Lyons Rachael M, Yule Amy M, Schiff Davida, Bagley Sarah M, Wilens Timothy E
Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
Addiction Recovery Management Service (ARMS), Massachusetts General Hospital, Boston, Massachusetts.
J Child Adolesc Psychopharmacol. 2019 Aug;29(7):487-497. doi: 10.1089/cap.2019.0013. Epub 2019 Jun 27.
Drug overdose (OD) deaths have been increasing over the past 20 years. Although risk factors for drug OD have been identified in adult populations, less is known about risk factors for OD in young people. The aim of this review is to systematically examine the literature to identify risk factors for drug OD specific to young people, including adolescents and young adults. Our initial PubMed search identified 4001 articles. Included were cross-sectional and longitudinal cohort studies published in English that compared young people who experienced a drug OD to those who did not. Review articles, meta-analyses, case-reports, editorials, epidemiological studies, and qualitative studies were excluded. Two investigators reviewed the full texts of all relevant articles and extracted data on sample demographics, prevalence of OD, and correlates associated with OD. Twelve relevant studies were identified reflective of a sample of 5020 unique individuals with an age range of 14-30 years, and a mean age range of 20.2-26 years. The lifetime prevalence of OD in these young people ranged from 24% to 48%. Substance use characteristics most often associated with OD included injection drug, opioid, and tranquilizer use. Polysubstance use was also found to be strongly associated with OD in three studies. Other replicated risk factors for OD in young people included histories of psychopathology, incarceration, unstable housing, and witnessing an OD. Opioid, tranquilizer, and injection drug use have been identified as risk factors for OD in both younger and older adult populations. Risk factors that emerged as noteworthy predictors of OD in young people specifically include polysubstance use, psychiatric comorbidity, unstable housing, and witnessing an OD. There remains a paucity of literature on drug OD risk factors in young people, with little information regarding medical and treatment history risk factors.
在过去20年里，药物过量（OD）致死人数一直在增加。尽管已在成年人群体中确定了药物过量的风险因素，但对于年轻人药物过量的风险因素却知之甚少。本综述的目的是系统地审查文献，以确定特定于年轻人（包括青少年和青年成年人）的药物过量风险因素。我们最初在PubMed上进行的搜索共识别出4001篇文章。纳入的文章为以英文发表的横断面研究和纵向队列研究，这些研究比较了经历过药物过量的年轻人与未经历过的年轻人。综述文章、荟萃分析、病例报告、社论、流行病学研究和定性研究均被排除。两名研究人员审查了所有相关文章的全文，并提取了有关样本人口统计学、药物过量患病率以及与药物过量相关的关联因素的数据。共识别出12项相关研究，这些研究反映了一个由5020名独特个体组成的样本，年龄范围为14至30岁，平均年龄范围为20.2至26岁。这些年轻人中药物过量的终生患病率在24%至48%之间。与药物过量最常相关的物质使用特征包括注射吸毒、使用阿片类药物和镇静剂。在三项研究中还发现多药合用与药物过量密切相关。年轻人药物过量的其他反复出现的风险因素包括精神病理学病史、监禁、住房不稳定以及目睹他人药物过量。阿片类药物、镇静剂和注射吸毒已被确定为年轻和年长成年人群体中药物过量的风险因素。特别值得注意的是，在年轻人中出现的药物过量预测因素包括多药合用、精神疾病共病、住房不稳定以及目睹他人药物过量。关于年轻人药物过量风险因素的文献仍然匮乏，关于医疗和治疗史风险因素的信息很少。
