Department of Clinical Neuroscience, Karolinska Institute, SE-17177 Stockholm, Sweden.
Former National Institute of Public Health, SE-11662 Stockholm, Sweden.
Drug Alcohol Depend. 2022 May 1;234:109402. doi: 10.1016/j.drugalcdep.2022.109402. Epub 2022 Mar 11.
To identify and characterize oxycodone related deaths in Sweden from 2006 to 2018 and to compare them to other opioid-related deaths.
To assess the factors contributing to the deaths, we used multinomial logistic regression to compare oxycodone-related deaths extracted from all forensic autopsy examinations and toxicology cases in the age groups 15-34 (reference group), 35-54 and 55-74 with regard to sex, presence of benzodiazepines and alcohol at the time of death, prescription of oxycodone, benzodiazepines and antidepressants, previous substance use-related (SUD) treatment, and manner of death. The oxycodone related deaths were compared with deaths with presence of other opioids.
We identified 575 oxycodone-related deaths, and the rate increased during the study period from 0.10 to 1.12 per 100,000 in parallel with an increase of oxycodone prescriptions from 3.17 to 30.33 per 1000. Oxycodone-related deaths amounted to 10.0% of all opioid-related deaths. The deaths occurred mainly in older patients previously being prescribed oxycodone. Benzodiazepines were present at the time of death in 403 (70%) and alcohol in 259 (45%). Prescriptions of any opioid for pain (61%), oxycodone (50%), benzodiazepines (67%) and antidepressants (55%) were common. Only 15% had received treatment for SUD during the last year.
Oxycodone-related deaths increased in Sweden between 2006 and 2018 in parallel to an increase in oxycodone prescriptions. The increase occurred mainly in older patients being prescribed oxycodone for pain. There might be specific interventions needed to avoid oxycodone-related deaths compared to other opioid-related deaths associated with illicit opioid use.
从 2006 年到 2018 年，识别并描述瑞典的羟考酮相关死亡案例，并将其与其他阿片类药物相关死亡案例进行比较。
为了评估导致死亡的因素，我们使用多项逻辑回归来比较从所有法医尸检和毒理学案例中提取的年龄在 15-34 岁（参考组）、35-54 岁和 55-74 岁的羟考酮相关死亡案例，比较因素包括性别、死亡时是否存在苯二氮䓬类药物和酒精、羟考酮、苯二氮䓬类药物和抗抑郁药的处方、先前与物质使用障碍（SUD）相关的治疗以及死亡方式。将羟考酮相关死亡案例与存在其他阿片类药物的死亡案例进行比较。
我们共发现 575 例羟考酮相关死亡案例，在研究期间，该死亡率从 0.10 增加到每 10 万人 1.12，同时羟考酮处方量从每 1000 人 3.17 增加到 30.33。羟考酮相关死亡案例占所有阿片类药物相关死亡案例的 10.0%。这些死亡主要发生在先前被开羟考酮处方的老年患者中。403 例（70%）死亡时存在苯二氮䓬类药物，259 例（45%）存在酒精。开处用于治疗疼痛的任何阿片类药物（61%）、羟考酮（50%）、苯二氮䓬类药物（67%）和抗抑郁药（55%）的情况很常见。只有 15%的患者在过去一年中接受过 SUD 治疗。
2006 年至 2018 年期间，瑞典的羟考酮相关死亡案例与羟考酮处方量的增加平行增加。这种增加主要发生在接受羟考酮治疗疼痛的老年患者中。与与非法阿片类药物使用相关的其他阿片类药物相关死亡案例相比，可能需要采取特定的干预措施来避免羟考酮相关死亡案例。
