在全州范围内实施芬太尼持有法和阿片类药物相关的过量死亡。

IF 11.3 Q1 HEALTH CARE SCIENCES & SERVICES
Cole Jurecka, Joella Adams, Pranav Padmanabhan, Jason Glanz, Paul Christine, Xiaoyu Guan, Danielle Kline, Ingrid Binswanger, Joshua Barocas
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引用次数: 0

摘要

重要性:2022年,科罗拉多州通过立法,将持有少量芬太尼(一种强效合成阿片类药物)定为重罪。科罗拉多州的法律是否影响阿片类药物过量死亡,以及这些影响是否因种族和族裔亚群体而异,目前尚不清楚。目的:评估科罗拉多州芬太尼持有的刑事处罚变化与阿片类药物过量死亡(OODs)之间的关系。设计、环境和人群:采用自回归综合移动平均(ARIMA)模型时间序列预测,对2022年7月(2018年1月至2023年11月)颁布的科罗拉多州众议院法案(HB) 22-1326前后的人口估计进行了系列横断面研究,比较了过量死亡的成年人(≥18岁)的ood。每月每10万 万居民的OOD率是使用美国社区调查5年数据和科罗拉多州地方事务部州人口办公室的州人口估计来计算的。药物过量死亡率按种族和族裔(西班牙裔、非西班牙裔黑人和非西班牙裔白人)分别计算。数据分析时间为2018年1月至2023年。暴露:HB 22-1326的颁布将持有任何重量为1克至4克且含有任何数量芬太尼的毒品的法律处罚从轻罪改为4级毒品重罪,可判处最高180天监禁和最长2年缓刑。主要结果:在增加刑事处罚后预期和观察到的不良反应率之间的差异。结果:共分析7099例OODs,其中西班牙裔1798例(25.3%),非西班牙裔黑人451例(6.4%),非西班牙裔白人4170例(58.7%),其他680例(9.5%),不包括在种族和民族类别中。在科罗拉多州的整个研究期间,OODs从2018年1月的20.46 / 100,000 万成年人增加到2023年11月的37.78 / 100,000 万成年人。在不同的种族和族裔群体中,非西班牙裔黑人的ood增幅最高(2018年为9.3 / 10万 万,2023年为56.9 / 10万 万),其次是西班牙裔人口。在HB 22-1326颁布后,总体人群中观察到的和预期的过量死亡之间没有差异。然而,在政策实施后的13个月中,非西班牙裔黑人人口中有4个显著增加。结论和相关性:本系列横断面研究的结果表明,增加对芬太尼持有的刑事处罚并没有改变科罗拉多州先前存在的OODs趋势,并且可能与黑人中阿片类药物过量使用的增加有关。这些结果应该根据研究期间全国黑人阿片类药物过量率的增加来解释。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Implementation of a Statewide Fentanyl Possession Law and Opioid-Related Overdose Deaths.

Implementation of a Statewide Fentanyl Possession Law and Opioid-Related Overdose Deaths.

Implementation of a Statewide Fentanyl Possession Law and Opioid-Related Overdose Deaths.

Importance: In 2022, Colorado passed legislation making possession of small amounts of fentanyl, a high-potency synthetic opioid, a felony. Whether the Colorado law affected opioid overdose fatalities and whether those effects differed by racial and ethnic subgroups is unknown.

Objective: To estimate the association between the change in criminal penalties for fentanyl possession with opioid-related overdose deaths (OODs) in Colorado.

Design, setting, and population: Serial cross-sectional study comparing OODs among adults (≥18 years) who died of an overdose and population estimates before and after Colorado House Bill (HB) 22-1326 was enacted in July 2022 (January 2018-November 2023) using autoregressive integrated moving averages (ARIMA) model time series forecasting. Monthly OOD rates per 100 000 residents were calculated using state population estimates from the American Community Survey 5-Year Data and the Colorado Department of Local Affairs State Demography Office. Overdose death rates were calculated separately by racial and ethnic group (Hispanic, non-Hispanic Black, and non-Hispanic White). Data were analyzed from January 2018 to 2023.

Exposure: Enactment of HB 22-1326 changed the legal penalty for possession of any drug weighing 1 g to 4 g that contained any amount of fentanyl from a misdemeanor to a level-4 drug felony punishable by up to 180 days in jail and up to 2 years of probation.

Main outcome: The difference between expected and observed OOD rates following the enactment of increased criminal penalties.

Results: A total of 7099 OODs were analyzed (1798 Hispanic [25.3%], 451 Non-Hispanic Black [6.4%], and 4170 Non-Hispanic White [58.7%], 680 other [9.5%] and not included in the race and ethnicity categories). OODs increased across the study period in Colorado from 20.46 per 100 000 adults in January 2018 to 37.78 per 100 000 adults in November 2023. Among different racial and ethnic groups, the non-Hispanic Black population had the highest increase in OODs (9.3 per 100 000 in 2018 to 56.9 per 100 000 in 2023) followed by the Hispanic population. There was no difference between the observed and expect overdose deaths for the overall population following the enactment of HB 22-1326. However, there were significant increases in 4 of 13 months after policy implementation among the non-Hispanic Black population.

Conclusions and relevance: The results of this serial cross-sectional study suggest that increased criminal penalties for fentanyl possession did not change preexisting trends of OODs in Colorado and may have been associated with an increase in opioid overdoses in the Black population. These results should be interpreted in light of increasing opioid overdose rates in Black populations nationally during the study period.

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来源期刊
CiteScore
4.00
自引率
7.80%
发文量
0
期刊介绍: JAMA Health Forum is an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health, and health care. The journal publishes original research, evidence-based reports, and opinion about national and global health policy. It covers innovative approaches to health care delivery and health care economics, access, quality, safety, equity, and reform. In addition to publishing articles, JAMA Health Forum also features commentary from health policy leaders on the JAMA Forum. It covers news briefs on major reports released by government agencies, foundations, health policy think tanks, and other policy-focused organizations. JAMA Health Forum is a member of the JAMA Network, which is a consortium of peer-reviewed, general medical and specialty publications. The journal presents curated health policy content from across the JAMA Network, including journals such as JAMA and JAMA Internal Medicine.
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