Opioid and stimulant attributed treatment admissions and fatal overdoses: Using national surveillance data to examine the intersection of race, sex, and polysubstance use, 1992-2020
Opioid and stimulant attributed treatment admissions and fatal overdoses: Using national surveillance data to examine the intersection of race, sex, and polysubstance use, 1992-2020
复制标题
DOI：
10.1016/j.drugalcdep.2023.109946
复制
发表时间：
2023-06-22
影响因子：
4.2
通讯作者：
Winkelman, T. N. A.
中科院分区：
文献类型：
--
作者：
Jones, A. A.;Shearer, R. D.;Winkelman, T. N. A.
背景：我们使用国家监测数据按性别/性别差异评估种族/族裔，以及涉及阿片类药物和兴奋剂使用的物质使用治疗入院和过量死亡的趋势。方法：我们使用治疗事件数据集入院的数据（1992-2019）来确定治疗入院情况，并使用疾病控制和预防中心流行病学研究的广泛在线数据（1999-2020）来确定用药过量死亡。我们按性别和种族/族裔对阿片类药物和兴奋剂组的每 100,000 名成年人的治疗入院和相关药物过量死亡进行了评估：可卡因、阿片类药物、甲基苯丙胺、可卡因和阿片类药物使用、可卡因和甲基苯丙胺以及阿片类药物和甲基苯丙胺。结果：我们发现按种族/种族和性别/性别划分的治疗入院和死亡存在显着差异。在研究年份中，与可卡因相关的治疗入院和死亡在非西班牙裔黑人中最为普遍，但其他种族/族裔群体中的比率较低。值得注意的是，1992 年至 2019 年间，非西班牙裔黑人男性仅吸食可卡因的入院人数增幅高于其他种族/族裔群体的男性。男性接受阿片类药物和兴奋剂治疗的入院人数以及服药过量死亡人数均高于女性。我们观察到，从 1992 年到 2019 年，美洲印第安人/阿拉斯加原住民男性和女性的甲基苯丙胺死亡人数急剧上升。讨论：非西班牙裔美洲原住民中甲基苯丙胺和非西班牙裔黑人中可卡因导致的过量死亡人数急剧增加，这表明需要采取更有效的干预措施来遏制兴奋剂的使用。种族/民族和性别/性别的差异也表明应通过交叉视角制定干预措施。
Background: We use national surveillance data to evaluate race/ethnicity by sex/gender differences and trends in substance use treatment admissions and overdose deaths involving opioid and stimulant use.Methods: We used data (1992-2019) from the Treatment Episode Dataset-Admissions to identify treatment ad -missions and the Center for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (1999-2020) to identify overdose deaths. We assessed treatment admissions and related drug overdose deaths per 100,000 adults by sex and race/ethnicity for opioid and stimulant groups: cocaine, opioid, meth-amphetamines, cocaine and opioid use, cocaine and methamphetamines, and opioid and methamphetamines.Results: We found significant variations in treatment admissions and deaths by race/ethnicity and sex/gender. Cocaine-related treatment admissions and deaths were most prevalent among Non-Hispanic Black individuals over the study years, yet lower rates were evident among individuals from other racial/ethnic groups. Notably, Non-Hispanic Black men experienced larger increases in cocaine-only admissions than men of other racial/ethnic groups between 1992 and 2019. Men had higher opioid and stimulant treatment admissions and overdose deaths than women. We observed skyrocketing methamphetamine deaths among American Indian/Native Alaskan men and women from 1992 to 2019.Discussion: Steep increases in overdose deaths fueled by methamphetamines among Non-Hispanic Native Americans and cocaine among Non-Hispanic Black individuals suggest a need for more effective interventions to curb stimulant use. Variations by race/ethnicity and sex/gender also suggest interventions should be developed through an intersectionality lens.