Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
Subst Use Misuse. 2021;56(8):1169-1181. doi: 10.1080/10826084.2021.1914101. Epub 2021 May 3.
Opioid-related deaths are a leading cause of accidental deaths in the United States (U.S.). This study aims to examine the national trends in opioid exposures reported to U.S. poison centers (PCs).
The National Poison Data System (NPDS) was queried for opioid exposures between 2011 and 2018. We descriptively assessed the demographic and clinical characteristics. Trends in opioid frequencies and rates were analyzed using Poisson regression. Independent predictors of serious adverse events in opioid exposures were studied.
There were a total of 604,183 opioid exposure calls made to the PCs during the study period. The frequency of opioid exposures decreased by 28.9% (95% CI: -29.6%, -28.1%; < 0.001), and the rate of opioid exposures decreased by 21.2% (95% CI: -24.7%, -16.9%; < 0.001). Multiple substance exposures accounted for 48.9% cases. The most frequent age group was 20-29 years (19.3%). Suspected suicides accounted for 34.9% cases. There were 7,246 deaths in our study sample, with 6.8% of cases demonstrating major effects. Hydrocodone was the most frequently observed opioid causing a toxic exposure and naloxone was used in 20.6% cases. Important predictors of a serious adverse event were age, gender, multi-substance exposures, and reasons for exposure.
Analysis of calls to PCs indicated a decreasing trend of opioid exposures. However, the proportion of SAEs due to such exposures increased. There was a high proportion of intentional exposures and occurred in older age groups. PCs are a vital component of real-time public health surveillance of overdoses in the current opioid crisis.
阿片类药物相关死亡是美国（美国）意外死亡的主要原因。本研究旨在研究向美国中毒控制中心（PC）报告的阿片类药物暴露的全国趋势。
国家毒物数据系统（NPDS）在 2011 年至 2018 年期间查询了阿片类药物暴露情况。我们对人口统计学和临床特征进行了描述性评估。使用泊松回归分析了阿片类药物频率和比率的趋势。研究了阿片类药物暴露中严重不良事件的独立预测因素。
在研究期间，共有 604,183 例阿片类药物暴露电话拨打到 PC。阿片类药物暴露的频率下降了 28.9%（95%CI：-29.6%，-28.1%；<0.001），暴露率下降了 21.2%（95%CI：-24.7%，-16.9%；<0.001）。多种物质暴露占 48.9%的病例。最常见的年龄组是 20-29 岁（19.3%）。疑似自杀占 34.9%的病例。在我们的研究样本中，有 7246 人死亡，其中 6.8%的病例表现出严重影响。氢可酮是最常观察到的引起毒性暴露的阿片类药物，纳洛酮在 20.6%的病例中使用。严重不良事件的重要预测因素是年龄、性别、多物质暴露和暴露原因。
对 PC 来电的分析表明，阿片类药物暴露呈下降趋势。然而，由于此类暴露导致的 SAE 比例增加。有意暴露的比例较高，发生在年龄较大的人群中。PC 是当前阿片类药物危机中实时监测过量用药的公共卫生监测的重要组成部分。
