Harms associated with prescription drug misuse in Ireland: A national observational study of trends in treatment demand, non-fatal intentional drug overdoses and drug related deaths 2010–2020

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-04-04 DOI:10.1016/j.drugalcdep.2025.112669

Louise Durand , Ella Arensman , Paul Corcoran , Caroline Daly , Kathleen Bennett , Suzi Lyons , Eamon Keenan , Gráinne Cousins

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引用次数: 0

Abstract

Aims

To describe the health-related harms associated with the misuse of benzodiazepines/z-drugs, prescription opioids, gabapentinoids, and psychostimulants in Ireland by examining trends in their involvement in treatment demand, non-fatal intentional drug overdoses (IDOs), and drug related deaths (DRDs).

Methods

A repeated cross-sectional study using data from the National Drug Treatment Reporting System (NDTRS), the National Self-Harm Registry Ireland (NSHRI) and the National Drug Related Deaths Index (NDRDI) between 2010 and 2020. Trends over time (2010–2020) in treatment demand, IDOs and DRDs involving benzodiazepines/z-drugs, prescription opioids excluding opioid agonist therapy drugs, gabapentinoids, or psychostimulants (alone or concurrently), adjusting for age and gender (Negative Binomial Regression).

Findings

A total of 102,661 treatment entry cases; 51,126 people presenting with at least one IDO; and 3626 DRDs included. Benzodiazepines/z-drugs were involved in 341 per 1000 treatment entry cases; 408 per 1000 IDOs; and 546 per 1000 DRDs, followed by prescription opioids (36 per 1000 treatment entry cases; 133 per 1000 IDOs; and 207 per 1000 DRDs) and gabapentinoids (5 per 1000 treatment entry cases; 54 per 1000 IDOs; and 118 per 1000 DRDs). Benzodiazepines/z-drugs, and prescription opioid involvement was stable over time with little or no changes observed in treatment demand, IDOs and DRDs. However, NPS-Benzodiazepines (etizolam) involvement in DRDs increased by 47 % annually (Adjusted Rate Ratio (ARR) 1.47, 95 % Confidence Interval (CI) 1.30–1.65, p < 0.0001). Gabapentinoids (primarily pregabalin) associated with a large annual increase in treatment demand (+44 % annually, ARR 1.44, 95 % CI 1.36–1.52, p < 0.0001), DRDs (+35 % annually, ARR 1.35, 95 % CI 1.25–1.46, p < 0.0001), and IDOs (+9 % annually, ARR 1.09, 95 % CI 1.07–1.10, p < 0.0001). Polysubstance use harms increased with respect to treatment demand, IDOs and DRDs over study period.

Conclusions

While benzodiazepines account for the greatest overall harm with respect to treatment demand, IDOs and DRDs, gabapentinoids (primarily pregabalin) had the largest annual increase in harm over the study period.

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爱尔兰与处方药滥用相关的危害：2010-2020年治疗需求、非致命性故意药物过量和药物相关死亡趋势的全国观察性研究

目的通过检查爱尔兰滥用苯二氮卓类药物/z类药物、处方阿片类药物、加巴喷丁类药物和精神兴奋剂在治疗需求、非致命性故意药物过量（IDOs）和药物相关死亡（DRDs）方面的趋势，描述与健康相关的危害。方法利用2010年至2020年国家药物治疗报告系统（NDTRS）、爱尔兰国家自残登记处（NSHRI）和国家药物相关死亡指数（NDRDI）的数据进行重复横断面研究。治疗需求的长期趋势（2010-2020年），涉及苯二氮卓类药物/z类药物、处方阿片类药物(不包括阿片类激动剂治疗药物、加巴喷丁类药物或精神兴奋剂（单独或同时）的IDOs和DRDs，调整年龄和性别（负二项回归）。共102,661例入组治疗病例；51,126人至少有一种IDO；包括3626个drd。每1000例入院治疗病例中有341例涉及苯二氮卓类药物/z类药物；每1000个ipo中有408个；每1000例drd中有546例，其次是处方阿片类药物(每1000例入院治疗病例中有36例；每1000个ido中有133个；每1000例drd中有207例)和加巴喷丁类药物(每1000例接受治疗的病例中有5例；每1000宗ipo中有54宗；118 / 1000 DRDs)。随着时间的推移，苯二氮卓类药物/z-药物和处方阿片类药物的参与是稳定的，治疗需求、IDOs和DRDs几乎没有变化。然而，nps -苯二氮卓类药物（乙唑仑）参与DRDs的比例每年增加47%（调整比率比（ARR） 1.47, 95%置信区间（CI） 1.30-1.65, p < 0.0001）。加巴喷丁类药物（主要是普瑞巴林）与治疗需求每年大幅增加（每年+ 44%，ARR 1.44, 95% CI 1.36-1.52, p < 0.0001）、DRDs（每年+ 35%，ARR 1.35, 95% CI 1.25-1.46, p < 0.0001）和IDOs（每年+ 9%，ARR 1.09, 95% CI 1.07-1.10, p < 0.0001）相关。在研究期间，多物质使用对治疗需求、IDOs和DRDs的危害有所增加。结论：虽然苯二氮卓类药物在治疗需求、IDOs和DRDs方面的总体危害最大，但加巴喷丁类药物（主要是普瑞巴林）在研究期间的危害年增幅最大。

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来源期刊

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.