State prescription drug monitoring programs and fatal drug overdoses.
State prescription drug monitoring programs and fatal drug overdoses.
复制标题
国家处方药监测计划和致命药物过量。
DOI：
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发表时间：
2017
影响因子：
3.2
通讯作者：
John R. Moran
中科院分区：
文献类型：
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作者：
Young Hee Nam;D. Shea;Yunfeng Shi;John R. Moran
目标
研究处方药监测计划（PDMP）对药物过量死亡的影响。
研究设计
我们使用了州药物滥用立法和实施时间的变化来估计这些计划对1999年至2014年所有药物类别的药物过量死亡率的影响，并分别为1999年至2010年的每个类别。使用的数据包括美国所有管辖区的死亡率数据，估计的人口数据，以及来自CDC和美国人口普查局的社会人口数据。
方法
多变量回归模型应用于国家面板数据，包括国家和年固定效应和国家特定的线性时间趋势。预程序测试被用来评估我们的经验方法的共同趋势假设。
结果
与没有PDMP的预期死亡率相比，PDMP的实施与总体药物过量或处方阿片类药物过量死亡率的降低无关。对于大多数类别，PDMP与死亡率增加有关，但这种关联在统计学上不显著。在对PDMP实施5年或5年以上的州进行的子样本分析中，发现这些项目与法律的麻醉品、非法药物和其他未指明药物的死亡率显著升高相关。
结论
PDMP与药物过量死亡率的降低无关，可能与非法药物和其他未指明药物的死亡率增加有关。可能需要采取更加全面和以预防为导向的办法，以有效减少吸毒过量死亡，并避免因用作处方类阿片替代品的其他药物而导致致命的吸毒过量。
OBJECTIVES
To examine the impact of prescription drug monitoring programs (PDMPs) on drug overdose deaths.
STUDY DESIGN
We used variation in the timing of state PDMP legislation and implementation to estimate the impact of these programs on drug overdose mortality rates across all drug categories from 1999 to 2014 and separately for each category from 1999 to 2010. Data used include US all-jurisdiction mortality data, estimated population data, and sociodemographic data from the CDC and the US Census Bureau.
METHODS
Multivariate regression models were applied to state panel data, including state and year fixed effects and state-specific linear time trends. Preprogram tests were used to assess the common trends assumption underlying our empirical approach.
RESULTS
The implementation of PDMPs was not associated with reductions in overall drug overdose or prescription opioid overdose mortality rates relative to expected rates in the absence of PDMPs. For most categories, PDMPs were associated with increased mortality rates, but the associations were statistically insignificant. In a subsample analysis of states with PDMPs in operation for 5 or more years, the programs were found to be associated with significantly higher mortality rates in legal narcotics, illicit drugs, and other and unspecified drugs.
CONCLUSIONS
PDMPs were not associated with reductions in drug overdose mortality rates and may be related to increased mortality from illicit drugs and other, unspecified drugs. More comprehensive and prevention-oriented approaches may be needed to effectively reduce drug overdose deaths and avoid fatal overdoses from other drugs used as substitutes for prescription opioids.