Trends in Medical Use of Opioids in the US, 2006-2016
Trends in Medical Use of Opioids in the US, 2006-2016
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DOI：
10.1016/j.amepre.2018.01.034
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发表时间：
2018-05-01
影响因子：
5.5
通讯作者：
Nichols, Stephanie D.
中科院分区：
文献类型：
--
作者：
Piper, Brian J.;Shah, Dipam T.;Nichols, Stephanie D.
导读：美国正在经历阿片类药物的流行，至少部分是医源性的，并由处方和非法滥用推动。这项研究提供了在过去十年中阿片类药物分布模式的全国检查。&对位;&对位;方法：数据来自美国缉毒局2006-2016年报告和综合订单自动化系统。分析包括全国按重量合法分配的十种阿片类药物的数量，并将其转换为吗啡毫克当量。地理空间和国家层面的分析也在2017年完成。&对位;&对位;结果：相对于2006年（286.1）和2016年（364.6），10种阿片类药物的总量在2011年达到峰值（389.5公吨吗啡毫克当量）。在过去十年中，阿片类药物按重量计算的体积变化是特定于药物的。自2011年以来，氢可酮有所下降（-28.4%）；羟吗啡酮(-28.0%);芬太尼(-21.4%);吗啡(-18.9%);羟考酮(-13.8%);2016年哌嗪（-58.0%）和丁丙诺啡（75.2%）增加。2016年，吗啡毫克当量最高的州（罗德岛州= 2623.7毫克/人）与最低的州（北达科他州=484.7毫克/人）之间存在着巨大的差异。国家年龄中位数与人均吗啡毫克当量之间存在关联（r =0.49, p < 0.0005）。&对位;&对位;结论：在美国，除了用于治疗阿片类药物使用障碍的丁丙诺啡外，处方阿片类药物的使用在过去5年中有所减少，需要进一步努力继续优化阿片类药物治疗急性疼痛的适当获取与最大限度地减少转移和治疗阿片类药物成瘾之间的平衡。(C) 2018美国预防医学杂志。Elsevier Inc.出版。版权所有。
Introduction: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade.& para;& para;Methods: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents. Geospatial and state-level analyses were also completed in 2017. & para;& para;Results: The total for ten opioids peaked in 2011 (389.5 metric tons Morphine Milligram Equivalents) relative to both 2006 (286.1) and 2016 (364.6). Changes in the volume of opioids by weight over the decade were agent specific. Since 2011, there were decreases in hydrocodone (-28.4%); oxymorphone (-28.0%); fentanyl (-21.4%); morphine (-18.9%); oxycodone (-13.8%); and meperidine (-58.0%) and an increase in buprenorphine (75.2%) in 2016. There were substantial inter-state variations in rates with a fivefold difference between the highest Morphine Milligram Equivalents in 2016 (Rhode Island=2,623.7 mg/person) relative to the lowest (North Dakota=484.7 mg/person). An association was identified between state median age and per capita Morphine Milligram Equivalents (r =0.49, p < 0.0005).& para;& para;Conclusions: With the exception of buprenorphine, used to treat an opioid use disorder, prescription opioid use has been decreasing over the past 5 years in the U.S. Further efforts are needed to continue to optimize the balance between appropriate opioid access for acute pain while minimizing diversion and treating opioid addiction. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.