Division of Geriatric Medicine and Palliative Care, New York University School of Medicine, United States.
New York City Department of Health and Mental Hygiene, United States.
Drug Alcohol Depend. 2019 May 1;198:121-125. doi: 10.1016/j.drugalcdep.2019.01.042. Epub 2019 Mar 14.
Cocaine is commonly involved in unintentional drug poisoning (overdose) deaths, accounting for 46% of overdose deaths in New York City (NYC) in 2016. However, little research exists regarding cocaine use by middle-aged and older adults, who are more likely than younger individuals to have underlying cardiovascular disease (CVD) and therefore, may be at increased risk for the adverse health consequences of cocaine.
We conducted a retrospective analysis of unintentional drug overdose deaths of middle-aged and older NYC residents age 45-84 from 2000 to 2016 using two linked sources, NYC death certificates and toxicology results from the Office of the Chief Medical Examiner.
From 2000 to 2016, there were 6061 unintentional drug overdose deaths among New Yorkers age 45-84. Of those, cocaine was involved in 53% (n = 3183). Co-occurring opioid involvement (fentanyl, heroin, methadone, or opioid analgesics) among deaths involving cocaine was common (58%). Compared to decedents of non-cocaine involved overdose, decedents of cocaine-involved overdose were more likely to be male and non-Latino Black. Multivariable analysis showed that adults age 45-54 (adjusted odds ratio [AOR] = 1.34, 95% 1.05, 1.70), males (AOR = 1.30, 95% CI 1.15, 1.46), Bronx residence (AOR = 1.29, 95% CI 1.08, 1.54), and non-Latino black race/ethnicity (AOR = 2.37, 95% CI 2.07, 2.72) were independently associated with cocaine-involved overdose.
Characteristics of decedents of cocaine-involved overdose overlap with populations with high CVD burden in NYC. Studies are needed to better understand the risks of cocaine among adults with underlying CVD.
可卡因通常与非故意药物中毒（过量）死亡有关，占 2016 年纽约市（NYC）过量死亡人数的 46%。然而，关于中年和老年人使用可卡因的研究很少，与年轻人相比，他们更有可能患有潜在的心血管疾病（CVD），因此，他们可能面临更高的可卡因对健康造成不良后果的风险。
我们使用两个相关来源，即纽约市死亡证明和首席法医办公室的毒理学结果，对 2000 年至 2016 年期间年龄在 45-84 岁的纽约市中年和老年人的非故意药物过量死亡进行了回顾性分析。
2000 年至 2016 年，年龄在 45-84 岁的纽约人中，有 6061 人死于非故意药物过量。其中，可卡因涉及 53%（n=3183）。在涉及可卡因的死亡中，同时涉及阿片类药物（芬太尼、海洛因、美沙酮或阿片类镇痛药）的情况很常见（58%）。与非可卡因过量死亡的死者相比，可卡因过量死亡的死者更有可能是男性和非拉丁裔黑人。多变量分析显示，45-54 岁的成年人（调整后的优势比 [AOR] = 1.34，95%置信区间 [CI] 为 1.05-1.70）、男性（AOR = 1.30，95%CI 为 1.15-1.46）、布朗克斯区居民（AOR = 1.29，95%CI 为 1.08-1.54）和非拉丁裔黑人种族/民族（AOR = 2.37，95%CI 为 2.07-2.72）与可卡因过量死亡独立相关。
可卡因过量死亡死者的特征与纽约市 CVD 负担高的人群重叠。需要研究来更好地了解潜在 CVD 成年人使用可卡因的风险。
