An age–period–cohort–interaction analysis of meth/amphetamine-related deaths in Australia, 2001–2020

IF 5.3 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-07-01 DOI:10.1111/add.70100

Oisin Stronach, Paul Dietze, Michael Livingston, Amanda Roxburgh

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Abstract

Background and Aims

The number of meth/amphetamine related deaths in Australia has quadrupled in the last 20 years, primarily due to drug toxicity and suicide among individuals in their 30s and 40s. Previous analysis of Australian meth/amphetamine-related deaths covered limited timeframes and causes, and there has been no exploration of the effects of changing cohorts on meth/amphetamine mortality. This paper provides comprehensive insights across 20 years into the evolving cohort trends in meth/amphetamine-related deaths in Australia.

Methods

An age–period–cohort–interaction (APC-I) analysis of Australian meth/amphetamine-related deaths (2001–2020) by cause extracted from the National Coronial Information System, a database of all deaths reported to the coroner in Australia and New Zealand.

Results

APC-I analyses revealed that unintentional drug toxicity deaths peaked at ages 35–38 [Coefficient (Coef) = 0.92; 95% confidence interval (CI) = 1.0–0.8], intentional self-harm deaths peaked at ages 31–34 (Coef = 1.2; 95% CI = 1.4–1.0), unintentional injury deaths peaked at ages 23–26 (Coef = 1.02; 95% CI = 1.2–0.8) and natural cause deaths at 39–42 (Coef = 1.15; 95% CI = 1.4–0.9). Period effects were consistent across all causes, with a mean 29.3% increase in estimated mortality rate from 2001 to 2012, followed by a mean 103.3% increase in estimated mortality rate to 2016, at which time period effects stabilised. Cohort effects revealed that individuals born between 1962 and 1982 (mainly Generation X) faced a higher-than-average mortality risk across all four causes, with risk decreasing in later generations.

Conclusions

Despite different age profiles across the various causes of death, cohort effects suggest a single generation (Generation X: people born between 1962 and 1982) is predominantly experiencing the increase in meth/amphetamine-related mortality observed in Australia over the past 20 years. As Generation X ages, the risk of meth/amphetamine-related natural deaths, especially from cardiovascular disease, is likely to increase.

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2001-2020年澳大利亚冰毒/安非他明相关死亡的年龄期队列相互作用分析

背景和目的：澳大利亚与冰毒/安非他明有关的死亡人数在过去20年中翻了两番，主要是由于药物毒性和30多岁和40多岁的人自杀。以前对澳大利亚冰毒/安非他明相关死亡的分析涵盖了有限的时间范围和原因，并且没有探索改变队列对冰毒/安非他明死亡率的影响。这篇论文提供了20年来澳大利亚冰毒/安非他明相关死亡不断变化的队列趋势的全面见解。方法：对2001-2020年澳大利亚冰毒/安非他明相关死亡进行年龄-时期-队列交互作用（APC-I）分析，按死因提取自国家冠状信息系统，该系统是澳大利亚和新西兰向验尸官报告的所有死亡数据库。结果：APC-I分析显示，非故意药物毒性死亡在35-38岁达到高峰[系数(Coef) = 0.92；95%可信区间(CI) = 1.0-0.8]，故意自残死亡在31-34岁达到高峰(Coef = 1.2；95% CI = 1.4-1.0)，意外伤害死亡在23-26岁达到高峰(Coef = 1.02；95% CI = 1.2-0.8)和39-42岁的自然原因死亡(Coef = 1.15；95% ci = 1.4-0.9)。期间效应在所有原因中都是一致的，从2001年到2012年，估计死亡率平均增加29.3%，随后到2016年，估计死亡率平均增加103.3%，在此期间，时间段效应趋于稳定。队列效应显示，1962年至1982年之间出生的人（主要是X一代）在所有四种原因中面临的死亡风险都高于平均水平，后代的风险降低。结论：尽管各种死亡原因的年龄分布不同，但队列效应表明，在过去20年里，澳大利亚观察到的与冰毒/安非他明有关的死亡率增加主要发生在一代人（X一代：1962年至1982年之间出生的人）身上。随着X一代年龄的增长，与冰毒/安非他明相关的自然死亡风险，特别是心血管疾病的风险可能会增加。

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

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.