Carfentanil and the rise and fall of overdose deaths in the United States.
Carfentanil and the rise and fall of overdose deaths in the United States.
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DOI：
10.1111/add.15260
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Burke DS
中科院分区：
文献类型：
--
作者：
Jalal H;Burke DS
人们普遍认为，2018年美国过量死亡人数的下降可归因于一系列公共卫生干预措施；然而，这一下降也与有效芬太尼类似物，特别是卡芬太尼的监管和使用减少不谋而合。这项研究的目的是调查过量死亡与卡芬太尼在美国的可得性之间的关系。来自疾病控制中心和卡芬太尼的药物过量死亡的二次分析展示了提交给毒品犯罪实验室并由禁毒署(DEA)发布的毒品缉获数据。比较了卡芬太尼含量较高的州与卡芬太尼含量较低或没有卡芬太尼含量的州的过量死亡趋势。美国。研究人员对1979年至2019年期间美国共有1,035,923例吸毒过量死亡记录进行了研究。研究结果是各州的服药过量死亡人数和死亡率。药物过量死亡一直沿着指数曲线密切跟踪。2016年和2017年出现了超指数级激增，过量死亡人数分别增加了11,228人(+21.4%)和6,605人(+10.4%)。随后在2018年，药物过量死亡人数下降了−2,870人(−4.1%)。这一上升和下降恰逢卡芬太尼药物缉获展品在同一年出现激增和下降：0(2015)、1292(2016)、5,857(2017)和804(2018)。卡芬太尼的大部分展品都局限于几个州。在2017年卡芬太尼展品数量激增最多的前五个州(俄亥俄州、佛罗里达州、宾夕法尼亚州、肯塔基州和密歇根州)，2018年过量死亡人数下降了2848人，几乎占了美国总降幅的全部。2016-2017年间美国吸毒过量死亡人数的加速增长和2018年的下降与卡芬太尼可获得性的突然上升和下降有关。考虑到地区差异，卡芬太尼可获得性的减少可能是2018年过量死亡减少的原因之一。
It is widely believed that the 2018 decline in overdose deaths in the United States was attributable to a range of public health interventions; however, this decline also coincided with the regulation and decline in use of potent fentanyl analogs, especially carfentanil. The aim of this study was to investigate the association between overdose deaths and carfentanil availability in the United States. Secondary analysis of drug overdose deaths from the Center for Disease Control and carfentanil exhibit data from drug seizures submitted to drug crime labs and published by the Drug Enforcement Administration (DEA). Trends in overdose deaths were compared in states with high carfentanil exhibits with states with low or no carfentanil exhibits. United States. A total of 1,035,923 drug overdose death records in the United States from 1979 through 2019 were studied. The outcomes studied were number of overdose deaths and mortality rates by state. Drug overdose deaths have been closely tracking along an exponential curve. The years 2016 and 2017 witnessed a hyper-exponential surge with increases in overdose deaths of 11,228 (+21.4%), and 6,605 (+10.4%), respectively. Subsequently in 2018, drug overdose deaths declined by −2,870 (−4.1%). This rise and then fall coincided with a surge and then decline in carfentanil drug seizure exhibits during these same years: 0 (2015), 1292 (2016), 5,857 (2017) and 804 (2018). The majority of carfentanil exhibits were localized to a few states. The 2018 decline in overdose deaths in the top five states with the greatest spike in carfentanil exhibits in 2017 (Ohio, Florida, Pennsylvania, Kentucky and Michigan) was 2,848, which accounted for nearly all of the total US decline. The 2016-2017 acceleration and then 2018 decline in drug overdose deaths in the United States was associated with the sudden rise and then fall of carfentanil availability. Given the regional variation, carfentanil’s decreased availability may have contributed to the reduction in overdose deaths in 2018.
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DOI：
10.1126/science.aau1184
发表时间：
2018-09-21
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Jalal H;Buchanich JM;Roberts MS;Balmert LC;Zhang K;Burke DS
通讯作者：
Burke DS
影响因子：
13.8
作者：
Sohn, Minji;Talbert, Jeffery C.;Freeman, Patricia R.
通讯作者：
Freeman, Patricia R.
影响因子：
6
作者：
Young, April M.;Havens, Jennifer R.
通讯作者：
Havens, Jennifer R.
影响因子：
4.2
作者：
Freeman, Patricia R.;Hankosky, Emily R.;Talbert, Jeffery C.
通讯作者：
Talbert, Jeffery C.
影响因子：
12.7
作者：
King, Andrew;Foley, Daniel;Hlavaty, Leigh
通讯作者：
Hlavaty, Leigh