Mandavia Amar D, Fonda Jennifer R, Banducci Anne N, Ameral Victoria E, Sistad Hall Rebecca E, Loeffel Lauren B, Roth Clara E, Simpson Tracy L, Stein Michael D, Marx Brian P, Hyde Justeen, Davenport Michael, Meng Frank, Livingston Nicholas A
VA Boston Healthcare System, Medical Informatics, Boston, MA, United States; Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States.
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, United States; Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Drug Alcohol Depend. 2025 Sep 1;274:112764. doi: 10.1016/j.drugalcdep.2025.112764. Epub 2025 Jun 23.
Given increases in opioid overdose rates, and policy changes expanding access to medications for OUD, during the COVID-19 pandemic, we sought to understand how the opioid overdose epidemic impacted veterans with opioid use disorder (OUD), from 2016 to 2021.
We examined the prevalence and trends in opioid overdose deaths, and age at death, from 2016 to 2021, by sex and race/ethnicity among veterans with OUD enrolled in the Veterans Health Administration (VHA). We calculated the multiplicative and additive interactions between sex and age, and opioid overdose death.
203,950 veterans enrolled in VHA from 2016 to 2021 had an OUD; 16 % (n = 32,640) died during this period. Opioid overdose contributed to 17.42 % (n = 5686) of all deaths. Although the total number of overdose deaths rose each year, the relative risk of dying from an opioid overdose decreased. Of those who died, veterans, ages 18-29 were significantly more likely to die of an opioid overdose than veterans over the age of 40. Female veterans were significantly more likely to die from an opioid overdose, with this risk manifesting significantly earlier and faster when compared to male veterans of the same age. Black and Asian veterans were significantly more likely to die by opioid overdose than White veterans.
Despite an overall decrease in relative risk of opioid overdose death during the first two years of the COVID-19 pandemic (2020-2021) there was a significant increase in risk of opioid overdose death among female and racial and ethnic minority veterans with OUD.
鉴于在新冠疫情期间阿片类药物过量使用率上升，以及政策变化扩大了阿片类药物使用障碍（OUD）药物的可及性，我们试图了解2016年至2021年期间阿片类药物过量流行对患有阿片类药物使用障碍的退伍军人产生了怎样的影响。
我们研究了2016年至2021年期间，在退伍军人健康管理局（VHA）登记的患有OUD的退伍军人中，阿片类药物过量死亡的患病率和趋势，以及死亡年龄，按性别和种族/族裔分类。我们计算了性别与年龄以及阿片类药物过量死亡之间的乘法和加法相互作用。
2016年至2021年期间，在VHA登记的203,950名退伍军人患有OUD；在此期间，16%（n = 32,640）死亡。阿片类药物过量导致所有死亡人数的17.42%（n = 5686）。尽管每年过量死亡的总数有所上升，但因阿片类药物过量死亡的相对风险有所下降。在死亡者中，18至29岁的退伍军人死于阿片类药物过量的可能性明显高于40岁以上的退伍军人。女性退伍军人死于阿片类药物过量的可能性明显更高，与同年龄男性退伍军人相比，这种风险出现得更早且更快。黑人和亚裔退伍军人死于阿片类药物过量的可能性明显高于白人退伍军人。
尽管在新冠疫情的头两年（2020 - 2021年）阿片类药物过量死亡的相对风险总体有所下降，但患有OUD的女性以及少数族裔退伍军人中阿片类药物过量死亡的风险却显著增加。
