The rise in non‐fatal and fatal overdoses involving stimulants with and without opioids in the United States

Addiction - Tập 115 Số 5 - Trang 946-958 - 2020
Brooke Hoots1, Alana M. Vivolo‐Kantor1, Puja Seth1
1Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA

Tóm tắt

AbstractAimsTo examine trends and recent changes in non‐fatal and fatal stimulant overdose rates with and without opioids to improve the descriptive characterization of the US overdose epidemic.DesignSecondary analysis of non‐fatal (2006–16) and fatal (2006–17) drug overdose trends, focusing on the most recent years of data available to examine rate changes by demographics (2015–16 for non‐fatal and 2016–17 for fatal).SettingNon‐fatal drug overdoses from the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample; drug overdose deaths from the National Vital Statistics System.Participants/casesInternational Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) and Tenth Revision, Clinical Modification/Procedure Coding System (ICD‐10‐CM/PCS) codes for cocaine, psychostimulants and opioids were used to classify non‐fatal drug overdoses. Drug overdose deaths were identified using ICD‐10 multiple cause‐of‐death codes for cocaine, psychostimulants, all opioids, heroin and synthetic opioids.MeasurementsPercentage of changes in age‐adjusted non‐fatal and fatal rates of cocaine and psychostimulant‐involved drug overdose with and without opioids.FindingsOverall, cocaine‐involved non‐fatal overdose rates with an opioid increased from 2006 to 2016 [annual percentage change (APC) = 14.7], while rates without an opioid increased from 2006 to 2012 (APC = 11.3) and then remained stable (APC = −7.5). Psychostimulant‐involved non‐fatal rates with and without an opioid increased from 2006 to 2016 (APC = 49.9 with opioids; 13.9 without opioids). Cocaine‐involved death rates with and without opioids increased from 2014 to 2017 (APC = 46.0 with opioids, 23.6 without opioids). Psychostimulant‐involved death rates with opioids increased from 2010 to 2015 (APC = 28.6), with a dramatic increase from 2015 to 2017 (APC = 50.5), while rates without opioids increased from 2008 to 2017 (APC = 22.6). In 2016, 27% of non‐fatal cocaine‐ and 14% of psychostimulant‐involved overdoses included a reported opioid; 72.7% of cocaine‐ and 50.3% of psychostimulant‐involved deaths involved an opioid in 2017. From 2015 to 2016, cocaine‐involved and psychostimulant‐involved non‐fatal overdose rates with an opioid increased 17.0 and 5.9%, respectively; cocaine‐involved and psychostimulant‐involved non‐fatal overdoses without opioids decreased 13.6 and increased 18.9%, respectively. Death rates involving stimulants increased with and without opioids from 2016 to 2017 (cocaine with and without opioids = 37.7 and 23.3%; psychostimulants with and without opioids = 52.2 and 23.0%). Death rates involving stimulants with synthetic opioids increased dramatically from 2016 to 2017 (1.3–2.3 per 100 000 for cocaine and 0.3–0.8 for psychostimulants).ConclusionsWhile increases in cocaine‐involved deaths in the United States from 2006 seem to be driven by opioids, particularly synthetic opioids, increases in non‐fatal and fatal overdoses involving psychostimulants are occurring with and without opioids.

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10.15585/mmwr.mm675152e1

10.15585/mmwr.mm6817a3

10.2105/AJPH.2016.303627

10.1007/s11524-018-00343-z

10.1001/jama.2018.2844

10.1186/s12954-018-0240-z

10.1016/j.drugalcdep.2017.03.011

US Drug Enforcement Administration (USDEA).2018 National Drug Threat Assessment. Springfield VA: USDEA; 2018.

10.15585/mmwr.mm6712a1

Agency for Healthcare Quality and Research.NEDS Overview. Healthcare Cost and Utilization Project (HCUP). Available at:www.hcup‐us.ahrq.gov/nedsoverview.jsp(accessed 15 April 2019).

10.2105/AJPH.2017.304265

10.1093/qjmed/hcr074

US Drug Enforcement Administration (USDEA). DCDNational Forensic Laboratory Information System: NFLIS‐drug. 2017 Annual Report. Springfield VA: USDEA;2018.

Wang Y., 2019, Florida drug‐Related Outcomes and Surveillance Tracking System (FROST)

National Institute on Drug Abuse (NIDA) Fentanyl.NIDA; 20 February2019.

US Department of Health and Human Services (USDHHS).Naloxone: the Opioid Reversal Drug that Saves Lives. Washington DC: USDHHS;2018.

10.1146/annurev.publhealth.012809.103600

10.1016/j.drugpo.2012.07.004

10.1016/j.addbeh.2011.07.017

10.1097/JCP.0000000000000408

10.1111/add.13950

10.1373/49.3.357

10.1186/s12913-018-3756-8

10.1016/j.drugalcdep.2015.12.018

MooreBJ BarrettML.Case study: exploring how opioid‐related diagnosis codes translate from ICD‐9‐CM to ICD‐10‐CM. 24 April2017. Available at:https://www.hcup-;us.ahrq.gov/datainnovations/icd10_resources.jsp.(accessed February 28 2019).

10.1186/s40621-018-0165-8

10.1176/appi.ps.201600450

10.1055/s-0043-105500

10.1001/jama.2015.6303

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Addiction

Tập 115 Số 5

946-958

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