Using statewide death certificate data to understand trends and characteristics of polydrug overdose deaths in Tennessee, 2013-2017
Using statewide death certificate data to understand trends and characteristics of polydrug overdose deaths in Tennessee, 2013-2017
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DOI：
10.1016/j.annepidem.2019.12.001
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发表时间：
2020-01-01
影响因子：
5.6
通讯作者：
Nechuta, Sarah
中科院分区：
文献类型：
--
作者：
Golladay, Molly;Donner, Kayle;Nechuta, Sarah
目的：迫切需要关于多药过量趋势和特征的基于人群的数据，以帮助了解美国不断变化的药物流行，并确定处方和非法阿片类药物死亡的过量预防的风险模式和目标。我们在田纳西州进行了一项全州范围的研究，以评估2013-2017年间多药过量死亡的特征和趋势。方法：我们使用ICD-10编码和死亡统计文件中的文字死因文本来识别多药过量死亡。我们评估了过量用药的趋势、致病药物和人口学特征(n=2567例单药死亡和n=4683例多药死亡)。结果：多药过量呈逐年上升趋势，多药过量的AAPC高于单药过量(AAPC：13.6%，95%CI：10.6%~16.7%；5.2%，95%CI：2.9%~7.5%)。男性(AAPC：15.4%)、非西班牙裔黑人(AAPC：33.3%)和18-34岁死者(AAPC：21.3%)多药过量发生率最高。结论：2013-2017年间，所有药物和阿片类药物死亡人数均有所增加，男性、黑人和年轻年龄组增幅最高。80%以上的非法阿片类药物过量涉及一种以上药物，这突出表明需要超越阿片类药物以防止过量使用。(C)2019 Elsevier Inc.保留所有权利。
Purpose: Population-based data on trends and characteristics on polydrug overdoses are critically needed to help understand the changing drug epidemic in the United States, and to identify risk patterns and targets for overdose prevention for prescription and illicit opioid deaths. We conducted a statewide study in Tennessee to evaluate characteristics and trends of polydrug overdose deaths during 2013-2017.Methods: We identified polydrug overdose deaths using ICD-10 codes and literal cause-of-death text in the death statistical files. We evaluated trends, contributing drugs, and demographic characteristics of overdoses (n = 2567 single-drug and n = 4683 polydrug deaths). Average annual percent change estimates (AAPCs) with associated 95% Cls were estimated using Poisson regression.Results: Polydrug overdoses increased annually, with higher AAPC for polydrug compared with single-drug overdoses (AAPC: 13.6%, 95% CI: 10.6%-16.7% and 5.2%, 95% CI: 2.9%-7.5%, respectively). The highest increases in polydrug overdoses were observed in males (AAPC: 15.4%, non-Hispanic blacks (AAPC: 33.3%), and decedents aged 18-34 years (AAPC: 21.3%).Conclusions: All drug and opioid polydrug deaths increased during 2013-2017, with the highest increases seen in males, blacks, and younger age groups. Over 80% of illicit opioid overdoses involved more than one drug, highlighting the need to go beyond opioids to prevent overdoses. (C) 2019 Elsevier Inc. All rights reserved.