McAuley Andrew, Hecht Garry, Barnsdale Lee, Thomson Catherine S, Graham Lesley, Priyadarshi Saket, Robertson J Roy
NHS Health Scotland, Public Health Science Directorate, Meridian Court, Glasgow G2 6QE, Scotland, UK.
NHS National Services Scotland, Information Services Division, Gyle Square, Edinburgh EH12 9EB, UK.
Int J Drug Policy. 2015 May;26(5):461-7. doi: 10.1016/j.drugpo.2014.10.010. Epub 2014 Nov 10.
The growth of novel psychoactive substances (NPS) over the last decade, both in terms of availability and consumption, is of increasing public health concern. Despite recent increases in related mortality, the circumstances surrounding and characteristics of individuals involved in NPS deaths at a population level remain relatively unknown.
The Scottish National Drug Related Death Database (NDRDD) collects a wide-range of data relating to the nature and circumstances of individuals who have died a drug-related death (DRD). We conducted exploratory descriptive analysis of DRDs involving NPS recorded by the NDRDD in 2012. Statistical testing of differences between sub-groups was also conducted where appropriate.
In 2012, we found 36 DRDs in Scotland to have NPS recorded within post-mortem toxicology. However, in only 23 of these cases were NPS deemed by the reporting pathologist to be implicated in the actual cause of death. The majority of NPS-implicated DRDs involved Benzodiazepine-type drugs (13), mainly Phenazepam (12). The remaining 10 NPS-implicated deaths featured a range of different Stimulant-type drugs. The majority of these NPS-implicated deaths involved males and consumption of more than one drug was recorded by toxicology in all except one case. NPS-implicated deaths involving Benzodiazepine-type NPS drugs appeared to involve older individuals known to be using drugs for a considerable period of time, many of whom had been in prison at some point in their lives. They also typically involved combinations of opioids and benzodiazepines; no stimulant drugs were co-implicated. Deaths where stimulant-type NPS drugs were implicated appeared to be a younger group in comparison, all consuming two or more Stimulant-type drugs in combination.
This exploratory study provides an important insight into the circumstances surrounding and characteristics of individuals involved in NPS deaths at a population level. It identifies important issues for policy and practice, not least the prominent role of unlicensed benzodiazepines in drug-related mortality, but also the need for a range of harm reduction strategies to prevent future deaths.
在过去十年中，新型精神活性物质（NPS）在可得性和消费量方面的增长日益引起公众健康关注。尽管近期相关死亡率有所上升，但在人群层面，涉及NPS死亡的个体所处环境和特征仍相对不明。
苏格兰国家药物相关死亡数据库（NDRDD）收集了与药物相关死亡（DRD）个体的性质和情况有关的广泛数据。我们对NDRDD在2012年记录的涉及NPS的DRD进行了探索性描述分析。在适当情况下，还对亚组之间的差异进行了统计检验。
2012年，我们发现苏格兰有36例DRD在尸检毒理学中记录有NPS。然而，报告病理学家仅认为其中23例的NPS与实际死因有关。大多数与NPS有关的DRD涉及苯二氮䓬类药物（13例），主要是芬那西泮（12例）。其余10例与NPS有关的死亡涉及一系列不同的兴奋剂类药物。这些与NPS有关的死亡大多数涉及男性，除1例病例外，毒理学记录显示所有病例都使用了不止一种药物。涉及苯二氮䓬类NPS药物的死亡似乎涉及已知长期使用药物的老年人，其中许多人在生命中的某个时候曾入狱。这些死亡通常还涉及阿片类药物和苯二氮䓬类药物的联合使用；没有兴奋剂类药物与之共同牵涉。相比之下，涉及兴奋剂类NPS药物的死亡似乎是较年轻的群体，所有人都联合使用了两种或更多种兴奋剂类药物。
这项探索性研究为人群层面涉及NPS死亡的个体所处环境和特征提供了重要见解。它确定了政策和实践中的重要问题，尤其是无证苯二氮䓬类药物在药物相关死亡率中的突出作用，以及需要一系列减少伤害策略以预防未来死亡。
