Xylazine in Drug Seizure Reports and Overdose Deaths in the US, 2018-2022.
Xylazine in Drug Seizure Reports and Overdose Deaths in the US, 2018-2022.
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2018-2022 年美国毒品缉获报告和服药过量死亡中的甲苯噻嗪。
DOI：
10.1101/2023.08.24.23294567
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Marsiglia,Flavio
中科院分区：
文献类型：
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作者：
Cano,Manuel;Daniulaitye,Raminta;Marsiglia,Flavio
在美国，甲苯噻嗪在街头毒品和致命药物过量中的报道越来越多，通常与合成阿片类药物结合使用，但州级甲苯噻嗪数据有限，阻碍了当地的公共卫生应对措施。本研究分析了2018-2022年来自国家法医实验室信息系统（法医实验室分析的缉获药物的甲苯噻嗪阳性报告），疾病控制和预防中心（人口估计，合成阿片类药物过量死亡率）以及各州的体检医师/公共卫生机构报告（涉及甲苯噻嗪的过量死亡人数）的州一级数据。普通最小二乘回归模型通过甲苯噻嗪癫痫发作报告率预测州一级合成阿片类药物过量死亡率，并根据美国人口普查地区进行调整。2018年，观察到甲苯噻嗪缉获报告率相对较低，21个州报告甲苯噻嗪缉获量为零。在2022年，只有三个州报告了零甲苯噻嗪缉获量，观察到甲苯噻嗪缉获报告率（每10万居民）最高的是新泽西（30.4）、罗得岛（22.7）、马里兰州（18.9）、弗吉尼亚州（15.5）、新罕布什尔州（13.0）和俄亥俄州（10.9）。关于2019-2022年涉及甲苯噻嗪的过量死亡的数据可用于21个州/DC（60个州年），其中佛蒙特州（10.5）和康涅狄格州（9.8）的2022年涉及甲苯噻嗪的过量死亡率（每10万居民）最高。最后，在2021年，在州一级，每10万居民中每增加一次报告的甲苯噻嗪发作与合成阿片类药物过量死亡率增加2%相关（B=0.02，稳健标准误=0.01; p=0.049）。总体而言，研究结果强调甲苯噻嗪越来越多地参与美国执法部门的毒品缉获报告和过量死亡，主要是在东部，但也扩展到全国各地。
Xylazine is increasingly reported in street drugs and fatal overdoses in the United States (US), often in combination with synthetic opioids, yet state-level xylazine data are limited, hampering local public health responses. The present study analyzed 2018–2022 state-level data from the National Forensic Laboratory Information System (xylazine-positive reports of seized drugs analyzed by forensic laboratories), the Centers for Disease Control and Prevention (population estimates, synthetic opioid overdose mortality rates), and individual states’ medical examiner/public health agency reports (numbers of xylazine-involved overdose deaths). An ordinary least squares regression model predicted state-level synthetic opioid overdose mortality rates by xylazine seizure report rates, adjusting for US Census Region. In 2018, relatively low rates of xylazine seizure reports were observed, with 21 states reporting zero xylazine seizures. In 2022, only three states reported zero xylazine seizures, and the highest xylazine seizure report rates (per 100,000 residents) were observed in New Jersey (30.4), Rhode Island (22.7), Maryland (18.9), Virginia (15.5), New Hampshire (13.0), and Ohio (10.9). Data on 2019–2022 xylazine-involved overdose deaths were available for 21 states/DC (60 state-years), with the highest 2022 xylazine-involved overdose death rates (per 100,000 residents) in Vermont (10.5) and Connecticut (9.8). Finally, in 2021, at the state level, each additional reported xylazine seizure per 100,000 residents was associated with a 2% higher synthetic opioid overdose mortality rate (b=0.02, robust standard error=0.01; p=0.049). Overall, study results emphasize xylazine’s increasing involvement in US law enforcement drug seizure reports and overdose deaths, primarily in the East, yet also extending across the country.