Office of Drug Surveillance and Misuse Prevention, Pennsylvania Department of Health, Harrisburg, PA, USA.
Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, PA, USA.
Addiction. 2024 Aug;119(8):1400-1409. doi: 10.1111/add.16478. Epub 2024 May 29.
The aim of this study was to characterize the circumstances of drug overdose deaths and determine whether naloxone administration differed by overdose decedent race and ethnicity.
Analysis of data on unintentional and undetermined intent drug overdose deaths in Pennsylvania (2019-21) was collected from death certificates and the State Unintentional Drug Overdose Reporting System. Multivariable logistic regression models were adjusted for overdose death circumstances and the odds of naloxone administration were estimated by race/ethnicity and year.
The analytical sample included 3386 fatal overdose decedents in 2019, 3864 in 2020 and 3816 in 2021.
Evidence of naloxone administration (yes/no) was defined using scene evidence and toxicology reports from coroner and medical examiner records, while race/ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White) was based on the death certificate.
In the analytic sample, overdose death rates were the highest among Black people and increased over time (rate per 10 000 population, 2019: 4.3; 2020: 6.1; 2021: 6.5); rates were lowest among White people and remained constant over time (rate per 10 000 population, 2019: 2.6; 2020: 2.7; 2021: 2.6). Throughout all years, Black decedents had approximately 40-50% lower odds of naloxone administration compared with White decedents as referent [2019: odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.5-0.9; 2020: OR = 0.5, 95% CI = 0.4-0.7; 2021: OR = 0.6, 95% CI = 0.5-0.8], while Hispanic decedents had similar odds of naloxone administration to that of White decedents.
After controlling for overdose circumstances in drug overdose deaths in Pennsylvania, USA, from 2019 to 2021, Black people had lower odds of naloxone administration compared with White people, while there were no differences between Hispanic and White people.
本研究旨在描述药物过量死亡的情况，并确定纳洛酮的使用是否因过量死亡者的种族和民族而有所不同。
从死亡证明和州非故意药物过量报告系统收集了宾夕法尼亚州（2019-21 年）非故意和未确定意图的药物过量死亡数据。多变量逻辑回归模型根据过量死亡情况进行了调整，并按种族/族裔和年份估计了纳洛酮使用的可能性。
分析样本包括 2019 年 3386 名致命药物过量死亡者、2020 年 3864 名和 2021 年 3816 名。
使用来自验尸官和法医记录的现场证据和毒理学报告，定义了纳洛酮使用的证据（是/否），而种族/族裔（西班牙裔、非西班牙裔黑人、非西班牙裔白人）则基于死亡证明。
在分析样本中，黑人的药物过量死亡率最高，且随着时间的推移而增加（每 10000 人人口的死亡率，2019 年：4.3；2020 年：6.1；2021 年：6.5）；白人的死亡率最低，且随着时间的推移保持不变（每 10000 人人口的死亡率，2019 年：2.6；2020 年：2.7；2021 年：2.6）。在所有年份中，黑人死亡者接受纳洛酮治疗的可能性比白人死亡者低约 40-50%[2019 年：比值比（OR）=0.7，95%置信区间（CI）=0.5-0.9；2020 年：OR=0.5，95%CI=0.4-0.7；2021 年：OR=0.6，95%CI=0.5-0.8]，而西班牙裔死亡者接受纳洛酮治疗的可能性与白人死亡者相似。
在美国宾夕法尼亚州，2019 年至 2021 年期间，在控制了药物过量死亡的情况后，与白人相比，黑人接受纳洛酮治疗的可能性较低，而西班牙裔与白人之间没有差异。
