Department of Psychology, Boston College, Chestnut Hill, MA 02467, United States.
Department of Psychology, Boston College, Chestnut Hill, MA 02467, United States.
Int J Drug Policy. 2019 Dec;74:274-284. doi: 10.1016/j.drugpo.2019.07.026. Epub 2019 Aug 28.
Drug overdose deaths in the United States increased from approximately 16,000 per year in 2001 to 41,000 per year in 2014. Although every US state witnessed an increase, the increases were much larger in some states than others. There was also variation as a function of race and ethnicity. Non-Hispanic Whites accounted for more than 80% of the deaths, and in some states their rates were about ten times greater per capita than Hispanic and Non-White rates. State and temporal differences provide an opportunity to evaluate explanations of what is driving drug overdose deaths. In this report, we evaluate the degree to which state level variation in opioid prescription rates and social-economic conditions explain state level variation in overdose death rates.
We used publicly available data from the Center for Disease Control (CDC), Bureau of Labor Statistics (BLS), Drug Enforcement Agency (DEA) and the Opportunity Insights project.
Legally prescribed opioids, social capital and work force participation accounted for 53-69% of the between-state variation in overdose deaths in Non-Hispanic Whites. Prescriptions and the two social economic measures accounted for about the same amounts of unique variation, but shared variation among the three independent variables was the strongest predictor of overdose deaths. Panel regression results of the year-to-year changes in overdose deaths were similar. However, the pattern of correlations for Hispanics and Non-Whites was quite different. Neither opioid prescriptions nor social capital were significant predictors of overdose deaths in the between-state and between-year Hispanic and Non-White regression analyses.
Common variation in opioid prescriptions rates, social capital, and work force participation proved the strongest predictor of drug overdose deaths in Non-Hispanic Whites. We discuss reasons why the same did not hold for the Hispanic/Non-White population.
美国的药物过量死亡人数从 2001 年的每年约 16000 人增加到 2014 年的每年 41000 人。尽管每个州都看到了增长，但有些州的增长幅度远大于其他州。此外，这种增长还因种族和族裔而异。非西班牙裔白人占死亡人数的 80%以上，在一些州，他们的死亡率是西班牙裔和非白人的十倍左右。州和时间的差异为评估导致药物过量死亡的因素提供了机会。在本报告中，我们评估了州一级阿片类药物处方率和社会经济状况的差异在多大程度上解释了药物过量死亡率的州一级差异。
我们使用了疾病控制与预防中心（CDC）、劳工统计局（BLS）、缉毒署（DEA）和机会洞察项目（Opportunity Insights project）提供的公开数据。
合法开出的阿片类药物、社会资本和劳动力参与度解释了非西班牙裔白人州际间药物过量死亡率差异的 53-69%。处方和这两个社会经济指标解释了相同数量的独特差异，但三个独立变量之间的共享差异是药物过量死亡的最强预测因素。年度药物过量死亡变化的面板回归结果相似。然而，西班牙裔和非裔美国人的相关模式则大不相同。在西班牙裔和非裔美国人的州际和年度回归分析中，阿片类药物处方和社会资本都不是药物过量死亡的显著预测因素。
阿片类药物处方率、社会资本和劳动力参与度的共同差异是非西班牙裔白人药物过量死亡的最强预测因素。我们讨论了为什么同样的情况不适用于西班牙裔/非裔美国人的原因。
