Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Public Health Scotland, UK.
Addiction. 2024 Aug;119(8):1410-1420. doi: 10.1111/add.16500. Epub 2024 Apr 17.
Drug-related deaths in Scotland more than doubled between 2011 and 2020. To inform policymakers and understand drivers of this increase, we estimated the number of people with opioid dependence aged 15-64 from 2014/15 to 2019/20.
We fitted a Bayesian multi-parameter estimation of prevalence (MPEP) model, using adverse event rates to estimate prevalence of opioid dependence jointly from Opioid Agonist Therapy (OAT), opioid-related mortality and hospital admissions data. Estimates are stratified by age group, sex and year.
Scotland, 2014/15 to 2019/20.
People with opioid dependence and potential to benefit from OAT, whether ever treated or not. Using data from the Scottish Public Health Drug Linkage Programme, we identified a baseline cohort of individuals who had received OAT within the last 5 years, and all opioid-related deaths and hospital admissions (whether among or outside of this cohort).
Rates of each adverse event type and (unobserved) prevalence were jointly modelled.
The estimated number and prevalence of people with opioid dependence in Scotland in 2019/20 was 47 100 (95% Credible Interval [CrI] 45 700 to 48 600) and 1.32% (95% CrI 1.28% to 1.37%). Of these, 61% received OAT during 2019/20. Prevalence in Greater Glasgow and Clyde was estimated as 1.77% (95% CrI 1.69% to 1.85%). There was weak evidence that overall prevalence fell slightly from 2014/15 (change -0.07%, 95% CrI -0.14% to 0.00%). The population of people with opioid dependence is ageing, with the estimated number of people aged 15-34 reducing by 5100 (95% CrI 3800 to 6400) and number aged 50-64 increasing by 2800 (95% CrI 2100 to 3500) between 2014/15 and 2019/20.
The prevalence of opioid dependence in Scotland remained high but was relatively stable, with only weak evidence of a small reduction, between 2014/15 and 2019/20. Increased numbers of opioid-related deaths can be attributed to increased risk among people with opioid dependence, rather than increasing prevalence.
2011 年至 2020 年期间，苏格兰与药物相关的死亡人数增加了一倍多。为了为政策制定者提供信息并了解这一增长的驱动因素，我们估计了 2014/15 年至 2019/20 年期间 15-64 岁的阿片类药物依赖患者人数。
我们使用不良事件率拟合了贝叶斯多参数流行率估计（MPEP）模型，从阿片类药物激动剂治疗（OAT）、阿片类药物相关死亡率和住院数据中联合估计阿片类药物依赖的流行率。估计值按年龄组、性别和年份进行分层。
苏格兰，2014/15 年至 2019/20 年。
无论是否接受过治疗，有阿片类药物依赖且可能从 OAT 中受益的患者。我们利用苏格兰公共卫生药物关联计划的数据，确定了一个在过去 5 年内接受过 OAT 的个体的基线队列，以及所有阿片类药物相关的死亡和住院治疗（无论是否在该队列中）。
每种不良事件类型的比率和（未观察到的）流行率被联合建模。
2019/20 年苏格兰阿片类药物依赖患者的估计人数和流行率为 47100 人（95%可信区间 [CrI] 45700 至 48600）和 1.32%（95% CrI 1.28%至 1.37%）。其中，61%的人在 2019/20 年接受了 OAT。格拉斯哥和克莱德大区的流行率估计为 1.77%（95% CrI 1.69%至 1.85%）。有微弱的证据表明，整体流行率从 2014/15 年略有下降（变化-0.07%，95% CrI-0.14%至 0.00%）。阿片类药物依赖患者的人口正在老龄化，估计 15-34 岁的人数减少了 5100 人（95% CrI 3800 至 6400），50-64 岁的人数增加了 2800 人（95% CrI 2100 至 3500）2014/15 年至 2019/20 年期间。
苏格兰阿片类药物依赖的流行率仍然很高，但相对稳定，2014/15 年至 2019/20 年期间，仅出现了轻微减少的微弱证据。阿片类药物相关死亡人数的增加可归因于阿片类药物依赖者的风险增加，而不是流行率的增加。
