Observed transition from opioid analgesic deaths toward heroin
Observed transition from opioid analgesic deaths toward heroin
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DOI：
10.1016/j.drugalcdep.2014.10.005
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发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Proescholdbell, Scott K.
中科院分区：
文献类型：
--
作者：
Dasgupta, Nabarun;Creppage, Kathleen;Proescholdbell, Scott K.
背景资料：在美国，受管制物质导致的过量死亡率在过去二十年中有所增加，主要涉及处方阿片类镇痛剂。最近，有人猜测从处方阿片类药物使用过渡到海洛因，但对过量死亡的影响尚未评估。方法：北卡罗来纳州居民的时间序列研究，2007年至2013年。处方阿片类药物与海洛因过量死亡的每月比率。非参数局部回归模型，以确定从涉及处方阿片类药物过量的时间转移到heroine.Results：有4332过量死亡涉及处方阿片类药物，455涉及海洛因，其中包括44人都参与（总N = 4743）。观察到海洛因死亡率逐渐增加的6年转变。2007年1月，每例海洛因死亡有16例阿片类镇痛药死亡; 2013年12月，每例海洛因死亡有3例处方阿片类药物死亡。向海洛因的过渡似乎是在采用抗篡改类阿片镇痛剂之前开始的。海洛因死者的死亡年龄向年轻人转移。大多数海洛因和阿片类镇痛药死亡发生在大都市地区，2007年至2013年变化不大。结论：观察到的海洛因过量死亡增加不再被认为是推测。据指出，年轻人的死亡人数尤其增加，这表明有针对性的干预措施有了新的方向。需要进行更多的生命统计以外的研究，以了解从处方阿片类药物转向海洛因的根本原因。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Background: In the United States, overdose mortality from controlled substances has increased over the last two decades, largely involving prescription opioid analgesics. Recently, there has been speculation on a transition away from prescription opioid use toward heroin, however the impact on overdose deaths has not been evaluated.Methods: Time series study of North Carolina residents, 2007 through 2013. Monthly ratio of prescription opioid-to-heroin overdose deaths. Non-parametric local regression models used to ascertain temporal shifts from overdoses involving prescription opioids to heroin.Results: There were 4332 overdose deaths involving prescription opioids, and 455 involving heroin, including 44 where both were involved (total n = 4743). A gradual 6-year shift toward increasing heroin deaths was observed. In January, 2007, for one heroin death there were 16 opioid analgesic deaths; in December, 2013 there were 3 prescription opioid deaths for each heroin death. The transition to heroin appears to have started prior to the introduction of tamper-resistant opioid analgesics. The age of death among heroin decedents shifted toward younger adults. Most heroin and opioid analgesic deaths occurred in metropolitan areas, with little change between 2007 and 2013.Conclusions: The observed increases in heroin overdose deaths can no longer be considered speculation. Deaths among younger adults were noted to have increased in particular, suggesting new directions for targeting interventions. More research beyond vital statistics is needed to understand the root causes of the shift from prescription opioids to heroin. (C) 2014 Elsevier Ireland Ltd. All rights reserved.