National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-S106-8, Atlanta, GA, 30341, United States.
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS-S106-8, Atlanta, GA, 30341, United States.
Drug Alcohol Depend. 2020 Nov 1;216:108323. doi: 10.1016/j.drugalcdep.2020.108323. Epub 2020 Sep 25.
Emerging data indicate a resurgence of availability and harms of amphetamine-type stimulant (ATS) use. This study examined ATS overdose-involved emergency department (ED) visit trends and visit characteristics associated with ATS overdose.
Data from the Healthcare Cost and Utilization Project's (HCUP) 2010-2017 Nationwide Emergency Department Sample identified ATS overdose-involved visits. Predicted trend lines from 2010 to 2015 were fit using weighted logistic regression forany or only ATS-involved overdose using ICD-9-CM discharge diagnosis codes; percentage change from 2016 to 2017 used ICD-10-CM. Multivariable logistic regression examined characteristics in 2017 associated with only ATS-involved overdoses compared to drug overdoses not involving ATS.
Every year from 2010 to 2015 the odds of any ATS overdose-involved ED visits increased 11 % (odds ratio [OR]: 1.11, 95 % CI: 1.09, 1.14) and 7 % for only ATS overdose-involved visits (OR: 1.07, 95 % CI: 1.04, 1.10). From 2016 to 2017, any and only ATS overdose-involved visit rates increased 19.1 % and 20.5 %, respectively (P < .05). In 2017, ATS overdose-involved visits (N = 42,428) accounted for 4.4 % of all drug overdose visits (N = 956,266). In adjusted regression models, characteristics more prevalent among patients with only ATS overdose included Western region; micropolitan and noncore urbanization levels; unintentional, undetermined, and assault intents; and cardiovascular effects.
Our findings, coupled with the rising availability of ATS and related harms, underscore the expansion of current substance use and overdose prevention and response efforts to address stimulant use, particularly among groups at risk. Research to identify additional individual and community-level risk factors for increasing ATS overdose is warranted.
新出现的数据表明，苯丙胺类兴奋剂（ATS）的供应和危害再次出现。本研究考察了 ATS 过量使用导致的急诊（ED）就诊趋势，以及与 ATS 过量相关的就诊特征。
利用医疗保健成本和利用项目（HCUP）2010-2017 年全国急诊样本数据，确定了 ATS 过量使用相关的就诊。使用加权逻辑回归拟合 2010 年至 2015 年的预测趋势线，使用 ICD-9-CM 出院诊断代码分析任何或仅 ATS 相关的过量使用；2016 年至 2017 年的百分比变化使用 ICD-10-CM。多变量逻辑回归分析了 2017 年与仅 ATS 相关的过量使用相比，与不涉及 ATS 的药物过量使用相关的特征。
从 2010 年到 2015 年，每年 ATS 过量使用导致的 ED 就诊的可能性增加 11%（优势比[OR]：1.11，95%置信区间[CI]：1.09，1.14），仅 ATS 过量使用导致的就诊可能性增加 7%（OR：1.07，95% CI：1.04，1.10）。从 2016 年到 2017 年，任何和仅 ATS 过量使用导致的就诊率分别增加了 19.1%和 20.5%（P<.05）。2017 年，ATS 过量使用导致的就诊（N=42428）占所有药物过量就诊（N=956266）的 4.4%。在调整后的回归模型中，仅 ATS 过量使用的患者中更常见的特征包括西部地区、大都市和非核心城市化水平、非故意、不确定和攻击意图以及心血管效应。
我们的发现，加上 ATS 的供应增加和相关危害，突显了当前物质使用和过量预防和应对工作的扩大，以解决兴奋剂的使用问题，特别是在有风险的群体中。有必要开展研究，以确定增加 ATS 过量使用的其他个人和社区层面的风险因素。
