Adam J. Milam is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Debra Furr-Holden is with the Division of Public Health, College of Human Medicine, Michigan State University, Flint, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Ling Wang is with Department of Medicine, College of Human Medicine, Michigan State University, East Lansing. Kevin M. Simon is with Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, and Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA.
Am J Public Health. 2021 Sep;111(9):1627-1635. doi: 10.2105/AJPH.2021.306322. Epub 2021 Jun 29.
To examine temporal trends in the classification of opioid-involved overdose deaths (OODs) and racial variation in the classification of specific types of opioids used. We analyzed OODs coded as other or unspecified narcotics from 1999 to 2018 in the United States using data from the National Vital Statistics System and the Centers for Disease Control and Prevention. The total proportion of OODs from unspecified narcotics decreased from 32.4% in 1999 to 1.9% in 2018. The proportion of OODs from unspecified narcotics among African American persons was approximately 2-fold greater than that of non-Hispanic White persons until 2012. Similarly, the proportion of OODs from unspecified narcotics among Hispanic persons was greater than that of White persons until 2015. After we controlled for death investigation system, African American persons had a higher incidence rate of OODs from unspecified narcotics compared with White persons. There have been significant improvements in the specification OODs over the past 20 years, and there has been significant racial disparity in the classification of OODs until about 2015. The findings suggest a health data disparity; the excessive misclassification of OODs is likely attributable to the race/ethnicity of the decedent.
为了研究涉及阿片类药物的过量用药死亡（OOD）分类的时间趋势以及特定类型阿片类药物分类的种族差异。我们分析了美国国家生命统计系统和疾病控制与预防中心的数据中 1999 年至 2018 年编码为其他或未指定麻醉品的 OOD。未指定麻醉品的 OOD 总数比例从 1999 年的 32.4%下降到 2018 年的 1.9%。在 2012 年之前，非裔美国人的未指定麻醉品 OOD 比例大约是非西班牙裔白人的两倍。同样，在 2015 年之前，西班牙裔的未指定麻醉品 OOD 比例高于白人。在控制死亡调查系统后，与白人相比，非裔美国人未指定麻醉品 OOD 的发生率更高。在过去的 20 年中，OOD 的规范有了显著的改进，而且直到 2015 年左右，OOD 的分类一直存在显著的种族差异。这些发现表明存在卫生数据差异；OOD 的过度错误分类可能归因于死者的种族/民族。
