Temporal trend of drug overdose-related deaths and excess deaths during the COVID-19 pandemic: a population-based study in the United States from 2012 to 2022.

IF 9.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2024-07-26 eCollection Date: 2024-08-01 DOI:10.1016/j.eclinm.2024.102752
Yunyu Zhao, Yi Liu, Fan Lv, Xinyuan He, Wee Han Ng, Sikai Qiu, Lanting Zhang, Zixuan Xing, Yuxin Guo, Jian Zu, Yee Hui Yeo, Fanpu Ji
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引用次数: 0

Abstract

Background: Drug overdose is an escalating public health crisis in the United States (U.S.). This study evaluated the temporal trend of drug overdose-related deaths in the U.S., with an emphasis on identifying disparities across subpopulations and the contributing drugs.

Methods: Using the nationwide death dataset from the National Vital Statistics System (NVSS), we estimated the drug overdose-related age-standardized mortality rate (ASMR) and temporal trends for individuals aged 12 and older from 2012 to 2022. Excess mortality during the Coronavirus disease 2019 (COVID-19) pandemic was evaluated based on the pre-pandemic trends using predictive modeling analysis.

Findings: Among 809,967 overdose-related deaths during 2012-2022, ASMR increased by 8.9% [95% confidence interval (CI): 6.0%-11.9%] per year from 2012 to 2019 and increased to 12.9% (95% CI: 2.1%-24.8%) from 2019 to 2022, with the excess ASMR of 16.9% in 2020, increased to 26.4% in 2021 and then decreased to 19.3% in 2022. Significant age, sex, racial/ethnic and geographic disparities were demonstrated, with adolescents (annual percentage change [APC]:21.6%) and males (APC:13.6%) having the most pronounced increase during the pandemic. Ethnic minorities especially the non-Hispanic American Indian/Alaska Native experienced the highest excess ASMR (33.1% in 2020). Illicit fentanyl and synthetics starting with the lowest ASMR in 2012 (1.0 per 100,000), marked the most dramatic increase and became the leading cause of overdose-related death since 2016 (7.5 per 100,000), leading to the highest ASMR by 2022 (27.4 per 100,000). All drug types except heroin experienced varying degrees of excess ASMRs, with prescription opioid pain relievers (23.5%-55.1%), benzodiazepines (27.4%-40.9%) and antidepressants (10.4%-17.8%) exhibiting consistent increases from 2020 to 2022, while the excess ASMRs for illicit fentanyl and synthetics (25.3%-10.0%), psychostimulants (32.8%-14.6%) and methadone (35.0%-33.3%) decreased between 2021 and 2022.

Interpretation: Overdose-related mortality is increasing at an alarming rate, and the stark differences point to the need for targeted interventions to reduce the burden of drug overdose deaths.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

COVID-19大流行期间吸毒过量相关死亡和超额死亡的时间趋势:2012年至2022年在美国开展的一项基于人群的研究。
背景:吸毒过量是美国不断升级的公共卫生危机。本研究评估了美国药物过量相关死亡的时间趋势,重点是确定不同亚人群和致病药物之间的差异:利用美国国家生命统计系统(NVSS)的全国死亡数据集,我们估算了 2012 年至 2022 年期间 12 岁及以上人群与吸毒过量相关的年龄标准化死亡率(ASMR)和时间趋势。根据大流行前的趋势,利用预测模型分析评估了 2019 年冠状病毒病(COVID-19)大流行期间的超额死亡率:在2012-2022年期间的809,967例用药过量相关死亡中,ASMR从2012年到2019年每年增加8.9%[95%置信区间(CI):6.0%-11.9%],从2019年到2022年增加到12.9%(95% CI:2.1%-24.8%),2020年的超额ASMR为16.9%,2021年增加到26.4%,2022年下降到19.3%。在年龄、性别、种族/族裔和地域方面都存在显著差异,其中青少年(年度百分比变化[APC]:21.6%)和男性(年度百分比变化[APC]:13.6%)在大流行期间的增幅最为明显。少数民族,尤其是非西班牙裔美国印第安人/阿拉斯加原住民的 ASMR 超标率最高(2020 年为 33.1%)。非法芬太尼和合成药物在 2012 年的 ASMR 最低(每 100,000 人中有 1.0 人),但自 2016 年(每 100,000 人中有 7.5 人)以来,其增幅最为显著,成为过量相关死亡的主要原因,到 2022 年,其 ASMR 达到最高(每 100,000 人中有 27.4 人)。除海洛因外,所有类型的药物都出现了不同程度的 ASMR 超标,其中处方阿片类止痛药(23.5%-55.1%)、苯二氮卓类(27.4%-40.9%)和抗抑郁药(10.4%-17.从 2020 年到 2022 年,非法芬太尼和合成药物(25.3%-10.0%)、精神兴奋剂(32.8%-14.6%)和美沙酮(35.0%-33.3%)的超额 ASMRs 持续上升,而从 2021 年到 2022 年,非法芬太尼和合成药物(25.3%-10.0%)、精神兴奋剂(32.8%-14.6%)和美沙酮(35.0%-33.3%)的超额 ASMRs 有所下降:与用药过量相关的死亡率正在以惊人的速度上升,这种明显的差异表明需要采取有针对性的干预措施来减轻用药过量死亡的负担:本研究未从公共、商业或非营利部门的资助机构获得任何特定资助。
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
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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