Estimating the impact of drug use on US mortality, 1999-2016
Estimating the impact of drug use on US mortality, 1999-2016
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DOI：
10.1371/journal.pone.0226732
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发表时间：
2020-01-15
期刊：
影响因子：
3.7
通讯作者：
Preston, Samuel H.
中科院分区：
文献类型：
--
作者：
Glei, Dana A.;Preston, Samuel H.
吸毒增加对美国死亡率的影响可能不仅限于与吸毒有关的死亡，还包括受吸毒影响的其他原因导致的超额死亡率。在这里，我们估计了与药物相关的死亡率的全部范围。我们使用 1999-2016 年按州、性别、五年年龄组和死因划分的年度死亡率来模拟药物编码死亡率（作为人口水平吸毒流行率的指标）与其他原因导致的死亡率之间的关系。在美国 50 个州的 15-64 岁居民中，2016 年与毒品相关的死亡人数 (141,695 人) 是毒品相关死亡人数 (63,000 人) 的 2.2 倍。自 2010 年以来中年死亡率的不利趋势主要归因于与药物相关的死亡率。如果没有吸毒，我们估计 2010 年之后，男性 15 岁至 65 岁之间的死亡概率将继续下降（2016 年降至 15%），而女性则保持在较低水平（10%）。我们的研究结果表明，2016 年 15 岁至 65 岁之间，另有 3.9% 的男性和 1.8% 的女性因吸毒死亡。就 15 岁以上的预期寿命而言，我们估计男性平均因吸毒而损失 1.4 年，女性平均损失 0.7 年。在受灾最严重的州（西弗吉尼亚州），吸毒使男性损失了 3.6 生命年，女性损失了 1.9 生命年。最近美国人预期寿命的下降主要归咎于毒品泛滥。与这一推论一致，我们的结果表明，在不使用毒品的情况下，2014 年至 2016 年间，15 岁的预期寿命会略有增加。在美国，与毒品相关的死亡率大约是单独因毒品导致的死亡的两倍。毒品泛滥给美国人带来了沉重的生命损失，这不仅是由于吸毒过量造成的，而且是由多种原因造成的。
The impact of rising drug use on US mortality may extend beyond deaths coded as drug-related to include excess mortality from other causes affected by drug use. Here, we estimate the full extent of drug-associated mortality. We use annual death rates for 1999-2016 by state, sex, five-year age group, and cause of death to model the relationship between drug-coded mortality-which serves as an indicator of the population-level prevalence of drug use-and mortality from other causes. Among residents aged 15-64 living in the 50 US states, the estimated number of drug-associated deaths in 2016 (141,695) was 2.2 times the number of drug-coded deaths (63,000). Adverse trends since 2010 in midlife mortality are largely attributable to drug-associated mortality. In the absence of drug use, we estimate that the probability of dying between ages 15 and 65 would have continued to decline after 2010 among men (to 15% in 2016) and would have remained at a low level (10%) among women. Our results suggest that an additional 3.9% of men and 1.8% of women died between ages 15 and 65 in 2016 because of drug use. In terms of life expectancy beyond age 15, we estimate that drug use cost men 1.4 years and women 0.7 years, on average. In the hardest-hit state (West Virginia), drug use cost men 3.6 and women 1.9 life years. Recent declines in US life expectancy have been blamed largely on the drug epidemic. Consistent with that inference, our results imply that, in the absence of drug use, life expectancy at age 15 would have increased slightly between 2014 and 2016. Drug-associated mortality in the US is roughly double that implied by drug-coded deaths alone. The drug epidemic is exacting a heavy cost to American lives, not only from overdoses but from a variety of causes.