Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017.
Drug and Opioid-Involved Overdose Deaths - United States, 2013-2017.
复制标题
DOI：
10.15585/mmwr.mm6751521e1
复制
发表时间：
2018-01-04
期刊：
影响因子：
--
通讯作者：
Baldwin, Grant
中科院分区：
文献类型：
--
作者：
Scholl, Lawrence;Seth, Puja;Baldwin, Grant
2016年美国有63632例药物过量致死案例，较2015年增长了21.4%；其中三分之二的死亡案例涉及阿片类药物（1）。从2015年到2016年，所研究的所有药物类别中的药物过量致死案例都有所增加；增长幅度最大的是涉及美沙酮以外的合成阿片类药物（合成阿片类药物）的死亡案例，其中包括非法制造的芬太尼（IMF）（1）。自2013年以来，主要受包括芬太尼类似物（2 - 4）在内的IMF推动，当前这波阿片类药物过量流行的特点是涉及合成阿片类药物的死亡案例增加。IMF导致了过量致死案例的增加，且存在地域差异（1）。美国疾病控制与预防中心（CDC）研究了2013 - 2017年期间50个州和哥伦比亚特区（DC）所有药物过量致死率的州级变化，以及20个州涉及合成阿片类药物致死率的变化。此外，还按人口统计学特征、县的城市化水平以及34个州和DC，研究了2016年到2017年涉及所有阿片类药物和阿片类药物子类别的致死率变化。2017年的70237例药物过量致死案例中，47600例（67.8%）涉及阿片类药物。从2013年到2017年，50个州中的35个州和DC的药物过量致死率有所上升，20个州中的15个州涉及合成阿片类药物的致死率显著上升，这很可能是由IMF推动的（2，3）。从2016年到2017年，涉及所有阿片类药物和合成阿片类药物的过量致死案例增加，但涉及处方阿片类药物和海洛因的死亡案例保持稳定。由于涉及合成阿片类药物的死亡案例持续增加，阿片类药物过量流行的情况继续恶化和演变。2018年的初步数据显示一些药物过量指标可能有所改善；然而，有必要对2018年的最终数据进行分析以确认。更及时和全面的监测数据对于为预防和应对阿片类药物过量的工作提供信息至关重要；迫切需要加强预防和应对措施，以遏制涉及处方和非法阿片类药物，特别是IMF的死亡案例。
The 63,632 drug overdose deaths in the United States in 2016 represented a 21.4% increase from 2015; two thirds of these deaths involved an opioid (1). From 2015 to 2016, drug overdose deaths increased in all drug categories examined; the largest increase occurred among deaths involving synthetic opioids other than methadone (synthetic opioids), which includes illicitly manufactured fentanyl (IMF) (1). Since 2013, driven largely by IMF, including fentanyl analogs (2-4), the current wave of the opioid overdose epidemic has been marked by increases in deaths involving synthetic opioids. IMF has contributed to increases in overdose deaths, with geographic differences reported (1). CDC examined state-level changes in death rates involving all drug overdoses in 50 states and the District of Columbia (DC) and those involving synthetic opioids in 20 states, during 2013-2017. In addition, changes in death rates from 2016 to 2017 involving all opioids and opioid subcategories,* were examined by demographics, county urbanization levels, and by 34 states and DC. Among 70,237 drug overdose deaths in 2017, 47,600 (67.8%) involved an opioid. From 2013 to 2017, drug overdose death rates increased in 35 of 50 states and DC, and significant increases in death rates involving synthetic opioids occurred in 15 of 20 states, likely driven by IMF (2,3). From 2016 to 2017, overdose deaths involving all opioids and synthetic opioids increased, but deaths involving prescription opioids and heroin remained stable. The opioid overdose epidemic continues to worsen and evolve because of the continuing increase in deaths involving synthetic opioids. Provisional data from 2018 indicate potential improvements in some drug overdose indicators; however, analysis of final data from 2018 is necessary for confirmation. More timely and comprehensive surveillance data are essential to inform efforts to prevent and respond to opioid overdoses; intensified prevention and response measures are urgently needed to curb deaths involving prescription and illicit opioids, specifically IMF.