Vivolo-Kantor Alana M, Seth Puja, Gladden R Matthew, Mattson Christine L, Baldwin Grant T, Kite-Powell Aaron, Coletta Michael A
MMWR Morb Mortal Wkly Rep. 2018 Mar 9;67(9):279-285. doi: 10.15585/mmwr.mm6709e1.
From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination.
Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016-September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics. To assess trends based on urban development, data from 16 states were analyzed by state and urbanization level.
From July 2016 through September 2017, a total of 142,557 ED visits (15.7 per 10,000 visits) from 52 jurisdictions in 45 states were suspected opioid-involved overdoses. This rate increased on average by 5.6% per quarter. Rates increased across demographic groups and all five U.S. regions, with largest increases in the Southwest, Midwest, and West (approximately 7%-11% per quarter). In 16 states, 119,198 ED visits (26.7 per 10,000 visits) were suspected opioid-involved overdoses. Ten states (Delaware, Illinois, Indiana, Maine, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, and Wisconsin) experienced significant quarterly rate increases from third quarter 2016 to third quarter 2017, and in one state (Kentucky), rates decreased significantly. The highest rate increases occurred in large central metropolitan areas.
With continued increases in opioid overdoses, availability of timely data are important to inform actions taken by EDs and public health practitioners. Increases in opioid overdoses varied by region and urbanization level, indicating a need for localized responses. Educating ED physicians and staff members about appropriate services for immediate care and treatment and implementing a post-overdose protocol that includes naloxone provision and linking persons into treatment could assist EDs with preventing overdose.
2015年至2016年，阿片类药物过量致死人数增加了27.7%，这表明阿片类药物过量流行情况正在恶化，并凸显了快速收集、分析和传播数据的重要性。
对2016年7月至2017年9月期间急诊科（ED）涉及阿片类药物过量的症状数据和医院账单数据进行了检查。在区域层面并按人口特征分析了45个州52个司法管辖区阿片类药物过量的时间趋势。为了评估基于城市发展的趋势，对16个州的数据按州和城市化水平进行了分析。
2016年7月至2017年9月期间，45个州52个司法管辖区共有142,557次急诊科就诊（每10,000次就诊中有15.7次）被怀疑为涉及阿片类药物过量。该比率平均每季度增长5.6%。各人口群体和美国所有五个地区的比率均有所上升，西南部、中西部和西部的增幅最大（约为每季度7%-11%）。在16个州，有119,198次急诊科就诊（每10,000次就诊中有26.7次）被怀疑为涉及阿片类药物过量。从2016年第三季度到2017年第三季度，有10个州（特拉华州、伊利诺伊州、印第安纳州、缅因州、密苏里州、内华达州、北卡罗来纳州、俄亥俄州、宾夕法尼亚州和威斯康星州）的季度比率显著上升，而在一个州（肯塔基州），比率显著下降。增幅最高的是大型中部大都市地区。
随着阿片类药物过量情况持续增加，及时提供数据对于指导急诊科和公共卫生从业人员采取行动非常重要。阿片类药物过量的增幅因地区和城市化水平而异，这表明需要采取本地化应对措施。对急诊科医生和工作人员进行关于即时护理和治疗的适当服务的培训，并实施包括提供纳洛酮和将患者转介至治疗机构的过量用药后方案，有助于急诊科预防过量用药。
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