Sharp Mark J, Melnik Thomas A
MMWR Morb Mortal Wkly Rep. 2015 Apr 17;64(14):377-80.
Deaths involving opioid analgesics have increased dramatically in the United States. Approximately 4,000 such deaths were documented in 1999, increasing to 16,235 in 2013, reflecting a nearly quadrupled death rate from 1.4 to 5.1 deaths per 100,000. To investigate this increase in New York state, trends in poisoning deaths involving opioid analgesics from 2003 to 2012 were examined. Data sources used were New York state vital statistics multiple-cause-of-death data, consisting of data from both the New York City (NYC)* and non-NYC reporting jurisdictions, as well as statewide Medicaid enrollment data. Deaths involving opioid analgesics increased both in number and as a percentage of all drug poisoning deaths, and rates were highest among men, whites, persons aged 45-64 years, persons residing outside of NYC, and Medicaid enrollees. The analysis found that, in 2012, 70.7% of deaths involving opioid analgesics also involved at least one other drug, most frequently a benzodiazepine. These results underscore the potential to mitigate the trend of increasing opioid analgesic-related mortality through initiatives such as New York state's Internet System for Tracking Over-Prescribing (I-STOP) law,† which took effect on August 27, 2013. Provisions under I-STOP include the requirements that providers consult the Prescription Monitoring Program (PMP) Registry when writing prescriptions for controlled substances, and that they use electronic prescribing.
在美国,涉及阿片类镇痛药的死亡人数急剧增加。1999年记录了约4000例此类死亡,到2013年增至16235例,死亡率从每10万人1.4例几乎增至5.1例,增长了近四倍。为调查纽约州的这一增长情况,研究了2003年至2012年涉及阿片类镇痛药的中毒死亡趋势。所使用的数据来源包括纽约州生命统计多死因数据,该数据由纽约市(NYC)*和非纽约市报告辖区的数据以及全州医疗补助登记数据组成。涉及阿片类镇痛药的死亡人数及其在所有药物中毒死亡中所占的百分比均有所增加,且男性、白人、45 - 64岁的人、居住在纽约市以外的人以及医疗补助参保者中的死亡率最高。分析发现,2012年,70.7%的涉及阿片类镇痛药的死亡还涉及至少一种其他药物,最常见的是苯二氮䓬类药物。这些结果强调了通过诸如纽约州的《互联网过量处方追踪系统(I - STOP)法》†等举措来缓解阿片类镇痛药相关死亡率上升趋势的潜力,该法于2013年8月27日生效。I - STOP法的规定包括要求医疗服务提供者在开具管制药品处方时查阅处方监测计划(PMP)登记册,并使用电子处方。