Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017.

Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017.
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DOI:
10.15585/mmwr.mm675152e1
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发表时间:
2018-01-04
期刊:
MMWR. Morbidity and mortality weekly report
影响因子:
--
通讯作者:
Baldwin, Grant
Baldwin, Grant
中科院分区:
其他
文献类型:
--
作者:
Scholl, Lawrence;Seth, Puja;Baldwin, Grant

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2016年美国有63,632例药物过量死亡,比2015年增加了21.4%;其中三分之二的死亡涉及阿片类药物(1)。从2015年到2016年,药物过量死亡在所有药物类别中都有所增加;最大的增加发生在涉及美沙酮(合成阿片类药物)以外的合成阿片类药物的死亡中,其中包括非法制造的芬太尼(IMF)(1)。自2013年以来,在国际货币基金组织(IMF)的推动下,包括芬太尼类似物(2-4),目前阿片类药物过量流行病的特点是涉及合成阿片类药物的死亡人数增加。货币基金组织导致了过量死亡的增加,报告了地域差异(1)。CDC检查了2013-2017年期间50个州和哥伦比亚特区(DC)所有药物过量死亡率的州一级变化以及20个州涉及合成阿片类药物的死亡率。此外,2016年至2017年涉及所有阿片类药物和阿片类药物子类别的死亡率变化 * 通过人口统计学,县城市化水平以及34个州和DC进行了检查。在2017年的70,237例药物过量死亡中,47,600例(67.8%)涉及阿片类药物。从2013年到2017年,50个州中有35个州和华盛顿特区的药物过量死亡率增加,20个州中有15个州涉及合成阿片类药物的死亡率显着增加,这可能是由国际货币基金组织推动的(2,3)。从2016年到2017年,涉及所有阿片类药物和合成阿片类药物的过量死亡增加,但涉及处方阿片类药物和海洛因的死亡保持稳定。由于涉及合成类阿片的死亡人数持续增加,类阿片过量流行病继续恶化和演变。2018年的临时数据表明,一些药物过量指标可能有所改善;然而,需要对2018年的最终数据进行分析以进行确认。更及时和全面的监测数据对于为预防和应对类阿片过量的努力提供信息至关重要;迫切需要加强预防和应对措施,以遏制涉及处方和非法类阿片的死亡,特别是国际货币基金组织。
The 63,632 drug overdose deaths in the United States in 2016 represented a 21.4% increase from 2015; two thirds of these deaths involved an opioid (1). From 2015 to 2016, drug overdose deaths increased in all drug categories examined; the largest increase occurred among deaths involving synthetic opioids other than methadone (synthetic opioids), which includes illicitly manufactured fentanyl (IMF) (1). Since 2013, driven largely by IMF, including fentanyl analogs (2-4), the current wave of the opioid overdose epidemic has been marked by increases in deaths involving synthetic opioids. IMF has contributed to increases in overdose deaths, with geographic differences reported (1). CDC examined state-level changes in death rates involving all drug overdoses in 50 states and the District of Columbia (DC) and those involving synthetic opioids in 20 states, during 2013-2017. In addition, changes in death rates from 2016 to 2017 involving all opioids and opioid subcategories,* were examined by demographics, county urbanization levels, and by 34 states and DC. Among 70,237 drug overdose deaths in 2017, 47,600 (67.8%) involved an opioid. From 2013 to 2017, drug overdose death rates increased in 35 of 50 states and DC, and significant increases in death rates involving synthetic opioids occurred in 15 of 20 states, likely driven by IMF (2,3). From 2016 to 2017, overdose deaths involving all opioids and synthetic opioids increased, but deaths involving prescription opioids and heroin remained stable. The opioid overdose epidemic continues to worsen and evolve because of the continuing increase in deaths involving synthetic opioids. Provisional data from 2018 indicate potential improvements in some drug overdose indicators; however, analysis of final data from 2018 is necessary for confirmation. More timely and comprehensive surveillance data are essential to inform efforts to prevent and respond to opioid overdoses; intensified prevention and response measures are urgently needed to curb deaths involving prescription and illicit opioids, specifically IMF.