Non-fatal opioid-related overdoses among adolescents in Massachusetts 2012-2014
Non-fatal opioid-related overdoses among adolescents in Massachusetts 2012-2014
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DOI：
10.1016/j.drugalcdep.2018.09.020
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Bagley, Sarah M.
中科院分区：
文献类型：
--
作者：
Chatterjee, Avik;Larochelle, Marc R.;Bagley, Sarah M.
背景：美国青少年中与阿片类药物相关的过量和死亡人数持续增加，但对经历过阿片类药物相关非致命性过量(NFOD)的青少年知之甚少。我们的目标是描述(1)经历NFOD的11-17岁青少年的特征和(2)他们在NFOD后12个月内接受阿片类药物使用障碍(Moud)药物的情况，并与成年人进行比较。方法：我们使用6个马萨诸塞州政府机构的数据集建立了一个回溯性队列，其中包含98%的州居民的信息。如果个人在2012年1月1日至2014年12月31日期间经历NFOD，则进入队列。我们比较了患有NFOD的青少年和成年人，检查了个人特征和接受阿片类药物使用障碍(Moud)-美沙酮、丁丙诺啡或纳曲酮的情况。结果：在研究期间经历NFOD的22,506人中，195人(0.9%)年龄在11-17岁。52%的青少年是女性，而只有38%的成年人是女性(P<；0.001)。在NFOD之前的一年，11%(21/195)的青少年接受了处方阿片类药物，而成年人的这一比例为43%(P<；0.001)；5%的青少年(P<；10/195)接受了任何药物治疗，而成年人的这一比例为23%(P<；0.001)。在NFOD后的12个月里，只有8%(15/195)的青少年服用了Moud，而成年人的这一比例为29%。结论：在经历NFOD的个体中，青少年更有可能是女性，而不太可能在前一年开过阿片类药物。很少有青少年在NFOD之前或之后接受Moud治疗。非致命的过量用药错过了在青少年中开始循证治疗的机会。
Background: Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults.Methods: We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents. Individuals entered the cohort if they experienced NFOD between January 1, 2012 and December 31, 2014. We compared adolescents to adults experiencing NFOD, examining individual characteristics and receipt of medications for opioid use disorder (MOUD)-methadone, buprenorphine, or naltrexone.Results: Among 22,506 individuals who experienced NFOD during the study period, 195 (0.9%) were aged 11-17. Fifty-two percent (102/195) of adolescents were female, whereas only 38% of adults were female (P < 0.001). In the year prior to NFOD, 11% (21/195) of adolescents received a prescription opioid, compared to 43% of adults (P < 0.001), and < 5% (< 10/195) received any MOUD compared to 23% of adults (P < 0.001). In the 12 months after NFOD, only 8% (15/195) of adolescents received MOUD, compared to 29% of adults.Conclusion: Among individuals experiencing NFOD, adolescents were more likely to be female and less likely to have been prescribed opioids in the year prior. Few adolescents received MOUD before or after NFOD. Non-fatal overdose is a missed opportunity for starting evidence-based treatment in adolescents.