美国阿片类镇痛药滥用和死亡率的趋势。

Trends in opioid analgesic abuse and mortality in the United States.

机构信息

From the Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver (R.C.D., S.G.S., B.B.-B., J.L.G.); the Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Ft. Lauderdale, FL (H.L.S.); the Department of Psychiatry, Washington University School of Medicine, St. Louis (T.J.C.); and the American Association for the Treatment of Opioid Dependence, New York (M.W.P.).

出版信息

N Engl J Med. 2015 Jan 15;372(3):241-8. doi: 10.1056/NEJMsa1406143.

DOI:10.1056/NEJMsa1406143

PMID:25587948

Abstract

BACKGROUND

The use of prescription opioid medications has increased greatly in the United States during the past two decades; in 2010, there were 16,651 opioid-related deaths. In response, hundreds of federal, state, and local interventions have been implemented. We describe trends in the diversion and abuse of prescription opioid analgesics using data through 2013.

METHODS

We used five programs from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System to describe trends between 2002 and 2013 in the diversion and abuse of all products and formulations of six prescription opioid analgesics: oxycodone, hydrocodone, hydromorphone, fentanyl, morphine, and tramadol. The programs gather data from drug-diversion investigators, poison centers, substance-abuse treatment centers, and college students.

RESULTS

Prescriptions for opioid analgesics increased substantially from 2002 through 2010 in the United States but then decreased slightly from 2011 through 2013. In general, RADARS System programs reported large increases in the rates of opioid diversion and abuse from 2002 to 2010, but then the rates flattened or decreased from 2011 through 2013. The rate of opioid-related deaths rose and fell in a similar pattern. Reported nonmedical use did not change significantly among college students.

CONCLUSIONS

Postmarketing surveillance indicates that the diversion and abuse of prescription opioid medications increased between 2002 and 2010 and plateaued or decreased between 2011 and 2013. These findings suggest that the United States may be making progress in controlling the abuse of opioid analgesics. (Funded by the Denver Health and Hospital Authority.).

摘要

背景

在过去的二十年中，美国处方类阿片类药物的使用量大大增加；2010 年，有 16651 例与阿片类药物相关的死亡。作为回应，联邦、州和地方实施了数百项干预措施。我们描述了 2013 年之前处方类阿片类止痛药的转移和滥用趋势。

方法

我们使用研究性滥用、转移和成瘾相关监测（RADARS）系统中的五个程序，描述 2002 年至 2013 年期间六种处方类阿片类止痛药（羟考酮、氢可酮、氢吗啡酮、芬太尼、吗啡和曲马多）所有产品和配方的转移和滥用趋势。这些项目从药物滥用调查人员、中毒中心、药物滥用治疗中心和大学生那里收集数据。

结果

在美国，阿片类止痛药的处方量从 2002 年到 2010 年大幅增加，但从 2011 年到 2013 年略有减少。一般来说，RADARS 系统项目报告称，从 2002 年到 2010 年，阿片类药物转移和滥用的比率大幅增加，但从 2011 年到 2013 年，这一比率趋于平稳或下降。阿片类药物相关死亡人数也呈类似模式上升和下降。大学生报告的非医疗用途没有明显变化。