Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study
Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study
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DOI：
10.1016/s0140-6736(10)62353-7
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发表时间：
2011-04-23
期刊：
影响因子：
168.9
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Marshall, Brandon D. L.;Milloy, M-J;Kerr, Thomas
背景非法药物过量是北美过早死亡的主要原因。在国际上，作为减少与吸毒有关的危害的各种战略的一部分，已经开放了65个以上的受监督注射设施，吸毒者可以在这些设施中注射预先获得的非法药物。我们试图确定是否在温哥华，不列颠哥伦比亚省，加拿大的SIF开幕，与减少过量mortality.Methods我们研究了人口为基础的过量死亡率之前（2001年1月1日至2003年9月20日）和之后（2003年9月21日至2005年12月31日）开幕的温哥华SIF。死亡地点是根据省验尸官的记录确定的。我们比较了过量的死亡率在先验指定的500米半径的SIF和其他城市。结果290死者，229（79.0%）是男性，死亡的中位年龄为40岁（IQR 32-48岁）。三分之一（89，30.7%）的死亡发生在城市街区内的SIF 500米。在SIF开放后，该地区的致死性药物过量率下降了35.0%，从每10万人年253.8例死亡降至165.1例死亡（p=0.048）。相比之下，在同一时期，该市其他地区的致命过量死亡率仅下降了9.3%，从每10万人年7.6人下降到6.9人（p=0.490）。有一个显着的相互作用率差异的分层（p=0.049）。解释SIF应考虑注射药物使用是普遍的，特别是在高密度的过量的地区。
Background Overdose from illicit drugs is a leading cause of premature mortality in North America. Internationally, more than 65 supervised injecting facilities (SIFs), where drug users can inject pre-obtained illicit drugs, have been opened as part of various strategies to reduce the harms associated with drug use. We sought to determine whether the opening of an SIF in Vancouver, BC, Canada, was associated with a reduction in overdose mortality.Methods We examined population-based overdose mortality rates for the period before (Jan 1, 2001, to Sept 20, 2003) and after (Sept 21, 2003, to Dec 31, 2005) the opening of the Vancouver SIF. The location of death was determined from provincial coroner records. We compared overdose fatality rates within an a priori specified 500 m radius of the SIF and for the rest of the city.Findings Of 290 decedents, 229 (79.0%) were male, and the median age at death was 40 years (IQR 32-48 years). A third (89, 30.7%) of deaths occurred in city blocks within 500 m of the SIF. The fatal overdose rate in this area decreased by 35.0% after the opening of the SIF, from 253.8 to 165.1 deaths per 100000 person-years (p=0.048). By contrast, during the same period, the fatal overdose rate in the rest of the city decreased by only 9.3%, from 7.6 to 6.9 deaths per 100 000 person-years (p=0.490). There was a significant interaction of rate differences across strata (p=0.049).Interpretation SIFs should be considered where injection drug use is prevalent, particularly in areas with high densities of overdose.