Circumstances surrounding alcohol toxicity deaths and prior pharmacotherapy for alcohol use disorder in Ontario, Canada.

IF 2.2 4区 医学 Q3 SUBSTANCE ABUSE
William Wynne, Anita Iacono, Joanna Yang, Bisola Hamzat, Pamela Leece, Gillian Kolla, Rob Boyd, Nikki Bozinoff, Mike Franklyn, Dana Shearer, Ashley Smoke, Fangyun Wu, Paul Newcombe, Tara Gomes
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Abstract

Introduction: Despite a high prevalence of alcohol use disorder (AUD) in Canada, access to medication-based treatment remains poor. Therefore, our aim was to explore patterns of alcohol toxicity deaths in Ontario, Canada, circumstances surrounding death, prior healthcare interactions, and pharmacotherapy for AUD.

Methods: We conducted a population-based repeated cross-sectional study of alcohol toxicity deaths occurring between 1 January 2018 and 30 June 2022 in Ontario, Canada. We reported trends in deaths over time and determined demographic characteristics of decedents, circumstances surrounding death, and prior healthcare interactions. Among a subset of the cohort with an AUD diagnosis eligible for public drug benefits, we reported receipt of medications used to treat AUD before death.

Results: We identified 1346 alcohol toxicity deaths over the study period, at a median age of 42 years, with 73.8% occurring among men. The majority of alcohol toxicity deaths involved other substances, including opioids (75.2%), benzodiazepines (10.8%), and/or stimulants (45.2%). Half had an AUD (50.4%) and 62.7% had an opioid, benzodiazepine or stimulant use disorder. Among decedents who were public drug beneficiaries with an AUD (N = 361), only 3.6% were actively prescribed first-line AUD pharmacotherapies (naltrexone and/or acamprosate) at time of death.

Conclusions: We found that the majority of alcohol toxicity deaths in Ontario involved other non-alcohol substances. We also detected a high prevalence of prior healthcare encounters for substance use disorders (SUDs) and low prevalence of evidence-based AUD pharmacotherapy. This suggests a need for integrated treatment across concurrent SUDs and improved access to pharmacotherapies for AUD across Ontario.

Abstract Image

Abstract Image

加拿大安大略省酒精中毒死亡和先前药物治疗酒精使用障碍的情况。
简介:尽管加拿大酒精使用障碍(AUD)的患病率很高,但获得药物治疗的机会仍然很差。因此,我们的目的是探讨加拿大安大略省酒精中毒死亡的模式、死亡环境、既往医疗保健相互作用和AUD的药物治疗。方法:我们对加拿大安大略省2018年1月1日至2022年6月30日期间发生的酒精毒性死亡进行了一项基于人群的重复横断面研究。我们报告了随时间推移的死亡趋势,并确定了死者的人口统计学特征、死亡周围环境和先前的医疗保健相互作用。在诊断为AUD的队列中有资格获得公共药物福利的子集中,我们报告了在死亡前接受用于治疗AUD的药物。结果:在研究期间,我们确定了1346例酒精毒性死亡,中位年龄为42岁,其中73.8%发生在男性中。大多数酒精毒性死亡涉及其他物质,包括阿片类药物(75.2%)、苯二氮卓类药物(10.8%)和/或兴奋剂(45.2%)。一半患有澳元(50.4%),62.7%患有阿片类药物、苯二氮卓类药物或兴奋剂使用障碍。在公共药物受益人(N = 361)的死者中,只有3.6%的人在死亡时积极服用一线AUD药物治疗(纳曲酮和/或阿坎普罗酸)。结论:我们发现安大略省大多数酒精中毒死亡涉及其他非酒精物质。我们还发现,药物使用障碍(sud)的既往医疗遭遇的患病率很高,而循证AUD药物治疗的患病率很低。这表明需要对并发sud进行综合治疗,并改善安大略省AUD患者获得药物治疗的机会。
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来源期刊
Alcohol and alcoholism
Alcohol and alcoholism 医学-药物滥用
CiteScore
4.70
自引率
3.60%
发文量
62
审稿时长
4-8 weeks
期刊介绍: About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.
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