年下降，但 2009 年又回升。必须针对死亡风险最高的人群实施和研究干预措施，以防止死亡人数增加。
