School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia.
Int J Drug Policy. 2024 Sep;131:104548. doi: 10.1016/j.drugpo.2024.104548. Epub 2024 Aug 13.
Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes.
Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001-2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded).
Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001-2006 - annual percentage change (APC) = 15.4 %; 2009-2016 - APC 25.5 %), and two where they decreased (2006-2009 - APC = -11.8 %; 2017-2020 - APC = -2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases.
Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine.
在过去的二十年中，澳大利亚与甲基苯丙胺相关的危害有所增加。以前对与甲基苯丙胺相关的死亡的分析涵盖的时间有限，并且主要集中在与药物毒性相关的死亡上。本文研究了 20 多年来与甲基苯丙胺相关的死亡的长期趋势，包括由于各种特定原因导致的死亡。
从澳大利亚和新西兰验尸官报告的国家验尸信息系统中提取与甲基苯丙胺相关的死亡原因（2001-2023 年），进行描述性分析。使用 Joinpoint 趋势分析评估 2001 年至 2020 年期间的变化趋势（由于 2021 年至 2023 年的数据可能不完整，因此排除在外）。
意外药物毒性是与甲基苯丙胺相关死亡的 49.8%的原因，故意自我伤害（包括毒性）占 23.3%，意外受伤占 15.1%，自然原因占 9.6%，袭击占 2.3%。在 2001 年至 2020 年期间，所有原因与甲基苯丙胺相关的死亡率的 Joinpoint 分析显示出三个趋势变化点，导致四个不同的时期：两个增长率期（2001-2006 年，年百分比变化（APC）为 15.4%；2009-2016 年，APC 为 25.5%）和两个下降率期（2006-2009 年，APC 为-11.8%；2017-2020 年，APC 为-2.9%）。故意自我伤害和意外受伤的比率也出现了类似的模式。意外药物毒性导致的死亡有两个趋势变化点（2011 年，2016 年），并且在所有三个时期都有所增加。自然原因导致的死亡有三个趋势变化点（2007 年，2010 年，2015 年），并且在 2015 年之后仍在继续上升，主要是由于循环系统疾病的增加。
特定于原因的模型突出了不同的趋势。最近的趋势表明，意外药物毒性导致的死亡略有增加，故意自我伤害稳定，意外受伤和袭击导致的死亡下降。涉及甲基苯丙胺的自然原因导致的死亡继续增加，突显了公共卫生问题，可能需要对使用甲基苯丙胺的人进行早期循环系统疾病筛查。
