Stronach Oisin, Dietze Paul, Livingston Michael, Roxburgh Amanda
School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia.
Addiction. 2025 Oct;120(10):2032-2043. doi: 10.1111/add.70100. Epub 2025 Jul 1.
The number of meth/amphetamine related deaths in Australia has quadrupled in the last 20 years, primarily due to drug toxicity and suicide among individuals in their 30s and 40s. Previous analysis of Australian meth/amphetamine-related deaths covered limited timeframes and causes, and there has been no exploration of the effects of changing cohorts on meth/amphetamine mortality. This paper provides comprehensive insights across 20 years into the evolving cohort trends in meth/amphetamine-related deaths in Australia.
An age-period-cohort-interaction (APC-I) analysis of Australian meth/amphetamine-related deaths (2001-2020) by cause extracted from the National Coronial Information System, a database of all deaths reported to the coroner in Australia and New Zealand.
APC-I analyses revealed that unintentional drug toxicity deaths peaked at ages 35-38 [Coefficient (Coef) = 0.92; 95% confidence interval (CI) = 1.0-0.8], intentional self-harm deaths peaked at ages 31-34 (Coef = 1.2; 95% CI = 1.4-1.0), unintentional injury deaths peaked at ages 23-26 (Coef = 1.02; 95% CI = 1.2-0.8) and natural cause deaths at 39-42 (Coef = 1.15; 95% CI = 1.4-0.9). Period effects were consistent across all causes, with a mean 29.3% increase in estimated mortality rate from 2001 to 2012, followed by a mean 103.3% increase in estimated mortality rate to 2016, at which time period effects stabilised. Cohort effects revealed that individuals born between 1962 and 1982 (mainly Generation X) faced a higher-than-average mortality risk across all four causes, with risk decreasing in later generations.
Despite different age profiles across the various causes of death, cohort effects suggest a single generation (Generation X: people born between 1962 and 1982) is predominantly experiencing the increase in meth/amphetamine-related mortality observed in Australia over the past 20 years. As Generation X ages, the risk of meth/amphetamine-related natural deaths, especially from cardiovascular disease, is likely to increase.
在过去20年里，澳大利亚与甲基苯丙胺/苯丙胺相关的死亡人数增长了四倍，主要原因是药物毒性以及三四十岁人群的自杀行为。此前对澳大利亚与甲基苯丙胺/苯丙胺相关死亡的分析涵盖的时间范围和死因有限，且尚未探讨不同队列变化对甲基苯丙胺死亡率的影响。本文全面深入地研究了澳大利亚20年来与甲基苯丙胺相关死亡的队列演变趋势。
对从国家死因信息系统提取的澳大利亚与甲基苯丙胺相关死亡（2001 - 2020年）按死因进行年龄-时期-队列交互（APC-I）分析，该系统是澳大利亚和新西兰向死因裁判官报告的所有死亡的数据库。
APC-I分析显示，意外药物毒性死亡在35 - 38岁达到峰值[系数（Coef）= 0.92；95%置信区间（CI）= 1.0 - 0.8]，故意自残死亡在31 - 34岁达到峰值（Coef = 1.2；95% CI = 1.4 - 1.0），意外伤害死亡在23 - 26岁达到峰值（Coef = 1.02；95% CI = 1.2 - 0.8），自然原因死亡在39 - 42岁达到峰值（Coef = 1.15；95% CI = 1.4 - 0.9）。所有死因的时期效应一致，2001年至2012年估计死亡率平均上升29.3%，随后到2016年估计死亡率平均上升103.3%，此后时期效应稳定。队列效应表明，1962年至1982年出生的人群（主要是X一代）在所有四种死因上都面临高于平均水平的死亡风险，而在后代中风险降低。
尽管不同死因的年龄分布不同，但队列效应表明，在过去20年澳大利亚观察到的与甲基苯丙胺相关死亡率上升主要集中在一代人（X一代：1962年至1982年出生的人）身上。随着X一代年龄增长，与甲基苯丙胺相关的自然死亡风险，尤其是心血管疾病导致的死亡风险可能会增加。
