{"title":"2013-2022 年法国镇痛药医疗使用者致命中毒趋势:DTA 登记分析","authors":"","doi":"10.1016/j.puhe.2024.08.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To describe analgesic-related deaths in France and report trends over a 10-year period.</p></div><div><h3>Study design</h3><p>The DTA (<em>“Décès Toxiques par Antalgiques”</em>) register is a French database of analgesic-related deaths among people without a history of drug abuse, reported by forensic toxicology experts.</p></div><div><h3>Methods</h3><p>We included analgesic-related deaths occurring from January 2013 to December 2022 in France. Subject demographic characteristics and medical history, forensic autopsy findings, and toxicology reports were evaluated.</p></div><div><h3>Results</h3><p>Among the 1036 deceased individuals (mean [SD] age, 48.3 [15.6] years), there were slightly more women than men (M:F sex ratio, 0.89:1). Over the entire study period, tramadol was the leading cause of death, ahead of morphine. A relative increase in oxycodone-related mortality was observed (from 6.8% in 2013 to 21.1% in 2022) compared to a progressive decrease in tramadol, morphine, and codeine-related deaths (from 43.2%, 31.1% and 24.3% in 2013 to 37.5%, 26.6% and 20.3% in 2022, respectively). However, no statistically significant variations were found (Chi-squared tests of homogeneity). Other analgesics (buprenorphine, dihydrocodeine, fentanyl, gabapentin, ketamine, methadone, nefopam, and pregabalin) were also implicated in deaths, but with low and stable rates over the period studied.</p></div><div><h3>Conclusions</h3><p>In France, no increase in fentanyl-related deaths and only a non-significant increase in oxycodone-related deaths were observed over the period 2013–2022. Tramadol was the leading cause of analgesic-related deaths throughout this period. Although close monitoring is still required, particularly for oxycodone, our data do not support the hypothesis of an opioid crisis in France.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003652/pdfft?md5=5a87931b734fba840f1cfbe1c9880136&pid=1-s2.0-S0033350624003652-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Trends in fatal poisoning among medical users of analgesics in France from 2013 to 2022: an analysis of the DTA register\",\"authors\":\"\",\"doi\":\"10.1016/j.puhe.2024.08.019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To describe analgesic-related deaths in France and report trends over a 10-year period.</p></div><div><h3>Study design</h3><p>The DTA (<em>“Décès Toxiques par Antalgiques”</em>) register is a French database of analgesic-related deaths among people without a history of drug abuse, reported by forensic toxicology experts.</p></div><div><h3>Methods</h3><p>We included analgesic-related deaths occurring from January 2013 to December 2022 in France. Subject demographic characteristics and medical history, forensic autopsy findings, and toxicology reports were evaluated.</p></div><div><h3>Results</h3><p>Among the 1036 deceased individuals (mean [SD] age, 48.3 [15.6] years), there were slightly more women than men (M:F sex ratio, 0.89:1). Over the entire study period, tramadol was the leading cause of death, ahead of morphine. A relative increase in oxycodone-related mortality was observed (from 6.8% in 2013 to 21.1% in 2022) compared to a progressive decrease in tramadol, morphine, and codeine-related deaths (from 43.2%, 31.1% and 24.3% in 2013 to 37.5%, 26.6% and 20.3% in 2022, respectively). However, no statistically significant variations were found (Chi-squared tests of homogeneity). Other analgesics (buprenorphine, dihydrocodeine, fentanyl, gabapentin, ketamine, methadone, nefopam, and pregabalin) were also implicated in deaths, but with low and stable rates over the period studied.</p></div><div><h3>Conclusions</h3><p>In France, no increase in fentanyl-related deaths and only a non-significant increase in oxycodone-related deaths were observed over the period 2013–2022. Tramadol was the leading cause of analgesic-related deaths throughout this period. Although close monitoring is still required, particularly for oxycodone, our data do not support the hypothesis of an opioid crisis in France.</p></div>\",\"PeriodicalId\":49651,\"journal\":{\"name\":\"Public Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0033350624003652/pdfft?md5=5a87931b734fba840f1cfbe1c9880136&pid=1-s2.0-S0033350624003652-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0033350624003652\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0033350624003652","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
研究设计DTA("Décès Toxiques par Antalgiques")登记册是法国的一个数据库,收录了法医毒理学专家报告的无药物滥用史的镇痛药相关死亡病例。结果在1036名死者中(平均[标码]年龄为48.3[15.6]岁),女性略多于男性(男女性别比为0.89:1)。在整个研究期间,曲马多是导致死亡的主要原因,排在吗啡之前。据观察,与羟考酮相关的死亡率相对上升(从2013年的6.8%上升到2022年的21.1%),而与曲马多、吗啡和可待因相关的死亡率则逐渐下降(分别从2013年的43.2%、31.1%和24.3%下降到2022年的37.5%、26.6%和20.3%)。然而,并未发现统计学上的显著差异(卡方同质性检验)。其他镇痛药(丁丙诺啡、双氢可待因、芬太尼、加巴喷丁、氯胺酮、美沙酮、奈福泮和普瑞巴林)也与死亡有关,但在研究期间发生率较低且保持稳定。在此期间,曲马多是导致镇痛药相关死亡的主要原因。尽管仍需密切监测,尤其是对羟考酮的监测,但我们的数据并不支持法国阿片类药物危机的假设。
Trends in fatal poisoning among medical users of analgesics in France from 2013 to 2022: an analysis of the DTA register
Objective
To describe analgesic-related deaths in France and report trends over a 10-year period.
Study design
The DTA (“Décès Toxiques par Antalgiques”) register is a French database of analgesic-related deaths among people without a history of drug abuse, reported by forensic toxicology experts.
Methods
We included analgesic-related deaths occurring from January 2013 to December 2022 in France. Subject demographic characteristics and medical history, forensic autopsy findings, and toxicology reports were evaluated.
Results
Among the 1036 deceased individuals (mean [SD] age, 48.3 [15.6] years), there were slightly more women than men (M:F sex ratio, 0.89:1). Over the entire study period, tramadol was the leading cause of death, ahead of morphine. A relative increase in oxycodone-related mortality was observed (from 6.8% in 2013 to 21.1% in 2022) compared to a progressive decrease in tramadol, morphine, and codeine-related deaths (from 43.2%, 31.1% and 24.3% in 2013 to 37.5%, 26.6% and 20.3% in 2022, respectively). However, no statistically significant variations were found (Chi-squared tests of homogeneity). Other analgesics (buprenorphine, dihydrocodeine, fentanyl, gabapentin, ketamine, methadone, nefopam, and pregabalin) were also implicated in deaths, but with low and stable rates over the period studied.
Conclusions
In France, no increase in fentanyl-related deaths and only a non-significant increase in oxycodone-related deaths were observed over the period 2013–2022. Tramadol was the leading cause of analgesic-related deaths throughout this period. Although close monitoring is still required, particularly for oxycodone, our data do not support the hypothesis of an opioid crisis in France.
期刊介绍:
Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.