Enumerating contributions of fentanyls and other factors to the unprecedented 2020 rise in opioid overdose deaths: model-based analysis.
Enumerating contributions of fentanyls and other factors to the unprecedented 2020 rise in opioid overdose deaths: model-based analysis.
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DOI：
10.1093/pnasnexus/pgad064
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发表时间：
2023-04
期刊：
影响因子：
--
通讯作者：
Jalali, Mohammad S.
中科院分区：
文献类型：
--
作者：
Stringfellow, Erin J.;Lim, Tse Yang;DiGennaro, Catherine;Hasgul, Zeynep;Jalali, Mohammad S.
于二零二零年，美国持续的阿片类药物过量危机与新冠肺炎疫情发生冲突。阿片类药物过量死亡（OOD）增加了前所未有的38%，这是由于COVID-19破坏了对吸毒者至关重要的服务，非法药物供应中芬太尼的持续增加以及其他因素的综合作用。这些因素在多大程度上导致了OOD的增加？我们使用经过验证的阿片类药物过量危机模拟模型SOURCE来估计2020年过量的OOD以及归因于各种因素的过量分布。影响OOD的因素可能已被COVID-19破坏，并且数据可用，包括阿片类药物处方，纳洛酮分配和接受阿片类药物使用障碍的药物。我们还计算了海洛因中芬太尼的含量。我们估计总共有18，276个潜在的过量OOD，包括由于丁丙诺啡接收和纳洛酮分布的增加以及阿片类药物处方的减少而挽救的1，792个生命。至关重要的是，芬太尼的增长推动了43%（7，879）的过量OOD。另有8%归因于美沙酮维持治疗和缓释注射纳洛酮治疗的首次下降，最有可能是由于COVID-19相关的中断。总的来说，49%的潜在超额OOD仍然无法解释，其中至少有一部分可能是由于额外的COVID-19相关中断。虽然各种COVID-19相关因素的共同作用可能导致超过一半的过量OOD，但芬太尼继续在过量OOD中发挥独特作用，突出了减轻其对过量的影响的紧迫性。
In 2020, the ongoing US opioid overdose crisis collided with the emerging COVID-19 pandemic. Opioid overdose deaths (OODs) rose an unprecedented 38%, due to a combination of COVID-19 disrupting services essential to people who use drugs, continued increases in fentanyls in the illicit drug supply, and other factors. How much did these factors contribute to increased OODs? We used a validated simulation model of the opioid overdose crisis, SOURCE, to estimate excess OODs in 2020 and the distribution of that excess attributable to various factors. Factors affecting OODs that could have been disrupted by COVID-19, and for which data were available, included opioid prescribing, naloxone distribution, and receipt of medications for opioid use disorder. We also accounted for fentanyls’ presence in the heroin supply. We estimated a total of 18,276 potential excess OODs, including 1,792 lives saved due to increases in buprenorphine receipt and naloxone distribution and decreases in opioid prescribing. Critically, growth in fentanyls drove 43% (7,879) of the excess OODs. A further 8% is attributable to first-ever declines in methadone maintenance treatment and extended-released injectable naltrexone treatment, most likely due to COVID-19-related disruptions. In all, 49% of potential excess OODs remain unexplained, at least some of which are likely due to additional COVID-19-related disruptions. While the confluence of various COVID-19-related factors could have been responsible for more than half of excess OODs, fentanyls continued to play a singular role in excess OODs, highlighting the urgency of mitigating their effects on overdoses.
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影响因子：
3.9
作者：
Harris MTH;Lambert AM;Maschke AD;Bagley SM;Walley AY;Gunn CM
通讯作者：
Gunn CM
DOI：
10.3390/ijerph19042230
发表时间：
2022-02-16
影响因子：
--
作者：
Bolinski RS;Walters S;Salisbury-Afshar E;Ouellet LJ;Jenkins WD;Almirol E;Van Ham B;Fletcher S;Johnson C;Schneider JA;Ompad D;Pho MT
通讯作者：
Pho MT
影响因子：
4.4
作者：
Csete, Joanne;Elliott, Richard
通讯作者：
Elliott, Richard
影响因子：
4.4
作者：
Conway, Fiona N.;Samora, Jake;Brinkley, Katlyn;Jeong, Haelim;Clinton, Nina;Claborn, Kasey R.
通讯作者：
Claborn, Kasey R.
影响因子：
12.7
作者：
Friedman, Joseph;Akre, Samir
通讯作者：
Akre, Samir