苏格兰2019冠状病毒病大流行期间接受阿片类激动剂治疗人群的药物相关死亡率风险

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-07-06 DOI:10.1016/j.drugpo.2025.104912

Megan Glancy , Andrew McAuley , Norah Palmateer , Kirsten Trayner , Alan Yeung , Lee Barnsdale , Saket Priyadarshi , Kirsten Horsburgh , Matthew Hickman , Sharon Hutchinson

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引用次数: 0

摘要

背景2019冠状病毒病大流行导致苏格兰阿片类药物激动剂治疗（OAT）递送的变化和药物相关伤害的风险。本研究旨在(i)与前十年（2011-2019）相比，研究苏格兰COVID-19大流行期间（2020-2022年）药物相关死亡率（DRD）的变化和OAT的保护作用；（ii）描述同一时期OAT处方的趋势。方法我们进行了一项回顾性队列研究，使用了苏格兰国家处方信息系统与苏格兰公共卫生保健和行政数据相关的数据。该队列包括处方OAT（美沙酮或丁丙诺啡）的个体。我们检查了OAT处方的趋势，计算了每1000人年的DRD粗发病率，并使用多变量准泊松回归来估计四个时间段（2011-2013年、2014-2016年、2017-2019年和2020-2022年）DRD风险的调整发病率比（aIRR）。结果2011年至2022年期间，共有49,000人参与了OAT，贡献了366,344人年的随访，其间发生了5255例drd。在2019冠状病毒病大流行期间（2020-2022年），有34241人接受了OAT，有1825人接受了drd。在2020年之前，DRD率稳步上升，但在大流行期间保持稳定：2020 - 2022年期间观察到的DRD率与2017-2019年相当（aIRR=0.96, 95% CI=0.80, 1.15）。在所有期间，与不接受治疗相比，接受OAT治疗的患者发生DRD的风险始终较低（aIRR=3.47, 95% CI=2.98, 4.05）。在苏格兰的COVID-19大流行期间，DRD率在2011-13年以来上升了三倍后保持稳定。在大流行病期间，OAT的保护作用得以保持，这突出了在公共卫生危机期间保持获得OAT的重要性。

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Risk of drug-related mortality among people receiving opioid-agonist treatment during the COVID-19 pandemic in Scotland

Background

The COVID-19 pandemic led to changes in delivery of opioid-agonist treatment (OAT) and risk of drug-related harm in Scotland. This study aimed to (i) examine changes in drug-related death (DRD) rates and the protective effect of OAT during the COVID-19 pandemic in Scotland (2020–2022) compared with the previous decade (2011–2019); and (ii) describe trends in OAT prescribing over the same period.

Methods

We conducted a retrospective cohort study using data from the Scottish national Prescribing Information System linked to healthcare and administrative data from Public Health Scotland. The cohort included individuals prescribed OAT (methadone or buprenorphine). We examined trends in OAT prescribing, calculated crude DRD rates per 1000 person-years, and used multivariable quasi-Poisson regression to estimate adjusted incidence rate ratios (aIRR) for DRD risk across four time periods (2011–2013, 2014–2016, 2017–2019, and 2020–2022).

Results

Between 2011 and 2022, 49,000 individuals accessed OAT, contributing 366,344 person years of follow-up, during which 5255 DRDs occurred. In the COVID-19 pandemic period (2020–2022), 34,241 people received OAT and there were 1825 DRDs. DRD rates increased steadily prior to 2020, but remained stable during the pandemic: the observed DRD rate during 2020–2022 was comparable to 2017–2019 (aIRR=0.96, 95 % CI=0.80, 1.15). Across all periods, being on OAT was consistently associated with a lower risk of DRD compared to being off treatment (aIRR=3.47, 95 % CI=2.98, 4.05).

Conclusions

During the COVID-19 pandemic in Scotland, DRD rates remained stable following a three-fold rise since 2011–13. The protective effect of OAT was sustained during the pandemic, which highlights the importance of maintaining access to OAT during public health crises.

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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.