Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC.
MMWR Morb Mortal Wkly Rep. 2024 Aug 29;73(34):747-753. doi: 10.15585/mmwr.mm7334a3.
Drug overdose deaths remain a public health crisis in the United States; nearly 107,000 and nearly 108,000 deaths occurred in 2021 and 2022, respectively. Persons with mental health conditions are at increased risk for overdose. In addition, substance use disorders and non-substance-related mental health disorders (MHDs) frequently co-occur. Using data from CDC's State Unintentional Drug Overdose Reporting System, this report describes characteristics of persons in 43 states and the District of Columbia who died of unintentional or undetermined intent drug overdose and had any MHD. In 2022, 21.9% of persons who died of drug overdose had a reported MHD. Using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, the most frequently reported MHDs were depressive (12.9%), anxiety (9.4%), and bipolar (5.9%) disorders. Overall, approximately 80% of overdose deaths involved opioids, primarily illegally manufactured fentanyls. Higher proportions of deaths among decedents with an MHD involved antidepressants (9.7%) and benzodiazepines (15.3%) compared with those without an MHD (3.3% and 8.5%, respectively). Nearly one quarter of decedents with an MHD had at least one recent potential opportunity for intervention (e.g., approximately one in 10 decedents were undergoing substance use disorder treatment, and one in 10 visited an emergency department or urgent care facility within 1 month of death). Expanding efforts to identify and address co-occurring mental health and substance use disorders (e.g., integrated screening and treatment) and strengthen treatment retention and harm reduction services could save lives.
药物过量死亡仍然是美国的公共卫生危机;分别有近 107000 人和近 108000 人在 2021 年和 2022 年死亡。有心理健康状况的人过量用药的风险增加。此外,物质使用障碍和非物质相关的心理健康障碍(MHD)经常同时发生。本报告使用疾病预防控制中心州非故意药物过量报告系统的数据,描述了在 43 个州和哥伦比亚特区有任何 MHD 的因非故意或原因不明的药物过量而死亡的人的特征。在 2022 年,因药物过量死亡的人中,有 21.9%报告有 MHD。根据《精神障碍诊断与统计手册》第五版的标准,最常报告的 MHD 是抑郁(12.9%)、焦虑(9.4%)和双相(5.9%)障碍。总体而言,大约 80%的过量死亡涉及阿片类药物,主要是非法制造的芬太尼。有 MHD 的死者的死亡比例较高,涉及抗抑郁药(9.7%)和苯二氮䓬类药物(15.3%),而没有 MHD 的则分别为 3.3%和 8.5%。有 MHD 的死者中,近四分之一至少有一个最近的潜在干预机会(例如,大约十分之一的死者正在接受物质使用障碍治疗,十分之一的死者在死亡前 1 个月内曾到急诊室或紧急护理机构就诊)。扩大努力以识别和处理同时存在的心理健康和物质使用障碍(例如,综合筛查和治疗),并加强治疗保留和减少伤害服务,可以挽救生命。