Tennessee Department of Health, Office of Informatics and Analytics, Andrew Johnson Tower 7th Floor, 710 James Robertson Parkway, Nashville, TN 37243, United States.
Int J Drug Policy. 2023 Sep;119:104151. doi: 10.1016/j.drugpo.2023.104151. Epub 2023 Aug 5.
Phentermine, one of the most-commonly prescribed pharmaceuticals for weight-loss in the United States (US), has appeared on toxicology and listed as a cause of death in fatal drug overdoses in the state of Tennessee. This study aims to evaluate phentermine's involvement in fatal drug overdoses in the state of Tennessee.
We used Tennessee State Unintentional Drug Overdose Reporting System (SUDORS) data and controlled substances monitoring program data (CSMD) to evaluate demographics, prescription history and co-occurring substances on toxicology in phentermine-positive cases compared with all other SUDORS cases from January 1, 2019 to June 30, 2022. A subset of these cases which listed phentermine as a cause of death was also assessed.
We identified 51 phentermine-positive cases, with a subset of 20 that listed phentermine as a cause of death. When compared to all SUDORS cases, a higher proportion of cases that listed phentermine as a cause of death were White race, females, and aged 35-44. Additionally, in all phentermine-positive cases, 41% (21) of decedents had not had a phentermine prescription dating back to 2012 and 20% (Lee et al., 1998) did not have one within the last 30 days. While there was a slight decline each year in the number of phentermine-positive cases, the number of cases that listed phentermine as a cause of death remained relatively consistent, with 95% (19) of cases having different prescriptions and/or illicit drugs listed as a cause of death along with phentermine.
Phentermine was listed as a cause of death in 20 fatal drug overdoses in TN. Our findings suggest there may be differences in the characteristics of these decedents when compared to all SUDORS decedents, including distribution of age, gender, and race. We also found a large presence of other prescription and illicit drugs in toxicology and cause of death along with phentermine, as well as evidence of use of the drug without a prescription. Given the lack of currently available data about non-prescribed phentermine use and its involvement in fatal drug overdoses elsewhere, a need exists to both expand surveillance capabilities and broaden research to better inform policies governing this drug in the US and internationally.
在美国（US），苯丙胺是最常用于减肥的处方药物之一，已出现在田纳西州的毒理学报告中，并被列为致命药物过量的死因。本研究旨在评估苯丙胺在田纳西州致命药物过量中的作用。
我们使用田纳西州意外药物过量报告系统（SUDORS）数据和受控物质监测计划数据（CSMD），评估了 2019 年 1 月 1 日至 2022 年 6 月 30 日期间，与所有其他 SUDORS 病例相比，毒理学检测呈苯丙胺阳性的病例的人口统计学、处方历史和共同存在的物质。还评估了列出苯丙胺为死因的这些病例的一个子集。
我们确定了 51 例苯丙胺阳性病例，其中有 20 例列为死因。与所有 SUDORS 病例相比，列为死因的病例中，白人、女性和年龄在 35-44 岁的比例更高。此外，在所有苯丙胺阳性病例中，41%（21 例）的死者自 2012 年以来没有苯丙胺处方，20%（Lee 等人，1998 年）在过去 30 天内没有处方。虽然每年苯丙胺阳性病例的数量略有下降，但列为死因的病例数量相对保持不变，其中 95%（19 例）的病例有不同的处方和/或非法药物与苯丙胺一起列为死因。
在 TN 的 20 例致命药物过量中，苯丙胺被列为死因。我们的研究结果表明，与所有 SUDORS 死者相比，这些死者的特征可能存在差异，包括年龄、性别和种族的分布。我们还在毒理学和死因中发现了大量其他处方和非法药物与苯丙胺一起存在，以及在没有处方的情况下使用该药物的证据。鉴于目前缺乏有关非处方使用苯丙胺及其在其他地方致命药物过量中作用的可用数据，需要扩大监测能力并扩大研究范围，以更好地为美国和国际上管理这种药物的政策提供信息。
