Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates
Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates
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DOI：
10.1016/j.amepre.2017.06.009
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发表时间：
2017-12-01
影响因子：
5.5
通讯作者：
Ruhm, Christopher J.
中科院分区：
文献类型：
--
作者：
Ruhm, Christopher J.
简介：制定有效政策以解决美国致命过量的快速增长的一个重要障碍是，所涉及的特定药物通常不会在死亡证明上确定。该分析提供了2014年国家阿片类药物和海洛因相关药物死亡率的改进估计值，以及2008年至2014年的变化。方法：报告的死亡率直接从死亡证明中计算，并与未指定药物时插补药物参与的校正率进行比较。结果：在全国范围内，阿片类药物和海洛因相关的校正死亡率分别比报告死亡率高24%和22%。各州的差异各不相同，尤其是宾夕法尼亚州、印第安纳州和路易斯安那州。从2008年到2014年，校正的阿片类药物死亡率的增长与报告的增长几乎相同（每10万人中有2.5人死亡），而校正的海洛因死亡率的变化超过了报告的增长（每10万人中有2.7人死亡，2.3人死亡）。在没有校正的情况下，宾夕法尼亚州、印第安纳州、新泽西和亚利桑那州的阿片类药物死亡率变化被大大低估，但在南卡罗来纳州、新墨西哥州、俄亥俄州、康涅狄格州、佛罗里达和肯塔基州被大大高估。海洛因死亡率的增加被低估，在大多数州，并在宾夕法尼亚州，印第安纳州，新泽西，路易斯安那州和亚拉巴马的大量结论：这里开发的校正程序提供了一个更准确地了解药物中毒的地理差异，并提供重要的信息，以政策制定者试图减少或减缓致命的药物过量的增加。(C)2017年美国预防医学杂志。爱思唯尔公司出版All rights reserved.
Introduction: An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates. This analysis supplies improved estimates of state opioid and heroin involved drug fatality rates in 2014, and changes from 2008 to 2014.Methods: Reported mortality rates were calculated directly from death certificates and compared to corrected rates that imputed drug involvement when no drug was specified. The analysis took place during 2016-2017.Results: Nationally, corrected opioid and heroin involved mortality rates were 24% and 22% greater than reported rates. The differences varied across states, with particularly large effects in Pennsylvania, Indiana, and Louisiana. Growth in corrected opioid mortality rates, from 2008 to 2014, were virtually the same as reported increases (2.5 deaths per 100,000 people) whereas changes in corrected heroin death rates exceeded reported increases (2.7 vs 2.3 per 100,000). Without corrections, opioid mortality rate changes were considerably understated in Pennsylvania, Indiana, New Jersey, and Arizona, but dramatically overestimated in South Carolina, New Mexico, Ohio, Connecticut, Florida, and Kentucky. Increases in heroin death rates were understated in most states, and by large amounts in Pennsylvania, Indiana, New Jersey, Louisiana, and Alabama.Conclusions: The correction procedures developed here supply a more accurate understanding of geographic differences in drug poisonings and supply important information to policymakers attempting to reduce or slow the increase in fatal drug overdoses. (C) 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.