Gaur Dhruv S, Jacka Brendan P, Green Traci C, Samuels Elizabeth A, Hadland Scott E, Krieger Maxwell S, Yedinak Jesse L, Marshall Brandon D L
Department of Epidemiology, Brown University. 121 South Main Street, Providence, RI 02912, USA.
Department of Epidemiology, Brown University. 121 South Main Street, Providence, RI 02912, USA; Department of Emergency Medicine, The Warren Alpert Medical School, Brown University. 55 Claverick Street, Suite 100, Providence, RI 02903, USA; Department of Emergency Medicine, Boston University School of Medicine. 771 Albany St, Room 1208, Boston, MA 02118, USA; Rhode Island Hospital, COBRE on Opioids and Overdose. 8 Third Street, 2nd Floor, Providence, RI 02906, USA.
Int J Drug Policy. 2020 Nov;85:102906. doi: 10.1016/j.drugpo.2020.102906. Epub 2020 Oct 16.
Drug overdose mortality remains a public health concern in many countries globally. In the US, overdoses involving synthetic opioids are the primary contributor to overdose mortality. We aimed to assess trends in overdose death due to synthetic opioids among young people and describe key demographic and temporal changes.
Data from the US National Vital Statistics System Multiple Cause of Death files for 2009-2018 were analysed to determine age-specific overdose death rates by region (i.e. east versus west of the Mississippi River). Age-adjusted overdose mortality rates were used to compare demographic differences in all drug and synthetic opioid overdose among young people (aged 15-34 years) using a joinpoint regression with Poisson-approximated standard errors.
Driven by synthetic opioid overdose, the age burden of mortality shifted towards young people in eastern states and remained approximately constant in western states over the study period. The highest increases in drug overdose mortality rates were observed in young Black and Hispanic people and those living in large metropolitan areas.
Rapid changes in the demographics of overdose demonstrate distinct but overlapping US overdose sub-epidemics, and highlight the need for targeted interventions to reduce overdose risk in young people.
药物过量致死仍是全球许多国家关注的公共卫生问题。在美国，涉及合成阿片类药物的过量用药是过量用药致死的主要原因。我们旨在评估年轻人中因合成阿片类药物导致的过量用药死亡趋势，并描述关键的人口统计学和时间变化。
分析了美国国家生命统计系统2009 - 2018年多死因档案数据，以确定按地区（即密西西比河以东与以西）划分的特定年龄过量用药死亡率。年龄调整后的过量用药死亡率用于通过具有泊松近似标准误差的连接点回归来比较年轻人（15 - 34岁）中所有药物和合成阿片类药物过量用药的人口统计学差异。
在研究期间，受合成阿片类药物过量用药影响，东部各州的死亡年龄负担向年轻人转移，而西部各州则大致保持不变。药物过量死亡率上升幅度最大的是年轻黑人和西班牙裔人群以及居住在大都市地区的人群。
过量用药人口统计学的快速变化表明美国存在不同但相互重叠的过量用药子流行情况，并凸显了采取针对性干预措施以降低年轻人过量用药风险的必要性。
