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名美国居民死于与阿片类药物相关的过量死亡--惊人地增加了100倍 从1999年开始。随着药物供应、药物需求和政策的变化，阿片类药物危机继续演变。 干预。自2019年以来，这场危机已转变为高死亡率的第四波，其特征是 合成阿片与兴奋剂的混合物，如可卡因或甲基苯丙胺。合成阿片类药物， 具体地说，芬太尼及其类似物仍然是过量死亡的主要驱动因素。我们可以确定这一角色 合成阿片类药物，因为我们有按物质、年龄、种族、民族、性别、 和地理位置。我们缺乏的是及时的国家数据，表明兴奋剂的作用增加 阿片类药物过量死亡。在很大程度上，我们没有意识到阿片类药物危机已经转移到全国范围内，因为数据 直到含有兴奋剂的致命芬太尼鸡尾酒开始两年后才被释放。此外， 我们对个别死者的个人信息知之甚少。如果我们想要遏制阿片类药物过量 为了应对致命药物组合中兴奋剂使用的不断升级，我们需要了解 这些死亡发生得更早的背景，以及突发性事件、个人和病史 治疗企图，与刑事司法系统的互动，毒理学结果，毒品来源，毒品形式， 阿片类药物过量死亡的给药途径和其他相关因素。这些数据是存在的，但目前它们 在其当前状态下不可公开、集中或可用。拟议的研究将解决这一关键问题 阿片类药物研究中的数据限制。为了向预防和缓解战略提供信息，我们将利用关键的时间- 来自致命药物过量的法医调查的敏感信息。这些调查产生了 死亡证明、执法、毒物学和验尸官/法医报告中的数据。这些报告 包含结构化和非结构化的叙述数据，描述了每一起死亡的情况。 目前，研究人员只能通过限制访问访问来获取这些自杀和他杀报告 与联邦政府达成的数据协议。虽然有用，但阿片类药物引起的自杀和杀人案 中毒仅占阿片类药物过量死亡的6%。以获取剩余94%的详细信息 对于非故意的阿片类药物过量死亡，我们需要来自个人的相同的数据元素和描述 州政府。我们将保护有意和无意的服药过量记录，整合我的 这些数据用于确定以前未检查过的诱因事件、个人历史和情况 与吸毒过量有关的死亡案例。此外，我们将量化人口和地区的差异 阿片类药物过量死亡涉及的物质类型。这些目标将为预防和缓解提供信息 努力，包括关键的干预点和毒品供应的变化。我们创建的数据库不会 只允许我们实现这些目标，以解决不断升级的阿片类药物危机，涉及芬太尼和 刺激，但将为广泛的未来研究奠定基础。