Leveraging state drug overdose data to build a comprehensive case level national dataset to inform prevention and mitigation strategies.

利用州药物过量数据建立全面的病例级国家数据集，为预防和缓解策略提供信息。

• 批准号: 10701215
• 负责人: Lori Ann Post
• 金额: $ 25.96万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10701215
• 关键词: Accidents; Address; Age; Agreement; Censuses; Cessation of life; Characteristics; Cocaine; Coroners and Medical Examiners; County; Criminal Justice; Data; Data Element; Data Science; Data Set; Databases; Death Certificates; Death Rate; Demography; Drug Combinations; Economics; Epidemiologist; Epidemiology; Ethnic Origin; Event; Federal Government; Fentanyl; Foundations; Frequencies; Funding; Gender; Geographic Locations; Geography; Government Agencies; Health; Homicide; Imprisonment; Individual; Informatics; Interdisciplinary Study; Intervention; Intoxication; Investigation; Law Enforcement; Location; Medical Examiners; Medical History; Medicine; Mental Health; Methamphetamine; Methods; Opioid; Overdose; Persons; Pharmaceutical Preparations; Police; Policies; Prevention; Prevention strategy; Process; Public Health; Race; Recording of previous events; Records; Reporting; Research; Research Personnel; Resources; Role; Route; Rural; Secure; Signal Transduction; Sociology; Source; State Government; Stimulant; Structure; Suicide; System; Time; Toxicology; United States; Universities; Variant; Violence; Vital Statistics; Woman; access restrictions; addiction; analog; combat; comparative; data exchange; data sharing; epidemiologic data; epidemiology study; implementation science; men; mortality; novel therapeutics; opioid epidemic; opioid mortality; opioid overdose; opioid use disorder; overdose death; response; sex; stimulant use; structured data; synthetic opioid; unstructured data; usability

Project Summary In 2021, 80,816 US residents died from an opioid-related overdose death—an astounding 100-fold increase since 1999. The opioid crisis continues to evolve with changes in the drug supply, drug demand, and policy intervention. Since 2019, the crisis has shifted into a ‘fourth wave’ of high mortality, characterized by the mixture of synthetic opioids with stimulants, such as cocaine or methamphetamine. Synthetic opioids, specifically fentanyl and its analogs, are still the major driver of overdose deaths. We can identify the role of synthetic opioids because we have national data to track deaths by substance, age, race, ethnicity, gender, and geographical location. What we don’t have is timely national data signaling the increased role of stimulants in opioid overdose deaths. Largely, we were unaware that the opioid crisis had shifted nationally because data were not released until two years after the onset of lethal fentanyl cocktails that included a stimulant. Moreover, we know very little about the personal details of individual decedents. If we want to curb opioid overdose deaths and respond to the escalating use of stimulants in fatal drug combinations, we need to understand the context in which those deaths occur sooner along with precipitating events, personal and medical history, prior treatment attempts, interactions with the criminal justice system, toxicology results, drug sources, drug forms, routes of administration, and other correlates of opioid overdose deaths. These data exist, but currently they are not publicly available, centralized, or usable in their current state. The proposed study will solve this key data limitation in opioid research. To inform prevention and mitigation strategies, we will leverage critical, time- sensitive information from medicolegal investigations of fatal drug overdoses. These investigations produce data from death certificates, law enforcement, toxicology, and coroner/medical examiner reports. The reports contain both structured and unstructured narrative data, which describe the circumstances around each death. Currently, researchers can only access these reports for suicides and homicides through Restricted Access to Data agreements with the federal government. While useful, suicides and homicides caused by opioid poisoning account for only 6% of opioid overdose deaths. To obtain detailed information on the remaining 94% of “unintentional” opioid overdose deaths, we need the same data elements and narratives from individual state governments. We will secure both intentional and unintentional overdose records, integrate, and mine these data to identify previously unexamined precipitating events, personal histories, and circumstances surrounding drug overdose deaths. Furthermore, we will quantify demographic and regional variation in the types of substances involved in opioid overdose deaths. These objectives will inform prevention and mitigation efforts, including critical intervention points and changes in the drug supply. The database we create will not only allow us to achieve these objectives to address the escalating opioid crisis that involves fentanyl and stimulants but will lay the foundation for extensive future research.

项目摘要 2021年，80,816名美国居民死于阿片类药物相关的过量死亡 - 惊人的100倍 自1999年以来。阿片类药物危机继续随着药物供应，药物需求和政策的变化而演变 干涉。自2019年以来，这场危机已转变为“第四波”高死亡率，其特征是 合成阿片类药物与兴奋剂（例如可卡因或甲基苯丙胺）的混合物。合成阿片类药物， 特别是芬太尼及其类似物，仍然是过量死亡的主要驱动力。我们可以确定 综合阿片类药物是因为我们有国家数据可以通过实质，年龄，种族，种族，性别，性别， 和地理位置。我们没有的是及时的国家数据信号表明兴奋剂的作用增加 在阿片类药物过量死亡中。在很大程度上，我们没有意识到阿片类药物危机在全国范围内发生了变化 在包括兴奋剂的致命芬太尼鸡尾酒发作后的两年后才被释放。而且， 我们对个人决策的个人细节知之甚少。如果我们想遏制阿片类药物过量 死亡并应对致命药物组合中兴奋剂的升级使用，我们需要了解 这些死亡随着造成的事件，个人和病史而更快发生的背景 治疗尝试，与刑事司法系统的互动，毒理学结果，药物来源，药物形式， 给药途径以及阿片类药物过量死亡的其他相关性。这些数据存在，但目前 在当前状态下不公开，集中式或可用。拟议的研究将解决此键 阿片类药物研究中的数据限制。为了告知预防和缓解策略，我们将利用关键，时间 - 对致命药物过量的医疗研究研究的敏感信息。这些调查会产生 死亡证明，执法，毒理学和验尸官/医学检查员的数据报告。报告 包含结构化和非结构化叙事数据，这些数据描述了每次死亡的情况。 目前，研究人员只能通过限制访问来访问自杀和同型剂的这些报告 与联邦政府达成数据协议。虽然有用，但由Oopioid引起的自杀和凶杀 中毒仅占阿片类药物过量死亡的6％。获取有关其余94％的详细信息 在“无意”的阿片类药物过量死亡中，我们需要个人的数据元素和叙述 州政府。我们将确保有意和意外的过量记录，集成和矿山 这些数据以识别以前未经审查的降水事件，个人历史和情况 周围的药物过量死亡。此外，我们将量化人口统计和区域差异 阿片类药物过量死亡的物质类型。这些目标将为预防和缓解措施提供信息 努力，包括关键干预点和药物供应的变化。我们创建的数据库将不会 仅允许我们实现这些目标，以解决涉及芬太尼和的阿片类药物危机的升级 兴奋剂，但将为未来的广泛研究奠定基础。