An examination of Black-White disparities in repeat nonfatal opioid overdose incidents, fatal drug overdose, and all-cause mortality in Detroit, Michigan

IF 3.9 2区 医学 Q1 PSYCHIATRY
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Abstract

Background

There has been an approximately 38 percent increase in overdose deaths for Black men since 2015 yet estimates vary between major metropolitan areas. It is crucial to examine local data to inform community-driven harm reduction and overdose prevention services. We used administrative data to examine the effect of demographic characteristics and repeated nonfatal opioid overdoses (NFOO) on drug-related and all-cause mortality.

Methods

Emergency medical services (EMS) data were linked to vital records to determine fatal drug overdose and all-cause mortality. Demographic measures included age, race (Black/White), and sex (male/female). Binary logistic regression modeling was used to assess the relative influence of each of these factors on the odds of a fatal drug overdose.

Results

Among decedents, 27.0 % (n=47) experienced at least one additional NFOO prior to death. After controlling demographic characteristics, the odds of a fatal drug overdose increased by 17 % for each additional NFOO. Compared to White individuals, Black individuals were 60 % less likely to experience a fatal drug overdose, despite experiencing a significantly greater number of NFOO. All-cause mortality among Black individuals was approximately double that experienced by White individuals following a nonfatal opioid overdose.

Conclusion

There is a high risk of fatal drug overdose in the two-years following a nonfatal opioid overdose, and a greater risk of repeated NFOO. Black individuals’ mortality was associated with non-overdose causes, despite being associated with experiencing a significantly greater number of nonfatal overdoses. Widespread implementation of overdose prevention and general medical care is warranted to curb NFOO and allcause mortality.
对密歇根州底特律市黑人和白人在重复非致命性阿片类药物过量事件、致命性药物过量和全因死亡率方面的差异进行研究。
背景:自 2015 年以来,黑人男性用药过量死亡的人数增加了约 38%,但各大都市地区的估计数字各不相同。研究当地数据至关重要,以便为社区驱动的减低伤害和预防用药过量服务提供信息。我们利用行政数据研究了人口特征和重复非致命性阿片类药物过量(NFOO)对药物相关死亡率和全因死亡率的影响:方法:将紧急医疗服务(EMS)数据与生命记录联系起来,以确定致命性药物过量和全因死亡率。人口统计学指标包括年龄、种族(黑人/白人)和性别(男性/女性)。我们使用二元逻辑回归模型来评估这些因素对吸毒过量致死几率的相对影响:在死者中,27.0%(n=47)的人在死前至少经历过一次额外的NFOO。在控制人口统计学特征后,每增加一次NFOO,致命药物过量的几率就增加17%。与白人相比,尽管黑人经历的NFOO次数要多得多,但他们发生致命药物过量的几率要低60%。黑人在非致命性阿片类药物过量后的全因死亡率约为白人的两倍:结论:在非致命性阿片类药物过量吸食后的两年内,致命性药物过量吸食的风险很高,而反复发生非致命性阿片类药物过量吸食的风险更大。黑人的死亡率与非药物过量原因有关,尽管他们经历的非致命性药物过量次数要多得多。为遏制非致命性阿片类药物过量和全因死亡率,有必要广泛实施过量预防和一般医疗护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Drug and alcohol dependence
Drug and alcohol dependence 医学-精神病学
CiteScore
7.40
自引率
7.10%
发文量
409
审稿时长
41 days
期刊介绍: Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.
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