National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia; Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.
Drug Alcohol Rev. 2014 Jan;33(1):4-12. doi: 10.1111/dar.12088. Epub 2013 Nov 20.
The Global Burden of Disease (GBD) 2010 study updated the findings of earlier exercises. It provided regional and global estimates of the burden of disease attributable to diseases, injuries and risk factors. Here we provide a brief summary of the work for illicit drug use.
Systematic reviews were undertaken to estimate the major epidemiological parameters (incidence, prevalence, duration/remission and mortality) for each drug. Reviews evaluated the nature and quality of evidence for illicit drug use as a risk factor for many health outcomes, for the comparative risk assessment (CRA) exercise.
Substantial gaps existed in basic epidemiological parameters. Following modelling and imputation of missing data, it was estimated that opioid and amphetamine dependence were the most common forms of illicit drug dependence in 2010; opioid dependence was responsible for the greatest burden. Few putative consequences of illicit drug use had the quality or quantity of data required to be included in the CRA.
Estimates of the extent and distribution of disease burden are likely to shape global and regional health policy development. The GBD exercise will be repeated on an annual basis; GBD 2010 clearly demonstrated that although the illicit drug field is generating more and better epidemiological data on the health risks of drug use, there is still much work to be done to generate defensible estimates of the magnitude of risk, particularly for impactful and prevalent outcomes, such as injuries, violence and mental health complications. Until then, burden of disease attributable to illicit drugs will be underestimated.
《全球疾病负担（GBD）2010 研究》更新了早期研究的结果。它提供了区域和全球疾病、伤害和风险因素归因于疾病负担的估计。在这里，我们简要概述了滥用药物的研究工作。
系统综述用于估计每种药物的主要流行病学参数（发病率、患病率、持续时间/缓解和死亡率）。综述评估了作为许多健康结果风险因素的滥用药物的性质和证据质量，用于比较风险评估（CRA）。
基本流行病学参数存在很大差距。在对缺失数据进行建模和插补后，据估计，阿片类药物和苯丙胺依赖是 2010 年最常见的非法药物依赖形式；阿片类药物依赖造成的负担最大。滥用药物的少数潜在后果的数据质量或数量不足以纳入 CRA。
疾病负担的程度和分布的估计可能会影响全球和区域卫生政策的制定。GBD 研究将每年重复进行；GBD 2010 清楚地表明，尽管非法药物领域正在产生更多和更好的关于药物使用健康风险的流行病学数据，但仍有许多工作要做，以产生可防御的风险估计，特别是对于影响大且普遍的结果，如伤害、暴力和心理健康并发症。在那之前，非法药物造成的疾病负担将被低估。
