Julia M. Dennett, Yale University, New Haven, Connecticut.
Gregg S. Gonsalves (
Health Aff (Millwood). 2023 Aug;42(8):1081-1090. doi: 10.1377/hlthaff.2023.00146. Epub 2023 Jul 19.
The initial marketing of the opioid analgesic OxyContin in 1996 increased fatal drug overdoses over the course of the opioid epidemic in the US. However, the long-term impacts of this marketing on complications of injection drug use, a key feature of the ongoing crisis, are undetermined. This study evaluated the effects of exposure to initial OxyContin marketing on the long-term trajectories of injection drug use-related outcomes in the US. We used a difference-in-differences analysis to compare outcomes in states with high versus low exposure to initial marketing before and after the 2010 reformulation of OxyContin, which facilitated the use of illicit drugs and the spread of infectious disease. Exposure to initial OxyContin marketing statistically significantly increased rates of fatal synthetic opioid-related overdoses; acute hepatitis A, B, and C viral infections; and infective endocarditis-related deaths. The greatest burden of adverse long-term outcomes has been in states that experienced the highest exposure to early OxyContin marketing. Our findings indicate that OxyContin marketing decisions from the mid-1990s increased viral and bacterial complications of injection drug use and illicit opioid-related overdose deaths twenty-five years later.
1996 年阿片类镇痛药奥施康定（OxyContin）最初上市，这导致美国阿片类药物流行期间的致命药物过量情况有所增加。然而，这种营销活动对正在发生的危机的一个关键特征——注射吸毒并发症的长期影响尚未确定。本研究评估了接触最初奥施康定营销对美国与注射吸毒相关的长期结果轨迹的影响。我们使用了差异中的差异分析方法，比较了在奥施康定 2010 年重新配方之前和之后，高暴露和低暴露于最初营销的州的结果，这促进了非法药物的使用和传染病的传播。接触最初的奥施康定营销在统计学上显著增加了致命的合成阿片类药物相关过量服用、急性甲型、乙型和丙型肝炎病毒感染和感染性心内膜炎相关死亡的发生率。在经历早期奥施康定营销的最高暴露的州，不良长期后果的负担最大。我们的研究结果表明，1990 年代中期的奥施康定营销决策导致了 25 年后注射吸毒的病毒和细菌并发症以及非法阿片类药物相关的过量死亡增加。
