Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type
Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type
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DOI：
10.1002/pds.1626
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发表时间：
2008-10-01
影响因子：
2.6
通讯作者：
Xi, Yongli
中科院分区：
文献类型：
--
作者：
Paulozzi, Leonard J.;Xi, Yongli
目的：本研究旨在确定最近报道的美国药物中毒死亡率的增加如何随城市化程度而变化。虽然药物中毒传统上被视为一个城市问题，但有证据表明，最近增加的至少一个组成部分，涉及阿片类镇痛剂的死亡，方法该研究比较了1999年至2004年6个城市的国家生命统计系统（NVSS）中年龄调整的无意和未确定的药物中毒死亡率，结果1999 ~ 2004年，非故意和未确定的药物中毒死亡率上升了62%。大都市县的发病率上升了51%，增加了2.66/10万，而非大都市县的发病率上升了159%，增加了4.81/10万。到2004年，大城市和非大城市的药物中毒率大致相等。在包括海洛因、可卡因和阿片类镇痛药在内的麻醉药品类别中，大多数城市（“大中央都市”）县仅增加了16%，而大多数农村（“非核心、非都市”）县增加了248%。任何城市-农村类别的海洛因使用率都没有显著增加。非大都市县的人口增长率最高。阿片类镇痛药的增长率范围从低的52%，在大的中央地铁县，增加了371%，在非大都市，noncore country.Conclusions处方药已取代海洛因和可卡因的主要药物参与致命的药物过量，在所有的城市和农村类别。致命的药物过量不再是主要的城市现象。国家预防工作必须转向解决使用非传统药物的非传统人群。版权所有（C）2008约翰威利父子有限公司
Purpose This study was conducted to determine how the recently reported increase in drug poisoning mortality rates in the United States varied by degree of urbanization. Although drug poisoning is traditionally seen as an urban problem, evidence suggested that at least one component of the recent increase, deaths involving opioid analgesics, was increasing more rapidly in rural areas.Methods The study compared age-adjusted unintentional and undetermined drug poisoning mortality rates between 1999 and 2004 from the National Vital Statistics System (NVSS) in each of six urban-rural categories.Results Unintentional and undetermined drug poisoning mortality rates rose 62% from 1999 to 2004. Metropolitan county rates rose 51 %, an increase of 2.66/100 000, while nonmetropolitan county rates rose 159%, an increase of 4.81/100 000. By 2004, metropolitan and nonmetropolitan drug poisoning rates had roughly equalized. In the narcotic drug category, which included heroin, cocaine, and opioid analgesics, the most urban ("large central metro") counties increased only 16% while the most rural ("noncore, nonmetropolitan") counties increased 248%. Heroin rates did not increase significantly for any urban-rural category. Cocaine rate increases were largest in nonmetropolitan counties. Opioid analgesic rate increases ranged from a low of 52% in large central metro counties to an increase of 371% in nonmetropolitan, noncore counties.Conclusions Prescription drugs have replaced heroin and cocaine as the leading drugs involved in fatal drug overdoses in all urban-rural categories. Fatal drug overdoses are no longer a predominantly urban phenomenon. National prevention efforts will have to shift to address nontraditional populations using nontraditional drugs. Copyright (C) 2008 John Wiley & Sons, Ltd.