Department of Medical Pharmacology, Addictovigilance Center of Bordeaux, University Hospital of Bordeaux, 33000 Bordeaux, France; Inserm, BPH, U1219, University of Bordeaux, 33000 Bordeaux, France; CHU de Bordeaux, 33000 Bordeaux, France.
Service d'information médicale, unité de coordination et d'analyse de l'information médicale - département d'information médicale (UCAIM-DIM), CHU de Bordeaux, 33000 Bordeaux, France.
Therapie. 2024 Jul-Aug;79(4):419-428. doi: 10.1016/j.therap.2023.10.017. Epub 2023 Nov 22.
Incidence of hospitalisations related to psychoactive substance (H-PS) intoxication has been strongly decreased during the coronavirus disease 2019 (COVID-19) pandemic especially in young adult and French region of Nouvelle-Aquitaine was mostly concerned. This study aimed to describe (i) the incidence of H-PS in Bordeaux teaching hospital during and after the first 2020 lockdown in adults aged 18-29 years or 30+ then (ii) their characteristics specifically associated with the pandemic period by comparing 2020 with 2017-2019 baseline period.
This historical cohort study was conducted in adults admitted to the Bordeaux teaching hospital with main or associated diagnosis codes of intoxication with benzodiazepine, methadone, buprenorphine, codeine, morphine, heroin, cocaine, ecstasy and alcohol. Data were collected locally through the discharge database. Incidence and characteristics of H-PS were described according to patients' age, in 2020 before (01/01-16/03), during (17/03-10/05), and after the first lockdown (11/05-31/07).
Among the 5,824 stays included over the study period, PS most involved were alcohol and benzodiazepines. Compared to baseline, the decrease in H-PS's incidence was more important in young adults (-40%; n=450) in comparison to those aged 30+ (-18%; n=1,101) during the pandemic period, especially during the lockdown compared to 2017 (-59%; n=145 vs. -35%; n=166) with far decrease in alcohol and ecstasy intoxications. Seriousness of hospitalisation indications was increased regardless of age during the pandemic. Particularly in young adults, the proportion of suicides attempts increased during lockdown compared to the baseline period (almost 50% vs. 29%) and the period after lockdown was associated with 1.7 more-time road accident increased and 3 more-time fights compared with pre-lockdown period.
DISCUSSION/CONCLUSION: The period following lockdown should be considered at risk H-PS due to accident. Recreational use of alcohol and ecstasy could be a target for minimize serious consequences associated to PS use in young adult.
2019 年冠状病毒病（COVID-19）大流行期间，与精神活性物质（H-PS）中毒相关的住院发病率大幅下降，尤其是在年轻成年人中，法国新阿基坦地区受影响最大。本研究旨在描述（i）2020 年首次封锁期间和之后波尔多教学医院中 18-29 岁或 30 岁以上成年人的 H-PS 发病率，以及（ii）通过将 2020 年与 2017-2019 年基线期进行比较，专门描述与大流行期间相关的 H-PS 的特征。
这是一项历史队列研究，在波尔多教学医院住院的成年人中进行，其主要或合并诊断代码为苯二氮卓类、美沙酮、丁丙诺啡、可待因、吗啡、海洛因、可卡因、摇头丸和酒精中毒。数据通过出院数据库在当地收集。根据患者年龄描述 H-PS 的发病率和特征，2020 年分为封锁前（01/01-16/03）、封锁期间（17/03-10/05）和封锁后（11/05-31/07）。
在研究期间的 5824 例住院病例中，PS 最常见的是酒精和苯二氮卓类。与基线相比，大流行期间年轻成年人的 H-PS 发病率下降更为明显（-40%；n=450），而 30 岁以上成年人的发病率下降（-18%；n=1101），尤其是与 2017 年相比，封锁期间下降更为明显（-59%；n=145 与-35%；n=166），酒精和摇头丸中毒的下降更为明显。无论年龄大小，大流行期间住院治疗的严重程度均有所增加。特别是在年轻成年人中，与基线期相比，封锁期间自杀企图的比例增加（近 50%比 29%），与封锁前相比，封锁后与车祸增加 1.7 倍和打斗增加 3 倍有关。
讨论/结论：封锁后的时期应被视为 H-PS 的高危时期，因为可能发生事故。减少年轻成年人中 PS 使用相关的严重后果，应成为娱乐性使用酒精和摇头丸的目标。
