Fentanyl and other opioid involvement in methamphetamine-related deaths
Fentanyl and other opioid involvement in methamphetamine-related deaths
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DOI：
10.1080/00952990.2021.1981919
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发表时间：
2021-11-07
影响因子：
2.7
通讯作者：
Smith, Gordon S.
中科院分区：
文献类型：
--
作者：
Dai, Zheng;Abate, Marie A.;Smith, Gordon S.
甲基苯丙胺相关的死亡一直在上升沿着那些涉及合成阿片类药物，主要是芬太尼和芬太尼类似物（FA）。然而，甲基苯丙胺参与死亡的程度与合成阿片类药物参与中发生的变化有多大不同尚不清楚。目的确定与其他药物有关和不涉及其他药物的甲基苯丙胺相关死亡的模式和时间变化。方法分析了2013年至2018年西弗吉尼亚州所有甲基苯丙胺相关死亡的数据。随着时间的推移进行准泊松回归分析，以比较甲基苯丙胺和芬太尼//FA亚组之间死亡计数的变化率。共分析了815例甲基苯丙胺相关死亡; 572例（70.2%）为男性，527例（64.7%）涉及阿片类药物。尽管实际死亡人数有所增加，但仅使用甲基苯丙胺的死亡比例随着时间的推移保持相对平稳。芬太尼/FAs和甲基苯丙胺的组合涉及337例死亡（41.3%），是2013年至2018年的最大增幅。2017-2018年每月死亡人数建模发现，涉及芬太尼但不含甲基苯丙胺的平均死亡人数显着下降（变化率-0.025，p < .001），而芬太尼与甲基苯丙胺和仅甲基苯丙胺共存的死亡人数显着增加（变化率分别为0.056和0.057，p < .001）。结论芬太尼和FAs在甲基苯丙胺相关死亡中起着越来越重要的作用。涉及芬太尼/FAs和甲基苯丙胺的死亡人数不断增加，表明兴奋剂和类阿片在意外死亡中的重要性。全面的监测工作应继续跟踪物质使用模式，以确保采取适当的预防方案。
Background Methamphetamine-related deaths have been rising along with those involving synthetic opioids, mostly fentanyl and fentanyl analogs (FAs). However, the extent to which methamphetamine involvement in deaths differs from those changes occurring in synthetic opioid involvement is unknown. Objectives To determine the patterns and temporal changes in methamphetamine-related deaths with and without other drug involvement. Methods Data from all methamphetamine-related deaths in West Virginia from 2013 to 2018 were analyzed. Quasi-Poisson regression analyses over time were conducted to compare the rates of change in death counts among methamphetamine and fentanyl//FA subgroups. Results A total of 815 methamphetamine-related deaths were analyzed; 572 (70.2%) were male and 527 (64.7%) involved an opioid. The proportion of methamphetamine only deaths stayed relatively flat over time although the actual numbers of deaths increased. Combined fentanyl/FAs and methamphetamine were involved in 337 deaths (41.3%) and constituted the largest increase from 2013 to 2018. The modeling of monthly death counts in 2017-2018 found that the average number of deaths involving fentanyl without methamphetamine significantly declined (rate of change -0.025, p < .001), while concomitant fentanyl with methamphetamine and methamphetamine only death counts increased significantly (rate of change 0.056 and 0.057, respectively, p < .001). Conclusions Fentanyl and FAs played an increasingly significant role in methamphetamine-related deaths. The accelerating number of deaths involving fentanyl/FAs and methamphetamine indicates the importance of stimulants and opioids in unintentional deaths. Comprehensive surveillance efforts should continue to track substance use patterns to ensure that appropriate prevention programs are undertaken.