Abstract：
Background: Accidental opioid-involved overdose deaths are increasing nationally in the wake of the COVID-19 pandemic, but it is unclear if this reflects a change in populations most at risk. Objective: To determine whether the demographic characteristics and controlled substance prescription history of accidental opioid-involved drug overdose decedents in 2020 differed from prior years. Methods: We identified accidental opioid-involved overdose decedents using Rhode Island (RI) State Medical Examiner\'s Office data. Decedents were linked to the RI Prescription Drug Monitoring Program database. We compared demographic characteristics and prescription history by year of death. Results: From 2018 to 2020, 763 RI residents died from accidental opioid-involved overdose in RI. From 2018 to 2019, deaths decreased by 7%, but then increased by 31% from 2019 to 2020. Demographic characteristics were similar by year of death (all p > 0.05). The percentage of decedents with a prior opioid prescription and a prior benzodiazepine prescription declined from 2018 to 2020 (p < 0.01 and p = 0.03). Conclusions: We found that opioid-involved overdose deaths in RI are increasing overall, but without significant changes in demographics. While prior exposure to some controlled substances did decline over time, it is not clear if these changes reflect more responsible prescribing practices, or a more concerning pattern such as patient abandonment or decreased healthcare access. More studies are needed to better describe the current trend of increasing opioid-involved deaths while also pursuing current evidence-based interventions.
摘要：
背景：在COVID-19大流行之后，全国范围内与阿片类药物有关的意外过量死亡人数正在增加，但目前尚不清楚这是否反映了高危人群的变化.目标：确定2020年意外阿片类药物过量患者的人口统计学特征和受控物质处方史是否与往年不同。方法：我们使用罗德岛州（RI）州立医学检查官办公室的数据确定了意外阿片类药物参与的过量死者。死者与RI处方药监测计划数据库相关联。我们比较了按死亡年份划分的人口统计学特征和处方史。结果：从2018年到2020年，763名RI居民死于RI中意外阿片类药物过量。从2018年到2019年，死亡人数下降了7%，但从2019年到2020年增长了31%。不同死亡年份的人口统计学特征相似(均p>0.05)。从2018年到2020年，既往有阿片类药物处方和苯二氮卓类药物处方的死者百分比下降(p<0.01和p=0.03)。结论：我们发现RI中阿片类药物参与的过量死亡总体上正在增加，但人口结构没有重大变化。虽然以前接触过一些受控物质确实随着时间的推移而下降，目前尚不清楚这些变化是否反映出更负责任的处方做法，或更令人担忧的模式，如患者放弃或减少医疗服务。需要更多的研究来更好地描述当前与阿片类药物有关的死亡人数增加的趋势，同时也追求当前基于证据的干预措施。
