Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
New Jersey Medical School, Newark, NJ, USA.
Clin Toxicol (Phila). 2021 Aug;59(8):705-714. doi: 10.1080/15563650.2020.1861287. Epub 2021 Jan 6.
To investigate characteristics and trends of methamphetamine exposures reported to United States (US) poison control centers.
Data from the National Poison Data System were analyzed.
From January 1, 2000 through December 31, 2019, US poison control centers managed 54,199 cases involving methamphetamine as the first-ranked substance. Adults 20-39 years old accounted for more than half (56.3%) of cases. There were 1,291 deaths, of which 43.0% involved multiple-substance exposures. Among multiple-substance exposures in which methamphetamine was the first-ranked substance, stimulants and street drugs (excluding methamphetamine) were most commonly also present (22.7%), followed by opioids (19.0%). The substance class associated with the most fatalities was opioids ( = 243, 26.6%). The rate of methamphetamine exposures per 100,000 US population increased from 0.6 to 1.1 from 2000-2005, then decreased from 1.1 to 0.4 from 2005-2007, followed by an increase from 0.4 to 2.6 from 2007-2019. From 2007-2019, the rate significantly increased in all US regions, and among all age groups, except among 6-12-year-olds. Also, the rates of single-substance and multiple-substance exposures each increased significantly (both < 0.0001) from 2007-2019, as did the overall methamphetamine fatality rate per 100,000 US population (0.0036 to 0.022, < 0.0001). From 2000-2019, the proportions of cases resulting in admission to a health care facility and serious medical outcome increased from 30.2% to 47.8% ( < 0.0001) and from 37.6% to 54.0% ( < 0.0001), respectively.
The rate of exposure to methamphetamine in the US declined initially following passage of the Combat Methamphetamine Epidemic Act of 2005. However, since 2007, the rate and severity of exposures to methamphetamine have increased, primarily driven by individuals 20 years or older. Increased prevention efforts are needed, including prevention of methamphetamine initiation among adolescents and young adults, improved access to effective treatment for co-occurring mental health and substance use disorders, and prevention of unintentional exposures among children.
调查美国（US）中毒控制中心报告的甲基苯丙胺暴露的特征和趋势。
对国家毒物数据系统的数据进行分析。
从 2000 年 1 月 1 日至 2019 年 12 月 31 日，美国中毒控制中心管理了 54199 例以甲基苯丙胺为首位物质的病例。20-39 岁的成年人占病例的一半以上（56.3%）。共有 1291 人死亡，其中 43.0%涉及多种物质暴露。在涉及甲基苯丙胺的多种物质暴露中，兴奋剂和街头毒品（不包括甲基苯丙胺）最常同时存在（22.7%），其次是阿片类药物（19.0%）。与最多死亡相关的物质类别是阿片类药物（ = 243，26.6%）。每 10 万美国人口中甲基苯丙胺暴露的比率从 2000-2005 年的 0.6 增加到 1.1，然后从 2005-2007 年的 1.1 减少到 0.4，然后从 2007-2019 年增加到 2.6。从 2007-2019 年，美国所有地区以及所有年龄组（除 6-12 岁儿童外）的比率均显著增加。此外，单物质和多物质暴露的比率都从 2007-2019 年显著增加（均 < 0.0001），每 10 万美国人口的总体甲基苯丙胺死亡率也从 0.0036 增加到 0.022（ < 0.0001）。从 2000-2019 年，因接触甲基苯丙胺而住院和严重医疗后果的病例比例从 30.2%增加到 47.8%（ < 0.0001）和从 37.6%增加到 54.0%（ < 0.0001）。
自 2005 年《打击甲基苯丙胺流行法》通过以来，美国接触甲基苯丙胺的比率最初有所下降。然而，自 2007 年以来，接触甲基苯丙胺的比率和严重程度有所增加，主要是 20 岁或以上的人。需要加强预防工作，包括预防青少年和年轻人开始使用甲基苯丙胺，改善对同时存在的心理健康和药物使用障碍的有效治疗的获取，以及预防儿童意外接触。
