BC Centre for Disease Control, UBC School of Population and Public Health, Vancouver, Canada.
BC Centre for Disease Control, Vancouver, Canada.
BMC Med. 2024 Nov 27;22(1):479. doi: 10.1186/s12916-024-03646-y.
Illicit drug toxicity (i.e., overdose) is the leading cause of death in British Columbia (BC) for people aged 10-59. Stimulants are increasingly detected among drug toxicity deaths. As stimulant use and detection in deaths rises, it is important to understand how people who die of stimulant toxicity differ from people who die of opioid toxicity.
BC Coroners Service records were retrieved for all people who died of unintentional illicit drug toxicity (accidental or undetermined) between January 1, 2015, and December 31, 2019, whose coroner investigation had concluded and who had an opioid and/or stimulant detected in post-mortem toxicology and identified by the coroner as relevant to the death (N = 3788). BC Chronic Disease Registry definitions were used to identify people with chronic disease. Multinomial regression models were used to examine the relationship between chronic disease diagnoses and drug toxicity death type.
Of the 3788 deaths, 11.1% (N = 422) had stimulants but not opioids deemed relevant to the cause of death (stimulant group), 26.8% (N = 1014) had opioids but not stimulants deemed relevant (opioid group), and 62.1% (N = 2352) had both opioids and stimulants deemed relevant (opioid/stimulant group). People with ischemic heart disease (1.80 (1.14-2.85)) and people with heart failure (2.29 (1.25-4.20)) had approximately twice the odds of being in the stimulant group as compared to the opioid group.
Findings suggest that people with heart disease who use illicit stimulants face an elevated risk of drug toxicity death. Future research should explore this association and should identify opportunities for targeted interventions to reduce drug toxicity deaths among people with medical comorbidities.
在不列颠哥伦比亚省（BC），10-59 岁人群中，非法药物毒性（即过量）是导致死亡的主要原因。在药物毒性死亡中，兴奋剂的检出率越来越高。随着兴奋剂使用和检测在死亡中的增加，了解死于兴奋剂毒性的人与死于阿片类药物毒性的人有何不同非常重要。
检索了 2015 年 1 月 1 日至 2019 年 12 月 31 日期间，因意外或原因不明的非故意非法药物毒性（意外或原因不明）而意外死亡，其死因调查已结束且死后毒理学检测中检出阿片类药物和/或兴奋剂，且被验尸官认定与死亡相关（N=3788）的不列颠哥伦比亚省验尸官服务记录。使用不列颠哥伦比亚省慢性疾病登记处的定义来识别患有慢性疾病的人。使用多项回归模型来检查慢性疾病诊断与药物毒性死亡类型之间的关系。
在 3788 例死亡中，11.1%（N=422）有兴奋剂但没有阿片类药物被认为与死因相关（兴奋剂组），26.8%（N=1014）有阿片类药物但没有兴奋剂被认为与死因相关（阿片类药物组），62.1%（N=2352）有阿片类药物和兴奋剂均被认为与死因相关（阿片类药物/兴奋剂组）。患有缺血性心脏病（1.80（1.14-2.85））和心力衰竭（2.29（1.25-4.20））的人患兴奋剂组的几率是阿片类药物组的两倍左右。
研究结果表明，患有心脏病且使用非法兴奋剂的人面临更高的药物毒性死亡风险。未来的研究应探讨这种关联，并应确定针对有医疗合并症的人减少药物毒性死亡的机会。
