Corrected US opioid-involved drug poisoning deaths and mortality rates, 1999-2015
Corrected US opioid-involved drug poisoning deaths and mortality rates, 1999-2015
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DOI：
10.1111/add.14144
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发表时间：
2018-07-01
期刊：
影响因子：
6
通讯作者：
Ruhm, Christopher J.
中科院分区：
文献类型：
--
作者：
Ruhm, Christopher J.
背景和目的大多数先前对阿片类药物中毒死亡率的估计都被低估了，因为导致死亡的具体药物往往没有在死亡证明上标明。这项分析提供了国家对阿片类药物和海洛因/合成阿片类药物涉及的计数和死亡率的订正估计数，以及1999年至2015年期间这些数字随时间的变化。方法从美国疾病控制和预防中心(CDC)的多死因(MCOD)档案中获得1999年至2015年美国居民药物中毒死亡的数据，将涉及致死过量的药物与死亡证明上未指明的药物一起使用。结果疾病预防控制中心的官方数据显示，2015年有33091人死于阿片类药物，这是一个低估的数字，实际数字约为39999人。与阿片类药物和海洛因/合成阿片类药物有关的任何药物死亡的校正计数和比率每年都比报告的数字高出20%至35%。改正几乎总是提出自1999年以来估计发生的变化，最大的差异是在2011年观察到的任何阿片类药物的差异(5677例死亡和每10万人1.7例)和2015年海洛因/合成阿片类药物的差异(3228例死亡和每10万例中的1.0例)。然而，如果根据的是修正的死亡数据，而不是报告的死亡数据，并且对基准年的选择敏感，则1999年以来的百分比增长有时会较慢。结论死亡证明报告低估了阿片类药物和海洛因/合成阿片类药物在美国的死亡率及其随时间的变化。对死亡证明上没有确定涉案药物的案件进行调整，可能会提供更准确的估计。
Background and Aims Most prior estimates of opioid-involved drug poisoningmortality counts or rates are understated because the specific drugs leading to death are frequently not identified on death certificates. This analysis provides corrected national estimates of opioid and heroin/synthetic opioid-involved counts and mortality rates, as well as changes over time in them from 1999 to 2015. Methods Data on drug poisoning deaths to US residents from 1999 to 2015, obtained from the Centers for Disease Control and Prevention (CDC) Multiple Cause of Death (MCOD) files, were used with the drugs involved in fatal overdoses imputed when not identified on the death certificates. Results The official CDC figure that 33 091 drug deaths involved opioids in 2015 is an undercount, with the actual number being approximately 39 999. Corrected counts and rates of any opioid and heroin/synthetic opioid-involved drug deaths are 20-35% higher in every year than reported figures. The corrections almost always raise the changes estimated to have occurred since 1999, with the largest differences observed in 2011 for any opioids (5677 deaths and 1.7 per 100 000) and in 2015 for heroin/synthetic opioids (3228 deaths and 1.0 per 100 000). However, percentage growth since 1999 is sometimes slower when based on corrected rather than reported fatality data, and with sensitivity to the choice of base years. Conclusions Death certificate reports understate the prevalence of and changes over time in opioid and heroin/synthetic opioid-involved drug mortality in the United States. Adjustments imputing the drugs involved for cases where none are identified on the death certificates are likely to provide more accurate estimates.