Seth Puja, Scholl Lawrence, Rudd Rose A, Bacon Sarah
MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):349-358. doi: 10.15585/mmwr.mm6712a1.
During 1999‒2015, 568,699 persons died from drug overdoses in the United States.* Drug overdose deaths in the United States increased 11.4% from 2014 to 2015 resulting in 52,404 deaths in 2015, including 33,091 (63.1%) that involved an opioid. The largest rate increases from 2014 to 2015 occurred among deaths involving synthetic opioids other than methadone (synthetic opioids) (72.2%) (1). Because of demographic and geographic variations in overdose deaths involving different drugs (2,3), CDC examined age-adjusted death rates for overdoses involving all opioids, opioid subcategories (i.e., prescription opioids, heroin, and synthetic opioids), cocaine, and psychostimulants with abuse potential (psychostimulants) by demographics, urbanization levels, and in 31 states and the District of Columbia (DC). There were 63,632 drug overdose deaths in 2016; 42,249 (66.4%) involved an opioid. From 2015 to 2016, deaths increased across all drug categories examined. The largest overall rate increases occurred among deaths involving cocaine (52.4%) and synthetic opioids (100%), likely driven by illicitly manufactured fentanyl (IMF) (2,3). Increases were observed across demographics, urbanization levels, and states and DC. The opioid overdose epidemic in the United States continues to worsen. A multifaceted approach, with faster and more comprehensive surveillance, is needed to track emerging threats to prevent and respond to the overdose epidemic through naloxone availability, safe prescribing practices, harm-reduction services, linkage into treatment, and more collaboration between public health and public safety agencies.
1999年至2015年期间,美国有568,699人死于药物过量。* 美国药物过量死亡人数在2014年至2015年期间增加了11.4%,2015年达到52,404人死亡,其中包括33,091人(63.1%)涉及阿片类药物。2014年至2015年期间,死亡率上升幅度最大的是涉及美沙酮以外的合成阿片类药物(合成阿片类药物)的死亡(72.2%)(1)。由于涉及不同药物的过量死亡存在人口统计学和地理差异(2,3),美国疾病控制与预防中心(CDC)按人口统计学、城市化水平以及在31个州和哥伦比亚特区(DC),对涉及所有阿片类药物、阿片类药物子类别(即处方阿片类药物、海洛因和合成阿片类药物)、可卡因以及有滥用潜力的精神兴奋剂(精神兴奋剂)的过量死亡年龄调整死亡率进行了研究。2016年有63,632人死于药物过量;42,249人(66.4%)涉及阿片类药物。从2015年到2016年,在所研究的所有药物类别中死亡人数均有所增加。总体死亡率上升幅度最大的是涉及可卡因(52.4%)和合成阿片类药物(100%)的死亡,这可能是由非法制造的芬太尼(IMF)推动的(2,3)。在各个人口统计学群体、城市化水平以及各州和哥伦比亚特区均观察到了增长。美国的阿片类药物过量流行情况继续恶化。需要采取多方面的方法,进行更快、更全面的监测,以追踪新出现的威胁,通过提供纳洛酮、安全的处方做法、减少伤害服务、与治疗机构建立联系以及公共卫生和公共安全机构之间加强合作来预防和应对过量用药流行。