Health Risks Program, Burnet Institute, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
Health Risks Program, Burnet Institute, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
Int J Drug Policy. 2022 Nov;109:103854. doi: 10.1016/j.drugpo.2022.103854. Epub 2022 Sep 20.
Increasing overdose deaths attributable to illicitly manufactured fentanyl and fentanyl analogues in North America has driven international concern about the expansion of these substances into drug markets elsewhere. This paper investigates 20-year trends in fentanyl deaths in Australia, distinguishing between deaths attributable to pharmaceutical, and to illicitly manufactured fentanyl and fentanyl analogues.
Analysis of fentanyl overdose deaths (2001-2021), extracted from the National Coronial Information System (NCIS).
833 fentanyl-related deaths were identified, predominantly occurring among males (73%), and people with a history of injecting drug use (67%). Rates of fentanyl deaths significantly increased between 2001 and 2014 and declined between 2015 and 2021. Drug dependence remained the most significant factor in deaths among people with a history of injecting drug use (87% vs 23% without such a history), while having died by suicide was the most significant factor for those without a history of injecting drug use (20% vs 4% respectively). Three quarters (72%) of deaths were attributable to pharmaceutical fentanyl and 21% to probable pharmaceutical fentanyl, with 5% attributable to fentanyl analogues (3%) (predominantly furanylfentanyl and acetylfentanyl) and illicitly manufactured fentanyl (2%). Deaths attributable to illicitly manufactured fentanyl and fentanyl analogues occurred from 2013 onwards.
Pharmaceutical fentanyl deaths in Australia have declined since 2015, in parallel with overall declines in pharmaceutical opioids (including fentanyl) dispensed since 2014. Deaths continue to occur among people with a history of injecting drug use and drug dependence. Deaths attributable to illicit fentanyl have emerged since 2013 but remain low in comparison to pharmaceutical fentanyl deaths.
在北美，与非法制造的芬太尼和芬太尼类似物有关的过量死亡人数不断增加，这引起了国际社会对这些物质向其他地方毒品市场扩散的关注。本文调查了澳大利亚 20 年来芬太尼死亡的趋势，区分了与制药芬太尼和非法制造的芬太尼和芬太尼类似物有关的死亡。
从国家验尸信息系统（NCIS）中提取芬太尼过量死亡（2001-2021 年）进行分析。
共确定了 833 例与芬太尼有关的死亡，主要发生在男性（73%）和有注射吸毒史的人群中（67%）。2001 年至 2014 年期间，芬太尼死亡人数显著增加，而 2015 年至 2021 年期间则有所下降。在有注射吸毒史的人群中，药物依赖仍然是死亡的最重要因素（87%比没有此类病史的人群中 23%），而自杀是没有注射吸毒史的人群中最重要的因素（20%比没有此类病史的人群中 4%）。四分之三（72%）的死亡归因于制药芬太尼，21%归因于可能的制药芬太尼，5%归因于芬太尼类似物（3%）（主要是呋喃芬太尼和乙酰芬太尼）和非法制造的芬太尼（2%）。2013 年以来发生了与非法制造的芬太尼和芬太尼类似物有关的死亡。
自 2015 年以来，澳大利亚的制药芬太尼死亡人数有所下降，与 2014 年以来制药类阿片类药物（包括芬太尼）的总体用量下降相吻合。死亡继续发生在有注射吸毒史和药物依赖的人群中。自 2013 年以来，与非法芬太尼有关的死亡已经出现，但与制药芬太尼死亡相比仍然较低。
