2016 年 1 月至 2019 年 9 月期间美国疑似合成大麻素暴露的地区趋势。
Regional trends in suspected synthetic cannabinoid exposure from January 2016 to September 2019 in the United States.
机构信息
Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS: S106-8, Atlanta, GA, 30341, USA.
Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS: S106-8, Atlanta, GA, 30341, USA.
出版信息
Drug Alcohol Depend. 2020 Feb 1;207:107810. doi: 10.1016/j.drugalcdep.2019.107810. Epub 2019 Dec 16.
BACKGROUND
The unpredictable physiologic and pharmacologic effects of synthetic cannabinoids (SCs) are continuously changing as the chemical structure of SCs evolve to avoid classification as a Schedule I drug under the Controlled Substances Act in the U.S. This results in unpredictable pharmacologic effects and subsequent sequelae. Little is known about national or regional trends of SC clusters. The objective of this study is to investigate trends in SC exposure using emergency department (ED) syndromic data.
METHODS
We analyzed ED syndromic data to detect quarterly trends from January 2016 through September 2019 for SC-related exposures within 59 jurisdictions in 47 states by U.S. region. Pearson chi-square tests detected quarter-to-quarter changes and Joinpoint regression assessed trends over time.
RESULTS
From January 2016 to September 2019, 21,714 of 303.5 million ED visits involved suspected SC exposures. Nationally, SC-related exposures decreased by 1.9 % (p = .04) on average per quarter, yet exposures increased in the Midwest by 6.3 % (p = .002) and in the Northeast by 3.2 % (p = .03) on average per quarter, and decreased on average per quarter by 7.7% (p ≤ .001) in the Southeast and 11.4 % in the West (p ≤ .001). Known SC exposures that may align with clusters were identified in quarter-to-quarter monitoring.
CONCLUSIONS
Only a small proportion of ED visits were related to suspected SC exposure. Although we did identify a small decrease in national SC exposures, there was wide variation by region. Additional efforts are needed to understand variation and to develop prevention and response strategies.
背景
合成大麻素（SCs）的生理和药理作用不可预测，随着 SCs 的化学结构不断演变，以避免根据《美国管制物质法》被归类为附表 I 药物，其药理作用和随后的后果也变得不可预测。关于 SC 集群的全国或地区趋势知之甚少。本研究旨在通过急诊（ED）症状数据调查 SC 暴露的趋势。
方法
我们分析了 ED 症状数据，以检测 2016 年 1 月至 2019 年 9 月期间美国 47 个州的 59 个司法管辖区内与 SC 相关的暴露情况，按美国地区划分。Pearson 卡方检验检测了逐季变化，Joinpoint 回归评估了随时间的趋势。
结果
从 2016 年 1 月至 2019 年 9 月，30350 万次 ED 就诊中有 21714 次涉及疑似 SC 暴露。从全国范围来看，SC 相关暴露平均每季度减少 1.9%（p=0.04），但中西部地区平均每季度增加 6.3%（p=0.002），东北地区增加 3.2%（p=0.03），东南部地区平均每季度减少 7.7%（p≤0.001），西部地区减少 11.4%（p≤0.001）。在逐季监测中发现了与集群可能一致的已知 SC 暴露。
结论
只有一小部分 ED 就诊与疑似 SC 暴露有关。尽管我们确实发现全国范围内 SC 暴露有所减少，但地区差异很大。需要进一步努力了解这种差异，并制定预防和应对策略。
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