Begley Mark R, Ravindran Chandru, Peltzman Talya, Morley Sybil W, Stephens Brady M, Ashrafioun Lisham, McCarthy John F
Veterans Affairs (VA) Veterans Integrated Service Network 2, Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.
Veterans Affairs (VA) Veterans Integrated Service Network 2, Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.
Drug Alcohol Depend. 2022 Apr 1;233:109296. doi: 10.1016/j.drugalcdep.2022.109296. Epub 2022 Jan 12.
Prior work documents that Veteran drug overdose mortality increased from 2010 to 2016. The present study assessed trends from 2010 to 2019, by drug type and recent receipt of Veterans Health Administration (VHA) services, and compared rates for Veteran and non-Veteran US adults.
This retrospective cross-sectional study used data from Veterans Affairs (VA) medical records, the VA/Department of Defense Mortality Data Repository, and CDC WONDER. Trends were compared using Joinpoint regression.
From 2010-2019, age-adjusted overdose mortality rates increased 53.2% among Veterans and 79.0% among non-Veterans. Age-adjusted rates of overdose mortality among Veterans rose from 19.8/100,000 in 2010 to 32.6/100,000 in 2017, before falling to 30.3/100,000 in 2019. Despite the decrease from 2017 to 2019 in overall overdose mortality, rates of overdose deaths involving synthetic opioids other than methadone and involving psychostimulants continued to increase through 2019. In 2019, overdose mortality was lower for male Veterans than male non-Veterans (standardized rate ratio (SRR) = 0.81, 95% confidence interval (CI): 0.77-0.84). Among male Veterans, rates were higher in all years for those with recent VHA use than those without (2019: SRR=1.69, 95% CI: 1.56-1.83). From 2010-2019, overdose mortality rates increased faster among female Veterans without VHA use than those with VHA use.
From 2015 onward, Veteran men experienced lower age-adjusted overdose rates than non-Veteran men. In all years, overdose rates were higher among male Veterans with recent VHA use than those without recent use. While overall rates of Veteran overdose deaths declined from 2017 to 2019, rates involving psychostimulants and synthetic opioids continued to rise.
先前的研究记录显示，2010年至2016年期间退伍军人药物过量死亡率有所上升。本研究评估了2010年至2019年期间按药物类型以及退伍军人健康管理局（VHA）服务近期接受情况划分的趋势，并比较了美国退伍军人与非退伍军人成年人的死亡率。
这项回顾性横断面研究使用了退伍军人事务部（VA）医疗记录、VA/国防部死亡率数据存储库以及疾病控制与预防中心（CDC）的WONDER数据。使用Joinpoint回归比较趋势。
2010年至2019年期间，退伍军人中年龄调整后的药物过量死亡率上升了53.2%，非退伍军人中上升了79.0%。退伍军人中年龄调整后的药物过量死亡率从2010年的19.8/10万上升至2017年的32.6/10万，随后在2019年降至30.3/10万。尽管2017年至2019年总体药物过量死亡率有所下降，但涉及美沙酮以外的合成阿片类药物以及精神兴奋剂的药物过量死亡发生率在2019年之前持续上升。2019年，男性退伍军人的药物过量死亡率低于男性非退伍军人（标准化率比（SRR）=0.81，95%置信区间（CI）：0.77 - 0.84）。在男性退伍军人中，所有年份里近期使用VHA服务者的死亡率均高于未使用者（2019年：SRR = 1.69，95% CI：1.56 - 1.83）。2010年至2019年期间，未使用VHA服务的女性退伍军人的药物过量死亡率上升速度快于使用VHA服务的女性退伍军人。
自2015年起，退伍军人男性的年龄调整后药物过量发生率低于非退伍军人男性。在所有年份里，近期使用VHA服务的男性退伍军人的药物过量发生率高于未近期使用者。尽管2017年至2019年退伍军人药物过量死亡的总体发生率有所下降，但涉及精神兴奋剂和合成阿片类药物的发生率仍在持续上升。
