Ghodse A H, Sheehan M, Taylor C, Edwards G
Br Med J (Clin Res Ed). 1985 Feb 9;290(6466):425-8. doi: 10.1136/bmj.290.6466.425.
A search of the Home Office index of notified drug addicts identified 1499 deaths during 1967-81, of which 226 (15%) were of therapeutic addicts--that is, patients who had become addicted during medical treatment with a notifiable drug--and 1273 (85%) were of non-therapeutic addicts. The crude mortality fell from 23.5/1000/year for the period 1968-70 to 18.4/1000/year for 1978-80. Altogether 416 addicts aged under 50 at notification died after 1972, which was 16 times the number of deaths expected in a population with a similar age and sex composition. A more detailed examination of the cohorts of addicts notified each year showed little variation between them in the first two years of follow up. Nineteen addicts (1.6%) had died by 31 December of the year of their notification and 39 (3.3%) one year later. These figures may be an indication of the clinical course of addiction. Most deaths of non-therapeutic addicts in which a drug was implicated (939 cases (74%] were due to medically prescribed drugs--barbiturates at first and later opiates such as dipipanone hydrochloride and dextromoramide. Heroin was implicated in only 65 (7%) of these deaths. The Home Office index is a valuable source for identifying drugs of abuse and serious problems of addiction. The fact that prescribed drugs are causing the death of so many addicts demands a response from the medical profession.
对内政部已通报吸毒者索引进行检索后发现,在1967年至1981年期间有1499人死亡,其中226人(15%)为治疗性成瘾者,即那些在使用应通报药物进行医学治疗期间成瘾的患者,1273人(85%)为非治疗性成瘾者。粗死亡率从1968 - 1970年期间的每年23.5‰降至1978 - 1980年的每年18.4‰。1972年后,共有416名通报时年龄在50岁以下的成瘾者死亡,这是具有相似年龄和性别构成人群预期死亡人数的16倍。对每年通报的成瘾者队列进行更详细检查发现,在随访的头两年中他们之间差异不大。到通报年份的12月31日,有19名成瘾者(1.6%)死亡,一年后有39名(3.3%)死亡。这些数字可能表明了成瘾的临床病程。在涉及药物的非治疗性成瘾者的大多数死亡案例中(939例(74%))是由于医生开的药——起初是巴比妥类药物,后来是阿片类药物,如盐酸二苯哌己酮和右吗拉胺。在这些死亡案例中,仅65例(7%)涉及海洛因。内政部索引是识别滥用药物和严重成瘾问题的宝贵来源。处方药导致如此多成瘾者死亡这一事实需要医学界做出回应。