Drug overdose deaths involving cocaine and psychostimulants with abuse potential among racial and ethnic groups - United States, 2004-2019
Drug overdose deaths involving cocaine and psychostimulants with abuse potential among racial and ethnic groups - United States, 2004-2019
复制标题
DOI：
10.1016/j.drugalcdep.2021.109001
复制
发表时间：
2021-09-04
影响因子：
4.2
通讯作者：
Davis, Nicole L.
中科院分区：
文献类型：
--
作者：
Kariisa, Mbabazi;Seth, Puja;Davis, Nicole L.
背景：涉及兴奋剂的药物过量死亡，包括可卡因和具有滥用潜力的精神兴奋剂（例如，甲基苯丙胺）的非法贩运一直在增加，部分原因是与类阿片同时存在。兴奋剂涉及过量死亡的非西班牙裔黑人（黑人）和非西班牙裔美国印第安人/阿拉斯加原住民（AI/AN）的人之间不成比例地增加，但是，阿片类药物在加剧不成比例的兴奋剂涉及的死亡率的作用是不清楚的。方法：国家生命统计系统的分析多个死因死亡率文件检查年龄调整后的可卡因和精神兴奋剂涉及的死亡率。按种族和民族以及阿片类药物共同参与分层的死亡率分析包括：1）2004-2019年趋势的Joinpoint回归，2）2018年至2019年的死亡率变化，3）2019年死亡的人口统计学和地理特征。从2004年到2019年，黑人和AI/AN人的可卡因和精神兴奋剂相关死亡率分别较高。在所有群体中，可卡因涉及的过量使用率的增加主要是由于阿片类药物的共同参与，特别是在2013年之后。从2004年到2019年，精神兴奋剂相关死亡率在有和没有阿片类药物共同参与的情况下增加。从2018年到2019年，西班牙裔，非西班牙裔白色（白色）和黑人的可卡因和合成阿片类药物过量率增加。在西班牙裔、白色和黑人中，有和没有合成阿片类药物共同参与的精神兴奋剂相关过量率增加。在2019年，黑人和AI/AN人继续经历更高的可卡因和精神兴奋剂相关的死亡率，分别。结论：兴奋剂相关的死亡继续增加，阿片类药物在驱动这些死亡中的作用因种族和民族而异。确保公平获得经证实的预防和治疗干预措施，并将健康的社会决定因素纳入今后围绕有效药物疗法的研究，可能有助于减少与兴奋剂有关的过量死亡。
Background: Drug overdose deaths involving stimulants, including cocaine and psychostimulants with abuse potential (e.g., methamphetamine), have been increasing, partly because of co-involvement with opioids. Stimulant-involved overdose deaths have disproportionately increased among non-Hispanic Black (Black) and non-Hispanic American Indian/Alaskan Native (AI/AN) persons; however, the role of opioids in exacerbating disproportionate stimulant-involved death rates is unclear.Methods: Analysis of National Vital Statistics System multiple cause-of-death mortality files examined age-adjusted cocaine-and psychostimulant-involved death rates. Analyses of death rates stratified by racial and ethnic group and opioid co-involvement included: 1) Joinpoint regression of 2004-2019 trends, 2) changes in rates from 2018 to 2019, and 3) demographic and geographic characteristics of 2019 deaths.Results: From 2004 to 2019, cocaine and psychostimulant-involved death rates were higher for Black and AI/AN persons, respectively. Among all groups, increases in cocaine-involved overdose rates were largely driven by opioid co-involvement, particularly after 2013. From 2004 to 2019, rates for psychostimulant-involved deaths increased with and without opioid co-involvement. Rates for overdoses co-involving cocaine and synthetic opioids increased from 2018 to 2019 for Hispanic, non-Hispanic White (White), and Black persons. Psychostimulant-involved overdose rates with and without synthetic opioid co-involvement increased among Hispanic, White, and Black persons. In 2019, Black and AI/AN persons continued to experience higher cocaine- and psychostimulant-involved death rates, respectively.Conclusions: Stimulant-involved deaths continue to increase, and the role of opioids in driving these deaths varies by race and ethnicity. Ensuring equitable access to proven prevention and treatment interventions and incorporating social determinants of health into future research around effective pharmacotherapies may help reduce stimulant-involved overdose deaths.