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Drug and Opioid-Involved Overdose Deaths - United States, 2017-2018.药物和阿片类药物相关过量死亡 - 美国,2017-2018 年。
MMWR Morb Mortal Wkly Rep. 2020 Mar 20;69(11):290-297. doi: 10.15585/mmwr.mm6911a4.
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Racial/Ethnic and Age Group Differences in Opioid and Synthetic Opioid-Involved Overdose Deaths Among Adults Aged ≥18 Years in Metropolitan Areas - United States, 2015-2017.大都市地区≥18 岁成年人中阿片类药物和合成阿片类药物相关过量死亡的种族/民族和年龄组差异 - 美国,2015-2017 年。
MMWR Morb Mortal Wkly Rep. 2019 Nov 1;68(43):967-973. doi: 10.15585/mmwr.mm6843a3.
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The epidemiology of benzodiazepine misuse: A systematic review.苯二氮䓬类药物滥用的流行病学:系统评价。
Drug Alcohol Depend. 2019 Jul 1;200:95-114. doi: 10.1016/j.drugalcdep.2019.02.033. Epub 2019 May 7.
4
History of regular nonmedical sedative and/or alcohol use differentiates substance-use patterns and consequences among chronic heroin users.在慢性海洛因使用者中,经常使用非医疗镇静剂和/或酒精的历史会导致不同的物质使用模式和后果。
Addict Behav. 2019 Oct;97:14-19. doi: 10.1016/j.addbeh.2019.05.017. Epub 2019 May 16.
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Sociodemographic factors and social determinants associated with toxicology confirmed polysubstance opioid-related deaths.社会人口学因素和社会决定因素与毒理学确认的多物质阿片类药物相关死亡有关。
Drug Alcohol Depend. 2019 Jul 1;200:59-63. doi: 10.1016/j.drugalcdep.2019.03.014. Epub 2019 May 8.
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Addressing the opioid crisis globally.全球应对阿片类药物危机。
World Psychiatry. 2019 Jun;18(2):231-232. doi: 10.1002/wps.20633.
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Non-Medical Use of Novel Synthetic Opioids: A New Challenge to Public Health.新型合成阿片类药物的非医疗用途:对公共健康的新挑战。
Int J Environ Res Public Health. 2019 Jan 9;16(2):177. doi: 10.3390/ijerph16020177.
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Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017.药物和阿片类药物滥用相关的过量死亡-美国,2013-2017 年。
MMWR Morb Mortal Wkly Rep. 2018 Jan 4;67(5152):1419-1427. doi: 10.15585/mmwr.mm675152e1.
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The Fentanyl Epidemic and Evolution of Fentanyl Analogs in the United States and the European Union.芬太尼泛滥及芬太尼类似物在美国和欧盟的演变。
Clin Chem. 2019 Feb;65(2):242-253. doi: 10.1373/clinchem.2017.281626. Epub 2018 Oct 10.
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Opioid-related Emergency Department Visits and Hospitalizations Among Commercially Insured Individuals, 2009-2015.2009-2015 年商业保险个体中与阿片类药物相关的急诊就诊和住院治疗情况。
Clin J Pain. 2018 Dec;34(12):1121-1125. doi: 10.1097/AJP.0000000000000643.

美国阿片类药物和苯二氮䓬类药物的国家治疗入院人数。

US national treatment admissions with opioids and benzodiazepines.

机构信息

Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, USA.

Detroit Wayne Integrated Health Network, Detroit, USA.

出版信息

Drug Alcohol Rev. 2020 Nov;39(7):862-869. doi: 10.1111/dar.13129. Epub 2020 Aug 3.

DOI:10.1111/dar.13129
PMID:32748413
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10336643/
Abstract

INTRODUCTION AND AIMS

Opioids and benzodiazepines (O/BZD) are increasingly involved in drug overdose deaths in the USA. Expanding treatment capacity may reduce these deaths. Knowledge about co-occurring O/BZD admissions compared to opioid admissions (opioid) is needed to plan this expansion.

DESIGN AND METHODS

US treatment admissions to specialty facilities for 2011-2017 were analysed for trends and 2017 for group differences. Due to 1.9 million admissions in 2017, comparisons between O/BZD and opioid admissions were summarised as effect sizes. Additional analysis compared the administratively pre-coded category 'other opiates and synthetics' to other opiates and synthetics/benzodiazepines admissions to control for possible similarity in drug source. Differences within O/BZD admissions by primary drug were explored.

RESULTS

Although opioid admissions showed a steady increase over time (25.9% to 38.2%), O/BZD admissions showed increases until decline in 2017 (3.2% to 4.0%). In 2017 no factor reached moderate effect size (≥0.2) in group comparisons or within the O/BZD admissions. Heroin was self-reported in 70% of both O/BZD and opioid admissions.

DISCUSSION AND CONCLUSIONS

No meaningful US national differences on data routinely collected were found for O/BZD compared to opioid admissions including the subgroup with other opiates and synthetics only. Efforts to expand existing opioid treatment in specialty treatments may help reduce opioid and O/BZD deaths. However, the analysis could not address whether changes in treatment would improve outcomes.

摘要

简介与目的

在美国,阿片类药物和苯二氮䓬类药物(O/BZD)越来越多地与药物过量死亡有关。扩大治疗能力可能会减少这些死亡。为了规划这一扩张,需要了解同时接受 O/BZD 和阿片类药物(阿片类药物)治疗的患者的情况。

设计与方法

分析了 2011 年至 2017 年期间美国专业治疗机构的治疗入院人数趋势,并对 2017 年的数据进行了组间差异分析。由于 2017 年有 190 万人入院治疗,因此将 O/BZD 和阿片类药物入院治疗的比较结果总结为效应大小。此外,还比较了行政预编码类别“其他阿片类药物和合成药物”与其他阿片类药物和合成药物/苯二氮䓬类药物的入院治疗情况,以控制可能存在的药物来源相似性。还探讨了 O/BZD 入院治疗中主要药物之间的差异。

结果

尽管阿片类药物入院治疗呈持续增加趋势(从 2011 年的 25.9%增加到 2017 年的 38.2%),但 O/BZD 入院治疗在 2017 年之前一直呈上升趋势,然后下降(从 2011 年的 3.2%增加到 2017 年的 4.0%)。2017 年,组间比较或 O/BZD 入院治疗中,没有任何因素达到中等效应大小(≥0.2)。在 O/BZD 和阿片类药物入院治疗中,海洛因均有 70%的患者自行报告。

讨论与结论

与阿片类药物入院治疗相比,O/BZD 入院治疗在常规收集的数据方面没有发现有意义的美国全国性差异,包括仅包含其他阿片类药物和合成药物的亚组。在专业治疗中扩大现有的阿片类药物治疗可能有助于减少阿片类药物和 O/BZD 死亡。然而,分析无法解决治疗方法的改变是否会改善结果的问题。