Prevalence and characteristics of opioid-related deaths involving alcohol in Ontario, Canada
Prevalence and characteristics of opioid-related deaths involving alcohol in Ontario, Canada
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DOI：
10.1016/j.drugalcdep.2017.07.008
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发表时间：
2017-10-01
影响因子：
4.2
通讯作者：
van den Brink, Wim
中科院分区：
文献类型：
--
作者：
Gomes, Tara;Juurlink, David N.;van den Brink, Wim
背景：虽然众所周知，接受阿片类药物治疗的患者应避免饮酒，但人们对酒精与阿片类药物相关死亡的关系知之甚少。方法：我们对1993年至2013年间安大略省阿片类药物相关死亡进行了基于人群的分析，并按死亡方式进行了总体和分层报告。我们比较了因阿片类药物过量而死亡的个体的特征，这些特征是基于是否存在酒精参与。结果：阿片类药物相关死亡率从1993年的11.9 /百万人（95%置信区间（CI） 9.8-13.9 /百万人）增加到2013年的46.2 /百万人（95% CI 42.6-49.8 /百万人），增加了288%。不涉及酒精的阿片类药物相关死亡率增加了388%，从每百万人7.4例增加到每百万人36.1例，而涉及酒精的死亡率增加了125%，从每百万人4.5例增加到每百万人10.1例。因此，尽管每年涉及酒精的阿片类药物相关死亡人数有所上升，但涉及酒精的阿片类药物相关死亡比例从1993年的37.8%下降到2013年的21.9%。一般来说，涉及酒精的阿片类药物相关死亡不太可能涉及其他中枢神经系统抑制剂，而更可能发生在男性和有酒精使用障碍史的人群中。结论：尽管酒精在阿片类药物相关死亡中的相对贡献有所下降，但2013年仍有五分之一的致命阿片类药物过量与酒精有关。我们的研究结果强调，目前需要针对阿片类药物单独使用的风险，以及与酒精和其他中枢神经系统抑制剂联合使用的风险，进行有针对性的信息传递。
Background: While it is well known that patients receiving opioids should refrain from alcohol consumption, little is known about the involvement of alcohol in opioid-related deaths.Methods: We conducted a population-based analysis of opioid-related deaths in Ontario with and without alcohol Involvement between 1993 and 2013, and reported rata overall and stratified by manner of death. We compared the characteristics of individuals who died of an opioid overdose based on the presence or absence of alcohol involvement.Results: The rate of opioid-related deaths increased 288% from 11.9 per million (95% confidence interval (CI) 9.8-13.9 per million) in 1993-46.2 per million (95% CI 42.6-49.8 per million) in 2013. The rate of opioid-related deaths without alcohol involvement increased 388% from 7.4 per million to 36.1 per million, while deaths involving alcohol increased by 125% from 4.5 per million to 10.1 per million. Therefore, although the annual number of opioid-related deaths involving alcohol rose, the proportion of opioid-related deaths involving alcohol declined from 37.8% in 1993-21.9% by 2013. Generally, opioid-related deaths involving alcohol were less likely to involve other central nervous system depressants, and more likely to occur among men and those with a history of alcohol use disorder.Conclusions: Although the relative contribution of alcohol in opioid-related deaths has declined, 1 in 5 fatal opioid overdoses still involved alcohol in 2013. Our findings highlight the ongoing need for targeted messaging around risks of opioids alone, and in combination with alcohol and other CNS depressants.