Fujita-Imazu Sayuri, Xie Jinzhao, Dhungel Bibha, Wang Xinran, Wang Yijing, Nguyen Phuong, Khin Maung Soe July, Li Jinghua, Gilmour Stuart
Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
School of Public Health, Sun Yat-Sen University, Guangzhou, China.
EClinicalMedicine. 2023 Jul 6;61:102079. doi: 10.1016/j.eclinm.2023.102079. eCollection 2023 Jul.
Drug overdose deaths in the USA have increased rapidly in the past 20 years, and understanding patterns and trends in mortality is essential to develop policy responses. This study aimed to determine whether cohort patterns in mortality due to drug overdose have changed in the past two decades and assess these patterns by race and sex.
The national records of accidental drug overdose death were extracted from Centers for Disease Control and Prevention, National Center for Health Statistics Mortality Data for 2000-2020. Age-period-cohort analysis was performed to examine independent effects of age, period and birth cohort on accidental drug overdose mortality.
The number of accidental drug overdose deaths increased by 622% between 2000 and 2020, and age-standardized mortality rates increased nearly four-fold in both men and women. Age-period-cohort decomposition found rapid increases in mortality since 2012 in men and women, with higher mortality risk in cohorts born after 1990. The fastest increase occurred in Black Americans since 2012, and Americans of all races born after 1975 had significantly higher mortality risk, with mortality risk increasing rapidly in more recent cohorts. The peak of mortality has shifted from the 40-59 age group to the 30-40 year age group in the past decade.
The burden of drug overdose mortality has shifted to younger Americans, and a new generation of Americans are at significantly higher and rapidly increasing risk of overdose death. Urgent action is needed to prevent an entire generation of young people being consigned to decades of preventable mortality.
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在过去20年中，美国药物过量致死人数迅速增加，了解死亡率的模式和趋势对于制定政策应对措施至关重要。本研究旨在确定过去二十年中药物过量致死的队列模式是否发生了变化，并按种族和性别评估这些模式。
从疾病控制与预防中心、国家卫生统计中心2000 - 2020年死亡率数据中提取全国意外药物过量死亡记录。进行年龄-时期-队列分析，以检验年龄、时期和出生队列对意外药物过量死亡率的独立影响。
2000年至2020年间，意外药物过量死亡人数增加了622%，年龄标准化死亡率在男性和女性中均增加了近四倍。年龄-时期-队列分解发现，自2012年以来，男性和女性的死亡率迅速上升，1990年后出生的队列死亡率风险更高。自2012年以来，非裔美国人的死亡率上升最快，1975年后出生的所有种族美国人的死亡率风险显著更高，且在最近的队列中死亡率风险迅速增加。在过去十年中，死亡高峰已从40 - 59岁年龄组转移到30 - 40岁年龄组。
药物过量死亡的负担已转移到更年轻的美国人身上，新一代美国人面临着显著更高且迅速上升的过量死亡风险。需要采取紧急行动，以防止整整一代年轻人陷入数十年可预防的死亡之中。
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