Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis.
JAMA Health Forum. 2024 May 3;5(5):e241262. doi: 10.1001/jamahealthforum.2024.1262.
Since 1999, over 1 million people have died of a drug overdose in the US. However, little is known about the bereaved, meaning their family, friends, and acquaintances, and their views on the importance of addiction as a policy priority.
To quantify the scope of the drug overdose crisis in terms of personal overdose loss (ie, knowing someone who died of a drug overdose) and to assess the policy implications of this loss.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from a nationally representative survey of US adults (age ≥18 years), the fourth wave of the COVID-19 and Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March to April 2023.
Respondents reported whether they knew someone who died of a drug overdose and the nature of their relationship with the decedent(s). They also reported their political party affiliation and rated the importance of addiction as a policy issue. Logistic regression models estimated the associations between sociodemographic characteristics and political party affiliation and the probability of experiencing a personal overdose loss and between the experience of overdose loss and the perceived salience of addiction as a policy issue. Survey weights adjusted for sampling design and nonresponse.
Of the 7802 panelists invited to participate, 2479 completed the survey (31.8% response rate); 153 were excluded because they did not know whether they knew someone who died of a drug overdose, resulting in a final analytic sample of 2326 (51.4% female; mean [SD] age, 48.12 [0.48] years). Of these respondents, 32.0% (95% CI, 28.8%-34.3%) reported any personal overdose loss, translating to 82.7 million US adults. A total of 18.9% (95% CI, 17.1%-20.8%) of all respondents, translating to 48.9 million US adults, reported having a family member or close friend die of drug overdose. Personal overdose loss was more prevalent among groups with lower income (<$30 000: 39.9%; ≥$100 000: 26.0%). The experience of overdose loss did not differ across political party groups (Democrat: 29.0%; Republican: 33.0%; independent or none: 34.2%). Experiencing overdose loss was associated with a greater odds of viewing addiction as an extremely or very important policy issue (adjusted odds ratio, 1.37; 95% CI, 1.09-1.72) after adjustment for sociodemographic and geographic characteristics and political party affiliation.
This cross-sectional study found that 32% of US adults reported knowing someone who died of a drug overdose and that personal overdose loss was associated with greater odds of endorsing addiction as an important policy issue. The findings suggest that mobilization of this group may be an avenue to facilitate greater policy change.
自 1999 年以来，美国已有超过 100 万人死于药物过量。然而，人们对死者的家属、朋友和熟人知之甚少，他们对成瘾作为政策优先事项的重要性的看法也知之甚少。
从个人药物过量损失（即认识因药物过量而死亡的人）的角度来量化药物过量危机的范围，并评估这种损失的政策意义。
设计、地点和参与者：这是一项使用美国成年人（年龄≥18 岁）全国代表性调查数据的横断面研究，即第四次 COVID-19 和生活压力对心理健康和幸福感的影响（CLIMB）研究，该研究于 2023 年 3 月至 4 月进行。
受访者报告他们是否认识因药物过量而死亡的人，以及他们与死者的关系性质。他们还报告了自己的政党归属，并对成瘾作为政策问题的重要性进行了评级。逻辑回归模型估计了社会人口特征和政党归属与经历个人药物过量损失的概率之间的关联，以及经历药物过量损失与将成瘾视为政策问题的显著程度之间的关联。调查权重调整了抽样设计和无应答的影响。
在邀请参加的 7802 名小组成员中，有 2479 人完成了调查（31.8%的回复率）；153 人因不知道是否认识因药物过量而死亡的人而被排除在外，因此最终分析样本为 2326 人（51.4%为女性；平均[SD]年龄为 48.12[0.48]岁）。在这些受访者中，32.0%（95%CI，28.8%-34.3%）报告了任何个人药物过量损失，换算为 8270 万美国成年人。所有受访者中，18.9%（95%CI，17.1%-20.8%），换算为 4890 万美国成年人，报告有家庭成员或亲密朋友死于药物过量。收入较低（<$30000：39.9%；≥$100000：26.0%）的人群中个人药物过量损失更为普遍。药物过量损失在各政党群体之间没有差异（民主党：29.0%；共和党：33.0%；独立或无党派：34.2%）。经历药物过量损失与将成瘾视为极其重要或非常重要的政策问题的可能性更大相关（调整后的优势比，1.37；95%CI，1.09-1.72），调整了社会人口学和地理特征以及政党归属。
这项横断面研究发现，32%的美国成年人报告认识因药物过量而死亡的人，个人药物过量损失与更有可能支持成瘾作为一个重要政策问题有关。研究结果表明，动员这一群体可能是促进政策更大变化的途径。
