Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong.
Int Health. 2023 Nov 3;15(6):715-722. doi: 10.1093/inthealth/ihad015.
The shifts in individual-level and neighborhood-level patterns of drug poisoning deaths in a high-density Asian city over time have been underestimated, although they provide essential information for community-based surveillance and interventions.
A case-only analysis with a 16-y, territory-wide, population-based registry in Hong Kong was applied to compare drug poisoning deaths from 2001 to 2010 with 2011 to 2016. Drug poisoning deaths, deaths from heroin and deaths from other opioids (codeine or morphine) were extracted (ICD codes: T36-T50, T40.1, T40.2). Binomial regressions were used to estimate the shifts in mortality patterns.
Among 3069 drug poisoning deaths, a significant shift in mortality patterns was found despite a decreasing mortality trend in Hong Kong. Overall, drug poisoning deaths shifted towards middle-aged/young-old, widowed/divorced, economically active, white collar and non-local born. Since 2011, more deaths from heroin were in older ages and non-local born, but less were never married and economically inactive. More deaths from other opioids were middle-aged, young-old and divorced. In particular, most decedents shifted towards young-old, especially deaths from other opioids. Compared with deaths during 2001-2010, there were 3.72- and 6.50-fold more deaths from heroin and deaths from other opioids in those aged ≥60 y since 2021 (ORs: 3.72 [2.37, 5.86], 6.50 [3.97, 10.65]), respectively. Additionally, drug poisoning deaths shifted towards areas with less neighborhood deprivation (more high-education individuals and a mix of private/public housing residents), especially deaths from other opioids.
Misuse of registered drugs (e.g. opioid pain relievers) could be a rising trend among vulnerable subpopulations in Hong Kong other than illegal drug use (heroin). Health officials should provide more advice and support on drug information. Specifically, an improved health system with education regarding the appropriate use of registered drugs for medical treatments should be provided to mid-/high-income and local-born individuals.
个体层面和社区层面的药物中毒死亡模式随时间的变化在高密度亚洲城市中被低估了，尽管它们为基于社区的监测和干预提供了重要信息。
本研究在香港应用了一项具有 16 年历史的、全港范围的、基于人群的登记处的病例对照分析，以比较 2001 年至 2010 年与 2011 年至 2016 年的药物中毒死亡情况。提取药物中毒死亡、海洛因死亡和其他阿片类药物（可待因或吗啡）死亡（ICD 代码：T36-T50、T40.1、T40.2）。使用二项回归估计死亡率模式的变化。
在 3069 例药物中毒死亡中，尽管香港的死亡率呈下降趋势，但仍发现死亡率模式发生了显著变化。总体而言，药物中毒死亡向中年/老年、丧偶/离异、经济活跃、白领和非本地出生者转移。自 2011 年以来，更多的海洛因死亡发生在年龄较大和非本地出生者中，但未婚和非经济活跃者的比例较低。更多的其他阿片类药物死亡发生在中年和老年，特别是离异者。特别是，大多数死者向老年转移，尤其是其他阿片类药物的死亡。与 2001-2010 年相比，2021 年以来≥60 岁人群中死于海洛因和其他阿片类药物的人数分别增加了 3.72 倍和 6.50 倍（ORs：3.72[2.37，5.86]，6.50[3.97，10.65]）。此外，药物中毒死亡向邻里剥夺程度较低的地区转移（更多的高学历人群和私人/公共住房居民的混合），尤其是其他阿片类药物的死亡。
在香港，除了非法使用药物（海洛因）外，弱势群体滥用已注册药物（如阿片类止痛药）可能呈上升趋势。卫生官员应就药物信息提供更多建议和支持。具体而言，应为中/高收入和本地出生者提供一个改进的卫生系统，包括有关适当使用注册药物进行医疗的教育。
