Opioid Overdose Deaths in the City and County of San Francisco: Prevalence, Distribution, and Disparities
Opioid Overdose Deaths in the City and County of San Francisco: Prevalence, Distribution, and Disparities
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DOI：
10.1007/s11524-015-9967-y
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发表时间：
2015-08-01
影响因子：
6.6
通讯作者：
Coffin, Phillip O.
中科院分区：
文献类型：
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作者：
Visconti, Adam J.;Santos, Glenn-Milo;Coffin, Phillip O.
由于处方阿片类药物过量使用的增加，药物过量现在是全国范围内意外死亡的主要原因。为了更好地了解城市阿片类药物过量死亡，本文研究了2010年至2012年旧金山海洛因相关死亡和处方阿片类药物死亡之间的地理、人口和临床差异。在此期间，331人死于阿片类药物引起的意外过量（310人涉及处方阿片类药物，31人涉及海洛因）。最常见的死亡涉及美沙酮（45.9%）、吗啡（26.9%）和羟考酮（21.8%）。大多数死亡还涉及其他物质（74.9%），最常见的是可卡因（35.3%）、苯二氮卓类药物（27.5%）、抗抑郁药（22.7%）和酒精（19.6%）。死亡人数集中在旧金山一个高度贫困的小中心地区，非洲裔美国人受到的影响尤为严重。极度贫困地区的死者更有可能死于美沙酮和可卡因，而来自较富裕地区的人更有可能死于羟考酮和苯二氮卓类药物。海洛因吸食者更有可能是年龄较小的人群，死于公共场所，吸食非法药物而非其他处方阿片类药物。总的来说，海洛因过量死亡，以前在旧金山很常见，现在很少见了。处方阿片类药物过量已成为一个重大问题，特别是在高度贫困地区的个人中。贫穷和富裕地区的死亡涉及不同的致病性阿片类药物和共存物质。
Drug overdose is now the leading cause of unintentional death nationwide, driven by increased prescription opioid overdoses. To better understand urban opioid overdose deaths, this paper examines geographic, demographic, and clinical differences between heroin-related decedents and prescription opioid decedents in San Francisco from 2010 to 2012. During this time period, 331 individuals died from accidental overdose caused by opioids (310 involving prescription opioids and 31 involving heroin). Deaths most commonly involved methadone (45.9 %), morphine (26.9 %), and oxycodone (21.8 %). Most deaths also involved other substances (74.9 %), most commonly cocaine (35.3 %), benzodiazepines (27.5 %), antidepressants (22.7 %), and alcohol (19.6 %). Deaths were concentrated in a small, high-poverty, central area of San Francisco and disproportionately affected African-American individuals. Decedents in high-poverty areas were significantly more likely to die from methadone and cocaine, whereas individuals from more affluent areas were more likely die from oxycodone and benzodiazepines. Heroin decedents were more likely to be within a younger age demographic, die in public spaces, and have illicit substances rather than other prescription opioids. Overall, heroin overdose death, previously common in San Francisco, is now rare. Prescription opioid overdose has emerged as a significant concern, particularly among individuals in high-poverty areas. Deaths in poor and affluent regions involve different causative opioids and co-occurring substances.