National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland.
Ann N Y Acad Sci. 2022 Feb;1508(1):3-22. doi: 10.1111/nyas.14688. Epub 2021 Sep 24.
Recent attention has focused on the growing role of psychostimulants, such as methamphetamine in overdose deaths. Methamphetamine is an addictive and potent stimulant, and its use is associated with a range of physical and mental health harms, overdose, and mortality. Adding to the complexity of this resurgent methamphetamine threat is the reality that the increases in methamphetamine availability and harms are occurring in the midst of and intertwined with the ongoing opioid overdose crisis. Opioid involvement in psychostimulant-involved overdose deaths increased from 34.5% of overdose deaths in 2010 to 53.5% in 2019-an increase of more than 50%. This latest evolution of the nation's overdose epidemic poses novel challenges for prevention, treatment, and harm reduction. This narrative review synthesizes what is known about changing patterns of methamphetamine use with and without opioids in the United States, other characteristics associated with methamphetamine use, the contributions of the changing illicit drug supply to use patterns and overdose risk, motivations for couse of methamphetamine and opioids, and awareness of exposure to opioids via the illicit methamphetamine supply. Finally, the review summarizes illustrative community and health system strategies and research opportunities to advance prevention, treatment, and harm reduction policies, programs, and practices.
最近，人们越来越关注苯丙胺类兴奋剂（如冰毒）在过量死亡中的作用。冰毒是一种成瘾性和强效兴奋剂，其使用与一系列身心健康危害、过量用药和死亡有关。使这一重新出现的冰毒威胁更加复杂的是，冰毒供应的增加和危害的增加，是在阿片类药物过量危机持续存在和相互交织的情况下发生的。阿片类药物在与苯丙胺类兴奋剂相关的过量死亡中的参与度从 2010 年的 34.5%增加到 2019 年的 53.5%，增加了 50%以上。这是美国阿片类药物流行的最新演变，给预防、治疗和减少伤害带来了新的挑战。本叙述性综述综合了已知的关于美国阿片类药物和非阿片类药物使用模式的变化、与冰毒使用相关的其他特征、不断变化的非法毒品供应对使用模式和过量风险的贡献、冰毒和阿片类药物使用的动机，以及通过非法冰毒供应接触阿片类药物的意识。最后，综述总结了具有代表性的社区和卫生系统战略和研究机会，以推进预防、治疗和减少伤害政策、方案和实践。
