Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA.
Public Health Rep. 2023 Jan-Feb;138(1):131-139. doi: 10.1177/00333549221074390. Epub 2022 Feb 21.
Increased drug overdose mortality among non-Hispanic Black people in the United States in the past 5 years highlights the need for better tailored programs and services. We evaluated (1) changes in drug overdose mortality for various racial and ethnic groups and (2) drug involvement to inform drug overdose prevention efforts in Kentucky.
We used Kentucky death certificates and postmortem toxicology reports from 2016-2020 (provisional data) to estimate changes in age-adjusted drug overdose death rates per 100 000 standard population.
The age-adjusted drug overdose death rate per 100 000 standard population among non-Hispanic Black residents doubled from 2016 (21.2) to 2020 (46.0), reaching the rate among non-Hispanic White residents in 2020 (48.7; = .48). From 2016 to 2020, about 80% of these drug overdose deaths involved opioids; heroin involvement declined about 20 percentage points; fentanyl involvement increased about 30 percentage points. The number of psychostimulant-involved drug overdose deaths increased 513% among non-Hispanic Black residents and 191% among non-Hispanic White residents. Cocaine-involved drug overdose deaths increased among non-Hispanic Black residents but declined among non-Hispanic White residents. Drug overdose death rates were significantly lower among Hispanic residents than among non-Hispanic White residents.
Increased opioid-involved overdose deaths among non-Hispanic Black residents in Kentucky in combination with rapidly expanding concomitant psychostimulant involvement require increased understanding of the social, cultural, and illicit market circumstances driving these rapid trend changes. Our findings underscore the urgent need to expand treatment and harm reduction services to non-Hispanic Black residents with substance use disorder.
在过去 5 年中，美国非西班牙裔黑人的药物过量死亡率上升，这凸显了需要更好地定制计划和服务。我们评估了（1）不同种族和族裔群体的药物过量死亡率变化，以及（2）药物使用情况，以为肯塔基州的药物过量预防工作提供信息。
我们使用了 2016-2020 年肯塔基州的死亡证明和死后毒理学报告（临时数据），以估计每 10 万标准人口的年龄调整后药物过量死亡率的变化。
非西班牙裔黑人居民的年龄调整后每 10 万标准人口的药物过量死亡率从 2016 年的 21.2 翻了一番，达到 2020 年的 46.0，与 2020 年非西班牙裔白人居民的死亡率（48.7；=0.48）相当。从 2016 年到 2020 年，这些药物过量死亡中有约 80%涉及阿片类药物；海洛因的参与度下降了约 20 个百分点；芬太尼的参与度增加了约 30 个百分点。非西班牙裔黑人居民的与苯丙胺类兴奋剂相关的药物过量死亡人数增加了 513%，非西班牙裔白人居民增加了 191%。可卡因相关的药物过量死亡人数在非西班牙裔黑人居民中增加，但在非西班牙裔白人居民中下降。与非西班牙裔白人居民相比，西班牙裔居民的药物过量死亡率明显较低。
肯塔基州非西班牙裔黑人居民中与阿片类药物相关的药物过量死亡人数增加，同时伴随苯丙胺类兴奋剂的使用迅速扩大，这需要更深入地了解推动这些快速趋势变化的社会、文化和非法市场情况。我们的研究结果强调了迫切需要扩大针对非西班牙裔黑人居民的药物使用障碍的治疗和减少伤害服务。
