Ledlie Shaleesa, Leece Pamela, Yang Joanna, Iacono Anita, Kolla Gillian, Boyd Rob, Bozinoff Nikki, Franklyn Mike, Shearer Dana, Smoke Ashley, Wu Fangyun, Gomes Tara
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, Canada.
Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
J Subst Use Addict Treat. 2025 Mar;170:209614. doi: 10.1016/j.josat.2024.209614. Epub 2024 Dec 21.
As the drug toxicity crisis continues to evolve globally, harms related to non-opioid substances, including stimulants, have risen in parallel. Our study aims were to describe trends in accidental stimulant toxicity deaths and to characterize demographic characteristics of decedents and the circumstances surrounding death.
We conducted a population-based repeated cross-sectional study, of all accidental stimulant toxicity deaths between January 1, 2018, and December 31, 2021, in Ontario, Canada. We reported monthly rates of stimulant toxicity deaths per 100,000 people residing in Ontario and the circumstances surrounding death. All analyses were stratified by the type of stimulant(s) involved in death.
Between 2018 and 2021, we identified 5210 stimulant toxicity deaths with the monthly rate rising from 0.4 to 1.0 per 100,000. Both cocaine and methamphetamine were involved in 16.2 % of deaths, and 56.2 % and 27.7 % involved cocaine or methamphetamine (without other stimulants), respectively. Over 80 % of deaths also involved an opioid. Among all deaths, 75.2 % of decedents were male, 53.1 % were aged 25-44, and over half of all deaths occurred in private residences (64.7 %).
The rate of stimulant toxicity deaths has continued to grow, more than doubling over a three-year period. As stimulant-related deaths continue to rise, comprehensive social supports and mental health services, including harm reduction and treatment programs adapted to the unique needs of people who use stimulants alone or in combination with other substances, are urgently required to meet the changing needs of people who use drugs.
随着全球药物毒性危机不断演变，与包括兴奋剂在内的非阿片类物质相关的危害也在同步上升。我们的研究目的是描述意外兴奋剂毒性死亡的趋势，并刻画死者的人口统计学特征以及死亡时的相关情况。
我们对2018年1月1日至2021年12月31日期间加拿大安大略省所有意外兴奋剂毒性死亡病例进行了基于人群的重复横断面研究。我们报告了安大略省每10万人中兴奋剂毒性死亡的月度发生率以及死亡时的相关情况。所有分析均按死亡所涉及的兴奋剂类型进行分层。
2018年至2021年期间，我们共识别出5210例兴奋剂毒性死亡病例，月度发生率从每10万人0.4例升至1.0例。可卡因和甲基苯丙胺均导致了16.2%的死亡病例，分别有56.2%和27.7%的死亡病例仅涉及可卡因或甲基苯丙胺（无其他兴奋剂）。超过80%的死亡病例还涉及阿片类药物。在所有死亡病例中，75.2%的死者为男性，53.1%的死者年龄在25至44岁之间，超过半数的死亡病例发生在私人住宅（64.7%）。
兴奋剂毒性死亡发生率持续上升，在三年时间里增加了一倍多。随着与兴奋剂相关的死亡人数持续增加，迫切需要全面的社会支持和心理健康服务，包括针对单独使用或与其他物质联合使用兴奋剂者的独特需求而制定的减少伤害和治疗方案，以满足吸毒者不断变化的需求。
