Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids
Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids
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DOI：
10.2105/ajph.2016.303627
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发表时间：
2017-03-01
影响因子：
12.7
通讯作者：
Compton, Wilson M.
中科院分区：
文献类型：
--
作者：
Jones, Christopher McCall;Baldwin, Grant T.;Compton, Wilson M.
目标。评估可卡因过量死亡的趋势，并检查阿片类药物在这些死亡中的作用。我们使用国家生命统计系统（National Vital Statistics System）收集的2000年至2015年美国药物过量死亡数据，计算可卡因相关药物过量死亡的总体年增长率和数量，以及涉及和不涉及阿片类药物的死亡人数。我们用连接点回归评估了统计学上显著的趋势变化。2000年至2006年，与可卡因有关的过量死亡率从每10万人1.26人大幅增加到2.50人，2010年下降到1.35人，2015年增加到2.13人。2000年至2006年，涉及阿片类药物的可卡因相关过量死亡人数从0.37人增加到0.91人，2010年下降到0.57人，2015年增加到1.36人。与可卡因相关的非阿片类药物过量死亡从2000年的0.89增加到2006年的1.59，然后在2015年下降到0.78。阿片类药物，主要是海洛因和合成阿片类药物，导致最近与可卡因有关的过量死亡人数增加。这与美国日益增长的海洛因和非法制造的芬太尼的供应和使用相对应。
Objectives. To assess trends in cocaine overdose deaths and examine the role opioids play in these deaths.Methods. We used data on drug overdose deaths in the United States from 2000 to 2015 collected in the National Vital Statistics System to calculate annual rates and numbers of cocaine-related overdose deaths overall and deaths both involving and not involving opioids. We assessed statistically significant changes in trends with joinpoint regression.Results. Rates of cocaine-related overdose deaths increased significantly from 1.26 to 2.50 per 100 000 population from 2000 to 2006, declined to 1.35 in 2010, and increased to 2.13 in 2015. Cocaine-related overdose deaths involving opioids increased from 0.37 to 0.91 from 2000 to 2006, declined to 0.57 in 2010, and then increased to 1.36 in 2015. Cocaine-related overdose deaths not involving opioids increased from 0.89 to 1.59 from 2000 to 2006 and then declined to 0.78 in 2015.Conclusions. Opioids, primarily heroin and synthetic opioids, have been driving the recent increase in cocaine-related overdose deaths. This corresponds to the growing supply and use of heroin and illicitly manufactured fentanyl in the United States.