Webb Lucy, Shi Xin, Goodair Christine, Cheeta Survjit
Department of Nursing, Manchester Metropolitan University, Manchester, United Kingdom.
School of Maths and Information Science, Shangdong Technology and Business University, Yantai, China.
Front Psychiatry. 2022 Apr 21;13:890840. doi: 10.3389/fpsyt.2022.890840. eCollection 2022.
This study aimed to examine drug-related deaths in the UK in which novel psychoactive substances (NPS) are an implicated substance, and to focus on female deaths in comparison with male deaths. While male overdoses dominate epidemiological statistics, there is an increase in female drug-related deaths and a narrowing of the gap between gender mortality rates which is to date unexplained.
This study analyzed data from the National Programme for Substance Abuse Deaths (NPSAD) database that records drug-related deaths in the UK from coronial records. A dataset was constructed using parameters to capture all drug-related cases during the period 2007-2017 when NPS were legal and highly available in the UK, in order to capture deaths recorded among both regular and occasional drug users, and to include all cases recorded during that period regardless of NPS status in order to make comparisons. The final dataset comprised 10,159 cases, with 456 NPS-related deaths. Data for NPS and non-NPS were compared, and comparisons were made between cohorts by gender. The dataset also includes coronial narrative notes which allowed a qualitative analysis of NPS female deaths to add contextual explanation.
The proportion of male NPS deaths is significantly higher than that for female NPS deaths but does not reflect the generalized difference between male and female drug-related mortality of this period studied. Demographic and outcome data by gender difference were significant for all drug-related deaths, but not for NPS-only deaths, indicating a greater homogeneity among NPS deaths by gender. Older women using NPS were more likely to have methadone or diazepam as another drug implicated and have established histories of drug misuse.
Where NPS have been used, differences in drug death profiles are less likely to be accounted for by gender than other demographic or behavioral differences more typically found in opiate deaths. The social and health problems of older women may be key characteristics that differentiate female deaths from male deaths. These findings also support evidence of increasing uptake of NPS among older established drug users that adds further risk to polydrug use.
本研究旨在调查英国与新型精神活性物质（NPS）相关的药物致死案例，并重点关注女性死亡案例与男性死亡案例的对比情况。虽然男性药物过量致死在流行病学统计中占主导地位，但女性药物相关死亡人数呈上升趋势，且性别死亡率差距在缩小，而这一现象至今仍无法解释。
本研究分析了国家药物滥用死亡计划（NPSAD）数据库中的数据，该数据库记录了英国死因裁判记录中的药物相关死亡案例。使用参数构建了一个数据集，以获取2007年至2017年期间英国NPS合法且极易获取时的所有药物相关案例，目的是涵盖经常和偶尔吸毒者中的死亡记录，并纳入该期间记录的所有案例，无论其NPS状态如何，以便进行比较。最终数据集包含10159个案例，其中456例与NPS相关的死亡案例。对NPS和非NPS的数据进行了比较，并按性别对队列进行了比较。该数据集还包括死因裁判的叙述性记录，以便对NPS女性死亡案例进行定性分析，以补充背景解释。
男性NPS死亡比例显著高于女性NPS死亡比例，但这并未反映出本研究期间男性和女性药物相关死亡率的总体差异。按性别差异划分的人口统计学和结果数据在所有药物相关死亡案例中具有显著性，但在仅与NPS相关的死亡案例中不具有显著性，这表明NPS死亡案例在性别上具有更大的同质性。使用NPS的老年女性更有可能同时使用美沙酮或地西泮等其他药物，且有药物滥用史。
在使用NPS的情况下，与其他人口统计学或行为差异相比，药物死亡情况的差异不太可能由性别来解释，而这些差异在阿片类药物死亡案例中更为常见。老年女性的社会和健康问题可能是区分女性死亡案例与男性死亡案例的关键特征。这些发现还支持了老年吸毒者中使用NPS的人数增加的证据，这进一步增加了多药滥用的风险。
