Trends in unintentional polysubstance overdose deaths and individual and community correlates of polysubstance overdose, North Carolina, 2009-2018.
Trends in unintentional polysubstance overdose deaths and individual and community correlates of polysubstance overdose, North Carolina, 2009-2018.
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DOI：
10.1016/j.drugalcdep.2020.108504
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发表时间：
2021-02-01
影响因子：
4.2
通讯作者：
Naumann RB
中科院分区：
文献类型：
--
作者：
Figgatt MC;Austin AE;Cox ME;Proescholdbell S;Marshall SW;Naumann RB
在致命的药物过量中，多种物质的参与正在增加。然而，对多物质药物过量的流行病学知之甚少。本文介绍了在北卡罗来纳州（NC）意外的多种药物过量死亡的新趋势，并检查与个人和社区因素的关联。使用2009-2018年NC死亡证明数据，我们确定了意外药物过量死亡和常见的药物（阿片类药物，兴奋剂，苯二氮卓类药物，酒精和抗癫痫药）。我们检查了多种物质的组合，比较了阿片类药物和非阿片类药物涉及的死亡。我们研究了来自死亡证明数据的个人水平相关性和来自美国社区调查和罗伯特·伍德约翰逊基金会县健康排名的社区水平相关性，以量化相关性。从2009年到2018年，53%的阿片类药物和19%的非阿片类药物过量死亡涉及多种物质。在此期间，多种药物过量死亡人数急剧增加，从每100 000人2.9人增加到12.1人，涉及兴奋剂的混合药物增加最多。最常见的多种药物组合为：阿片类药物和兴奋剂（过量死亡的12.1%）;阿片类药物和苯二氮卓类药物（9.0%）;阿片类药物和酒精（5.1%）;阿片类药物、兴奋剂和苯二氮卓类药物（3.1%）;以及阿片类药物、苯二氮卓类药物和抗癫痫药（2.2%）。与阿片类药物单独用药过量相比，阿片类药物、兴奋剂和苯二氮卓类药物联合用药过量涉及年轻个体（15-34岁年龄组中53.7% vs. 40.7%）。男性仅占阿片类药物过量的三分之二，然而，阿片类药物、苯二氮卓类药物和抗癫痫药物过量主要发生在女性中（60.6%）。NC中过量死亡的多物质参与增加。这些发现可用于为解决多种物质死亡以及相关的个人和社区因素的公共卫生干预提供信息。
Polysubstance involvement is increasing among fatal drug overdoses. However, little is known about the epidemiology of polysubstance drug overdoses. This paper describes emerging trends in unintentional polysubstance overdose deaths in North Carolina (NC) and examines associations with individual and community factors. Using 2009–2018 NC death certificate data, we identified unintentional drug overdose deaths and commonly involved substances (opioids, stimulants, benzodiazepines, alcohol, and antiepileptics). We examined polysubstance combinations, comparing opioid and non-opioid involved deaths. We examined individual level correlates from death certificate data and community level correlates from the American Community Survey and Robert Wood Johnson Foundation County Health Rankings to quantify associations. From 2009–2018, 53% of opioid and 19% of non-opioid overdose deaths involved multiple substances. During this period, polysubstance overdose death increased dramatically, from 2.9 to 12.1 per 100,000 persons, with the greatest increases among drug combinations involving stimulants. The most common polysubstance combinations were: opioids and stimulants (12.1% of overdose deaths); opioids and benzodiazepines (9.0%); opioids and alcohol (5.1%); opioids, stimulants, and benzodiazepines (3.1%); and opioids, benzodiazepines, and antiepileptics (2.2%). Compared to overdoses involving opioids alone, overdoses involving combinations of opioids, stimulants, and benzodiazepines involved younger individuals (53.7% in 15–34 years of age vs. 40.7%). Men comprised two-thirds of overdoses involving opioids alone, however, overdoses involving opioids, benzodiazepines, and antiepileptics were predominantly among women (60.6%). Polysubstance involvement has increased among overdose deaths in NC. These findings can be used to inform public health interventions addressing polysubstance deaths and associated individual and community level factors.
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