Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, USA.
Detroit Wayne Integrated Health Network, Detroit, USA.
Drug Alcohol Rev. 2020 Nov;39(7):862-869. doi: 10.1111/dar.13129. Epub 2020 Aug 3.
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.
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.
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.
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.
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。
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。
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。
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。