Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska Native populations from 1999 to 2019: a retrospective longitudinal ecological study.
Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska Native populations from 1999 to 2019: a retrospective longitudinal ecological study.
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DOI：
10.1136/bmjopen-2021-053686
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发表时间：
2022-05-02
期刊：
影响因子：
2.9
通讯作者：
Dixit, Amruta
中科院分区：
文献类型：
--
作者：
Qeadan, Fares;Madden, Erin F.;Mensah, Nana A.;Tingey, Benjamin;Herron, Jalene;Hernandez-Vallant, Alexandra;Venner, Kamilla L.;English, Kevin;Dixit, Amruta
自世纪之交以来，美国药物过量死亡率增加了两倍多，美国印第安人/阿拉斯加原住民（AI/AN）人口的死亡率高得不成比例。关于人工智能/非阿片类药物和阿片类药物/多种物质相关死亡率的总体历史趋势知之甚少。这项研究将解决这一差距。这是一项回顾性的纵向生态学研究。使用疾病控制和预防中心广泛的流行病学研究在线数据获取1999年至2019年的美国死亡记录。12岁及以上的美国非西班牙裔AI/AN人员。通过《国际疾病和相关健康问题统计分类法典》第十次修订确定的主要结果包括(1)仅因类阿片、类阿片与任何其他物质混合、与所有类阿片有关的过量使用造成的过量死亡；(2)类阿片与酒精、类阿片与甲基苯丙胺、类阿片与可卡因、类阿片与苯二氮卓类药物的组合；(3)阿片类药物的具体类型。从1999年到2019年，AI/AN女性的阿片类药物死亡率从每10万人2.8人增加到15.8人（p<0.001）， AI/AN男性的死亡率从每10万人4.6人增加到25.6人（p<0.001）。所有阿片类药物相关死亡率显著增加（p<0.001），从每10万AI/AN人口中的5.2人增加到33.9人，女性从3.9人增加到26.1人，男性从6.5人增加到42.1人。阿片类药物和酒精、阿片类药物和苯二氮卓类药物、阿片类药物和甲基苯丙胺导致的死亡率也显著上升，而且阿片类药物和可卡因导致的死亡率大幅上升。随着时间的推移，海洛因、天然和半合成（处方）以及除美沙酮以外的合成阿片类药物（芬太尼/芬太尼类似物）的个别阿片类药物死亡率显著增加。这些发现突出了阿片类药物相关死亡随着时间的推移而放大，并可能指出可能不成比例地影响人工智能/人工智能社区成员并导致不平等的更广泛的系统性因素。
The rate of drug overdose deaths in the USA has more than tripled since the turn of the century, and rates are disproportionately high among the American Indian/Alaska Native (AI/AN) population. Little is known about the overall historical trends in AI/AN opioid-only and opioid/polysubstance-related mortality. This study will address this gap. This is a retrospective longitudinal ecological study. US death records from 1999 to 2019 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research. US non-Hispanic AI/AN people age 12 years and older. The primary outcomes, identified via the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes, included overdose deaths due to (1) opioids only, opioids in combination with any other substance, all-opioid related overdoses; (2) combinations of opioids and alcohol, opioids and methamphetamine, opioids and cocaine, opioids and benzodiazepines; and (3) specific types of opioids. From 1999 to 2019, opioid-only mortality rates increased from 2.8 to 15.8 per 100 000 (p<0.001) for AI/AN women and 4.6 to 25.6 per 100 000 (p<0.001) for AI/AN men. All opioid-related mortality rates increased significantly (p<0.001) from 5.2 to 33.9 per 100 000 AI/AN persons, 3.9 to 26.1 for women and 6.5 to 42.1 for men. AI/AN also exhibited significant increases in mortality rates due to opioids and alcohol, opioids and benzodiazepines, opioids and methamphetamine, and AI/AN men experienced substantial increases in mortality due to opioids and cocaine. Mortality rates by individual opioid types increased significantly over time for heroin, natural and semi-synthetic (prescription), and synthetic opioids (fentanyl/fentanyl analogues) other than methadone. These findings highlight magnification over time in opioid-related deaths and may point to broader systemic factors that may disproportionately affect members of AI/AN communities and drive inequities.
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影响因子：
3.4
作者：
Meacham, Meredith C.;Strathdee, Steffanie A.;Garfein, Richard S.
通讯作者：
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影响因子：
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通讯作者：
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影响因子：
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DOI：
10.1126/science.aau1184
发表时间：
2018-09-21
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Jalal H;Buchanich JM;Roberts MS;Balmert LC;Zhang K;Burke DS
通讯作者：
Burke DS