加拿大安大略省实施COVID-19紧急措施后阿片类药物毒性死亡模式：每周中断的时间序列

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-04-09 DOI:10.1016/j.drugpo.2025.104797

Valeria Rolle , Nicholas Bakewell , Yingbo Na , Mohammad Karamouzian , Orville Burke , Seff Pinch , Dan Werb , Sanjana Mitra

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引用次数: 0

摘要

2020年3月，加拿大安大略省实施了2019冠状病毒病公共卫生措施，包括关闭学校和非必要的企业、保持身体距离、边境限制和改进卫生服务。我们研究了它们与阿片类药物毒性死亡率变化的关系，并评估了年龄、性别、健康地区和药物类型之间的差异。方法使用安大略省首席验尸官办公室的阿片类药物毒性死亡记录（2019年3月至2021年2月）进行中断时间序列。使用广义线性模型（泊松或负二项），我们估计了第一次（2020年3月17日至5月19日）和第二次（2020年11月23日至2021年2月14日）封锁后以及整个covid -19后时期每周死亡人数的变化，并将干预措施建模为阿片类药物毒性死亡的水平变化。结果在研究期间死亡的3844例患者中，74.4%为男性，中位年龄为40岁（四分位数范围：31 ~ 51）。每周死亡人数从9人到72人不等。全省进入紧急状态和首次封锁后，死亡人数逐步增加，估计死亡率比（RR）为1.21 （95% CI 1.02至1.52）。在covid -19后期间，全省观察到阿片类药物毒性死亡人数总体持续增加（RR为1.11 [95% CI为1.02至1.41]）。初步测量COVID-19后的时间与阿片类药物毒性死亡率的增加有关。未来对突发公共卫生事件的应对措施必须主动减轻与有毒药物有关的危害在物质使用人群中的潜在意外后果。

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Patterns of opioid toxicity deaths after the implementation of COVID-19 emergency measures in Ontario, Canada: a weekly interrupted time series

Background

In March 2020, Ontario, Canada, implemented COVID-19 public health measures, including school and non-essential business closures, physical distancing, border restrictions, and modified health services. We examined their association with changes in opioid toxicity mortality and assessed variations across age, sex, health region, and drug type.

Methods

We conducted an interrupted time series using opioid toxicity death records (March 2019 to February 2021) from the Office of the Chief Coroner for Ontario. Using a generalized linear model (Poisson or negative binomial), we estimated changes in weekly death counts following the first (March 17th to May 19th, 2020) and second (November 23rd, 2020, to February 14th, 2021) lockdowns, as well as the entire post-COVID-19 period, modelling interventions as level shifts in opioid toxicity deaths.

Results

Of 3844 individuals who died within the study period, 74.4 % were male, and the median age was 40 (interquartile range: 31 to 51). Weekly deaths ranged from 9 to 72. Following the province-wide state of emergency and first lockdown, there was a step increase in the number of deaths, with an estimated Rate Ratio (RR) of 1.21 (95 % CI 1.02 to 1.52). Over the duration of the post-COVID-19 period, an overall sustained increase in the number of opioid toxicity deaths (RR 1.11 [95 % CI 1.02 to 1.41]) was observed across the province.

Implications

The period after initial COVID-19 measures was associated with increases in opioid toxicity mortality. Future responses to public health emergencies must proactively mitigate the potential unintended consequence of toxic drug-related harms among substance-using populations.

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.