马萨诸塞州阿片类药物相关过量死亡和处方率的时间趋势

S. Pagsuyoin, Jiayue Luo, Jana Latayan
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引用次数: 1

摘要

吸毒成瘾给医疗保健系统和社会带来巨大负担。仅在美国,2015年阿片类药物成瘾的成本就超过5000亿美元,每年有超过5万人死于与阿片类药物有关的过量服用。卫生政策制定者依靠药物监测数据,通过干预项目来解决这一问题。在这项初步研究中,我们研究了马萨诸塞州阿片类药物相关死亡与阿片类药物处方之间的时间趋势和关系。近年来,该州与阿片类药物相关的过量用药和死亡人数显著增加;目前,马萨诸塞州被确定为该国阿片类药物危机的热点。从不同的州机构获得并整理了各县阿片类药物处方、相关死亡和人口普查的年度数据(2013-2017)。按县计算的年死亡率和处方率分别除以相应的年人口,得到死亡率和处方率。所有年度数据均为正态分布,因此采用Pearson相关分析确定年度死亡率与处方率之间的关系。我们发现,从2013年到2016年,死亡率每年显著($\ mathm {p} < 0.05$)上升;平均处方率在2015年最高,但过去两年呈下降趋势。我们没有发现同年死亡率与处方率之间的强相关性($\vert \ mathm {r}_{\max}\vert = 0.24, \ mathm {p}_{\min}=0.4$)。我们也没有发现当年死亡率与前一年处方率之间有很强的相关性($\vert \ mathm {r}_{\max}\vert =0.17, \ mathm {p}_{\min}=0.6$)。应该强调的是,本研究的范围有限,因为只考虑了两个变量(处方和死亡);还有其他因素(例如,药物获取、负担能力、疾病等)决定了阿片类药物成瘾,这些因素没有包括在我们的分析中。此外,仅凭处方数据并不能提供有关实际人均消费率的充分信息(即,还需要剂量、药物类型和补药次数)。尽管如此,研究结果可以提供一些关于获得阿片类药物的见解,特别是通过非法途径或滥用来源的阿片类药物。例如,在处方率下降但死亡率继续上升的地方,干预措施可包括控制潜在的其他药物来源。
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Temporal Trends in Opioids-Related Overdose Deaths and Prescription Rates in Massachusetts
Drug addiction exerts tremendous burdens on healthcare systems and societies. In the United States alone, opioids addiction cost over $500 billion in 2015 and over 50,000 people die each year from opioid-related overdoses. Health policymakers rely on drug surveillance data to combat this problem through intervention programs. In this preliminary study, we examine the temporal trends and relationship between opioids-related deaths and opioids prescription in Massachusetts. Opioids-related overdoses and fatalities have significantly increased in the state in recent years; currently, Massachusetts is identified as a hotspot in the opioids crisis in the country. By county yearly data (2013–2017) on opioids prescriptions, related deaths, and census were obtained and collated from different state agencies. Yearly deaths and prescription by county were divided by the corresponding yearly population to yield death rates and prescription rates, respectively. All yearly data were found to be normally distributed, thus Pearson correlation analysis was carried out to determine relationships between yearly death rates and prescription rates. We found significant ($\mathrm{p} < 0.05$) yearly increases in death rates from 2013 to 2016; average prescription rates were highest in 2015 but trends were decreasing in the last two years. We did not find strong correlations ($\vert \mathrm{r}_{\max}\vert = 0.24, \mathrm{p}_{\min}=0.4$) between same-year death and prescription rates. We also did not find strong correlations between current year death rates and immediate previous year prescription rates ($\vert \mathrm{r}_{\max}\vert =0.17, \mathrm{p}_{\min}=0.6$). It should be emphasized that this study is limited in scope in that only two variables were considered (prescription and death); there are other contributing factors (e.g., drug access, affordability, illness, etc.) that determine opioids addiction that were not included in our analysis. Furthermore, prescription data alone do not provide sufficient information regarding actual per capita consumption rate (i.e., dosages, drug type, and number of refills are also needed). Nonetheless, research findings can provide some insights with respect to access to opioids, particularly for opioids sourced through illicit routes or misuse. For example, where death rates continue to increase despite declining prescription rates, intervention measures may include controlling potential other drugs sources.
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