Drug Overdose Deaths Among Non-Hispanic Black Men in the U.S.: Age-Specific Projections Through 2025.
Drug Overdose Deaths Among Non-Hispanic Black Men in the U.S.: Age-Specific Projections Through 2025.
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DOI：
10.1016/j.focus.2022.100063
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发表时间：
2023-03-01
期刊：
影响因子：
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通讯作者：
Harris, Rebecca Arden
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文献类型：
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作者：
Harris, Rebecca Arden
导语：自2015年以来，致命的药物过量在美国急剧上升，达到疫情期间的最高水平。非西班牙裔黑人男性受到了最近这一激增的不成比例的伤害；自2015年以来，每10万人中的服药过量死亡率增加了四倍。死亡率是否会继续攀升还不得而知。在这项研究中，基于黑人男性人口年龄结构的可预见变化，我们解决了更狭隘的问题，即到2025年，哪些年龄组的药物过量死亡负担可能会显著增加或减少。方法：我们使用疾病控制中心WONDER(广泛在线流行病学研究数据)数据库中的2020年和2021年临时年龄特定死亡率和标准人口平衡方程来预测2025年药物过量死亡人数。过量死亡由ICD-10代码识别。我们将两种看似合理的预测区分开来：一种是基于时间序列外推的悲观预测，另一种是乐观预测，即假设通过预防、治疗和减少危害举措在全国范围内成功降低服药过量死亡。结果：在31-47岁的黑人男性中，2025年服药过量死亡人数预计将比2020年增加440%或11%(95%CI=8%，14%)。相比之下，19-30岁年轻黑人男性的过量死亡预计将下降160或-9%(95%CI=-15%，-5%)。在48-年龄的老年黑人男性中，服药过量死亡人数预计也将下降330人或-7%(95%CI=-10%，-4%)。使用2021年的临时死亡率也发现了类似的结果。结论：在30多岁和40多岁的黑人男性中，服药过量死亡人数预计将显著高于当前水平。当地政策制定者应该将减少伤害的资源，如纳洛酮试剂盒、注射器和芬太尼试纸，引导到这个年龄段的黑人男性经常光顾的地方。外展信息应该量身定做，以引起中年男性的共鸣。同样紧迫的是在黑人社区扩大非污名化、以证据为基础的药物治疗和康复支持服务。
Introduction: Fatal drug overdoses have risen sharply in the U.S. since 2015, reaching their highest levels during the pandemic. Non-Hispanic Black men have been disproportionately harmed by this latest surge; overdose mortality per 100,000 has increased fourfold since 2015. Whether the mortality rate will continue to climb is unknown. In this study, we addressed the narrower question of which age groups are likely to experience a significant increase or decrease in the burden of drug overdose deaths through 2025, based on foreseeable changes in the age structure of the Black male population.Methods: We used the 2020 and provisional 2021 age-specific mortality rates from the Centers for Disease Control WONDER (Wide-Ranging Online Data for Epidemiologic Research) database and the standard population balancing equation to project overdose deaths in 2025. Overdose deaths were identified by ICD-10 codes. We bracketed the projections between 2 plausible alternatives: a pessimistic forecast based on time series extrapolations and an optimistic forecast that assumes success nationally in lowering overdose deaths through prevention, treatment, and harm reduction initiatives.Results: Among Black men aged 31-47 years, overdose deaths in 2025 are expected to increase by 440 or 11% (95% CI=8%, 14%) relative to 2020. By contrast, overdose deaths among younger Black men aged 19-30 years are expected to decline by 160 or -9% (95% CI= -15%, -5%). Among older Black men aged 48-64 years, overdose deaths are also expected to decline by 330 or -7% (95% CI= -10%, -4%). Similar results were found using 2021 provisional mortality rates.Conclusions: Overdose deaths are predicted to increase significantly over current levels among Black men in their 30s and 40s. Local policy makers should direct harm reduction resources, such as naloxone kits, syringes, and fentanyl test strips, to places frequented by Black men in this age group. Outreach messaging should be tailored to resonate with men of middle age. Equally urgent is the scaling up of nonstigmatizing, evidence-based drug treatment and recovery support services in Black neighborhoods.