Milkin Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, United States.
Milkin Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, United States; Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900 Calverton, MD 20705, United States.
Drug Alcohol Depend. 2020 Jul 1;212:108059. doi: 10.1016/j.drugalcdep.2020.108059. Epub 2020 May 13.
From 1999 to 2017, more than 400,000 Americans died from a drug overdose death involving an opioid. Early surveillance studies have observed large variations in opioid-involved overdose deaths among different geographic regions and racial/ethnic groups. The purpose of this study was to characterize trends in racial/ethnic opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States from 1999 to 2017.
The analysis used National Vital Statistics System data from 1999 to 2017 that were accessed through the CDC WONDER online database. Drug overdose deaths involving any opioid were identified using the International Classification of Diseases, Tenth Revision, codes and were represented as age-adjusted rates per 100,000 population. Joinpoint regression was used to examine trends in opioid-involved overdose deaths among racial/ethnic groups (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic other) by metropolitan and non-metropolitan status (large metropolitan areas, medium-small metropolitan areas, and non-metropolitan areas).
The annual age-adjusted death rates for drug overdose deaths that involved any opioid significantly increased for all racial/ethnic groups in metropolitan and non-metropolitan areas from 1999 to 2017. The largest average annual increases in rates occurred among non-Hispanic whites in non-metropolitan areas (13.6% increase per year) and medium-small metropolitan areas (12.3% increase per year), followed by non-Hispanic blacks in medium-small metropolitan areas (11.3% increase per year).
The variations in opioid-involved overdose deaths among different racial/ethnic groups across geographic regions support the existence of multiple sub-epidemics in the current opioid overdose crisis and provide directions for targeted intervention efforts.
从 1999 年到 2017 年，超过 40 万美国人死于涉及阿片类药物的药物过量死亡。早期监测研究观察到不同地理区域和种族/族裔群体之间涉及阿片类药物的过量死亡存在很大差异。本研究的目的是描述 1999 年至 2017 年美国大都市和非大都市地区种族/族裔涉及阿片类药物的过量死亡趋势。
该分析使用了 1999 年至 2017 年通过疾病预防控制中心 WONDER 在线数据库获取的国家生命统计系统数据。涉及任何阿片类药物的药物过量死亡使用国际疾病分类，第十次修订版代码确定，并表示为每 10 万人年龄调整后的死亡率。使用 Joinpoint 回归检查大都市和非大都市状态（大城市、中-小城市和非大都市地区）中种族/族裔群体（非西班牙裔白人、非西班牙裔黑人、西班牙裔、非西班牙裔其他）中涉及阿片类药物的过量死亡趋势。
从 1999 年到 2017 年，大都市和非大都市地区所有种族/族裔群体涉及任何阿片类药物的药物过量死亡的年调整死亡率均显着增加。在非大都市地区（每年增加 13.6%）和中-小城市地区（每年增加 12.3%），非西班牙裔白人的比率年平均增长率最高，其次是中-小城市地区的非西班牙裔黑人（每年增加 11.3%）。
不同地理区域不同种族/族裔群体之间涉及阿片类药物的过量死亡的差异支持当前阿片类药物过量危机中存在多个亚流行，并为有针对性的干预措施提供了方向。
