A Transitioning Epidemic: How The Opioid Crisis Is Driving The Rise In Hepatitis C
A Transitioning Epidemic: How The Opioid Crisis Is Driving The Rise In Hepatitis C
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DOI：
10.1377/hlthaff.2018.05232
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发表时间：
2019-02-01
期刊：
影响因子：
9.7
通讯作者：
Pacula, Rosalie L.
中科院分区：
文献类型：
--
作者：
Powell, David;Alpert, Abby;Pacula, Rosalie L.
在美国，丙型肝炎病毒导致的死亡人数比其他任何传染病都多，自2010年以来，丙型肝炎感染人数一直在以惊人的速度上升。我们评估了阿片类药物流行的作用，特别是2010年推出了一种可遏制滥用的奥施康定。奥施康定的重新配方导致一些吸毒者改用海洛因，这可能会使他们接触到丙型肝炎病毒。我们使用差异法，使用2004-15年的数据，评估在重新配制之前OxyContin误用率较高的州-重新配制产生更大影响的州-是否在重新配制后经历了更快的感染增长。在重新配方前滥用OxyContin高于中位数的州，在重新配方后的丙型肝炎感染率增加了222%，而滥用低于中位数的州只增加了75%。这些结果表明，阻止阿片类药物滥用的干预措施可能会产生意想不到的长期公共健康后果。
The hepatitis C virus is responsible for more deaths in the United States than any other infectious disease, and hepatitis C infections have been rising at an alarming rate since 2010. We evaluated the role of the opioid epidemic and, in particular, the 2010 introduction of an abuse-deterrent version of OxyContin. The OxyContin reformulation led some users of the drug to switch to heroin, which could have exposed them to the hepatitis C virus. We used difference-in-differences methods, using data for the period 2004-15, to assess whether states with higher rates of OxyContin misuse prior to reformulation-states where the reformulation had more impact-experienced faster growth in infections after the reformulation. States with above-median OxyContin misuse before the reformulation experienced a 222 percent increase in hepatitis C infection rates in the post-reformulation period, while states with below-median misuse experienced only a 75 percent increase. These results suggest that interventions to deter opioid misuse can have unintended long-term public health consequences.