Easterling Keith W, Mack Karin A, Jones Christopher M
Department of Pharmacology, Emory University, School of Medicine, 1462 Clifton Road, Ste 304G, Atlanta, GA 30322, United States.
Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Atlanta, GA, United States.
J Safety Res. 2016 Sep;58:105-9. doi: 10.1016/j.jsr.2016.07.004. Epub 2016 Aug 7.
Prescription opioid pain reliever overdose is a major public health issue in the United States. To characterize the location of drug-related deaths, we examined fatal prescription opioid and illicit drug-related deaths reported in 12 states.
Data are from the Substance Abuse and Mental Health Services Administration's Drug Abuse Warning Network (DAWN). Medical examiners or coroners in 12 states (MA, MD, ME, NH, NM, OK, OR, RI, UT, VA, VT, WV) reported details of state-wide drug-related mortality during 2008-2010. DAWN data included location and manner of death, age, race, and drugs involved. Deaths were coded into three categories: prescription opioid-related, illicit drug-related, and cases that involved both a prescription opioid and an illicit drug.
During a 3-year period, there were 14,091 opioid or illicit drug-related deaths in 12 states. More than half of the prescription opioid-related deaths in all states, except Maryland, occurred at home, rather than in public or in a health care facility. Although it was still the predominant category, lower percentages of illicit drug-related deaths occurred at home.
Prescription opioid overdoses have increased substantially, and the location of the person at the time of death can have important public health implications for interventions.
This paper highlights that bystander support can be a critical lifesaving factor in drug related deaths but may be more likely for illicit drug-related deaths than for prescription opioid-related deaths.
处方阿片类镇痛药过量是美国的一个主要公共卫生问题。为了描述与药物相关死亡的地点特征,我们研究了12个州报告的致命处方阿片类药物及非法药物相关死亡情况。
数据来自物质滥用和精神健康服务管理局的药物滥用预警网络(DAWN)。12个州(马萨诸塞州、马里兰州、缅因州、新罕布什尔州、新墨西哥州、俄克拉何马州、俄勒冈州、罗德岛州、犹他州、弗吉尼亚州、佛蒙特州、西弗吉尼亚州)的法医或验尸官报告了2008 - 2010年全州范围内与药物相关的死亡详情。DAWN数据包括死亡地点和方式、年龄、种族以及涉及的药物。死亡被分为三类:处方阿片类药物相关、非法药物相关以及既涉及处方阿片类药物又涉及非法药物的案例。
在3年期间,12个州有14,091例与阿片类药物或非法药物相关的死亡。除马里兰州外,所有州超过一半的处方阿片类药物相关死亡发生在家中,而非公共场所或医疗机构。虽然非法药物相关死亡仍是主要类别,但在家中发生的比例较低。
处方阿片类药物过量情况大幅增加,死亡时人员所在位置对干预措施可能具有重要的公共卫生意义。
本文强调旁观者支持在与药物相关死亡中可能是关键的救命因素,但非法药物相关死亡比处方阿片类药物相关死亡更有可能获得旁观者支持。