Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Addiction. 2021 Jun;116(6):1593-1599. doi: 10.1111/add.15260. Epub 2020 Sep 25.
It is widely believed that the 2018 decline in overdose deaths in the United States was attributable to a range of public health interventions, however, this decline also coincided with the regulation and decline in use of potent fentanyl analogs, especially carfentanil. The aim of this study was to investigate the association between overdose deaths and carfentanil availability in the United States.
Secondary analysis of drug overdose deaths from the Center for Disease Control and Prevention (CDC) and carfentanil exhibit data from drug seizures submitted to drug crime labs and published by the Drug Enforcement Administration (DEA). Trends in overdose deaths were compared in states with high carfentanil exhibits with states with low or no carfentanil exhibits.
United States.
A total of 1 035 923 drug overdose death records in the United States from 1979 through 2019 were studied.
The outcomes studied were number of overdose deaths and mortality rates by state.
Drug overdose deaths have been closely tracked along an exponential curve. The years 2016 and 2017 witnessed a hyper-exponential surge with increases in overdose deaths of 11 228 (+21.4%) and 6605 (+10.4%), respectively. Subsequently in 2018, drug overdose deaths declined by -2870 (-4.1%). This rise and then fall coincided with a surge and then decline in carfentanil drug seizure exhibits during these same years: 0 (2015), 1292 (2016), 5857 (2017) and 804 (2018). The majority of carfentanil exhibits were localized to a few states. The 2018 decline in overdose deaths in the top five states with the greatest spike in carfentanil exhibits in 2017 (Ohio, Florida, Pennsylvania, Kentucky and Michigan) was 2848, which accounted for nearly all of the total US decline.
The 2016-2017 acceleration and then 2018 decline in drug overdose deaths in the United States was associated with the sudden rise and then fall of carfentanil availability. Given the regional variation, carfentanil's decreased availability may have contributed to the reduction in overdose deaths in 2018.
人们普遍认为，2018 年美国过量死亡人数的下降归因于一系列公共卫生干预措施，但这一下降也恰逢强效芬太尼类似物（尤其是卡芬太尼）的监管和使用减少。本研究旨在调查美国过量死亡与卡芬太尼供应之间的关系。
对疾病控制与预防中心（CDC）的药物过量死亡数据和缉毒署（DEA）公布的药物犯罪实验室提交的卡芬太尼检测数据进行二次分析。比较了卡芬太尼检测量高的州与卡芬太尼检测量低或无卡芬太尼检测量的州的过量死亡趋势。
美国。
研究了 1979 年至 2019 年美国共 1035923 例药物过量死亡记录。
研究的结果是各州的过量死亡人数和死亡率。
药物过量死亡人数一直沿着指数曲线密切跟踪。2016 年和 2017 年，药物过量死亡人数分别增加了 11228 人（增长 21.4%）和 6605 人（增长 10.4%），呈超指数增长。随后，2018 年药物过量死亡人数下降了-2870 人（下降 4.1%）。这种上升然后下降与同期卡芬太尼缉获量的激增然后下降相吻合：2015 年为 0，2016 年为 1292，2017 年为 5857，2018 年为 804。大多数卡芬太尼检测集中在少数几个州。在 2017 年卡芬太尼检测量最大的五个州（俄亥俄州、佛罗里达州、宾夕法尼亚州、肯塔基州和密歇根州），2018 年药物过量死亡人数下降了 2848 人，几乎占美国总降幅的全部。
美国 2016-2017 年药物过量死亡人数的加速增长，然后在 2018 年下降，与卡芬太尼供应的突然增加然后减少有关。鉴于区域差异，卡芬太尼可用性的降低可能导致 2018 年过量死亡人数的减少。
