PDF(Pubmed)
Abstract：
Background: Rates of psychostimulant use, misuse, and hospitalization have increased markedly over the past decade. The objective of this study was to estimate the association between receipt of a psychostimulant prescription in the past year and fatal, unintentional psychostimulant-involved overdose. Methods: We conducted a population-based case-control study using linked, state-level databases from the Rhode Island Department of Health. Cases were defined as Rhode Island residents who experienced a fatal, unintentional drug overdose involving a psychostimulant, and controls included non-psychostimulant involved fatal overdoses occurring between May 1, 2017 and May 31, 2020 The primary exposure of interest was receipt of a psychostimulant prescription within 12 months prior to death, ascertained through linkage to the state\'s prescription drug monitoring program. Conditional logistic regression was used to estimate unadjusted and adjusted odds ratios. Results: Of 894 eligible overdose fatalities, the majority were white/non-Hispanic (72%), mean age was 43 years, and most resided in Providence County (69%). A total of 39 (4%) involved a psychostimulant. After adjusting for year of death and matching by sex, age, and county of residence, cases had 4.1 (95% confidence interval: 1.6, 10.6) times the odds of receiving a prescription stimulant in the past year compared to controls. Conclusions: Our findings suggest that there is a strong, positive association between prescription psychostimulant receipt and psychostimulant-involved fatal overdose. In response to an evolving polysubstance use landscape, current harm reductions measures, including naloxone training, fentanyl test strip distribution, and overdose education, should be expanded to include patients who receive psychostimulant prescriptions.
摘要：
背景：精神兴奋剂使用率，误用，在过去的十年中，住院率显著增加。这项研究的目的是评估在过去一年中接受精神兴奋剂处方与致命疾病之间的关系。无意的精神兴奋剂过量。方法：我们进行了一项基于人群的病例对照研究，来自罗德岛州卫生部的州级数据库。病例被定义为罗德岛居民经历了致命的死亡，涉及精神兴奋剂的意外药物过量，和对照组包括2017年5月1日至2020年5月31日期间发生的非精神兴奋剂致命性过量，主要的暴露是在死亡前12个月内收到精神兴奋剂处方，通过与国家的处方药监测计划的链接确定。使用条件逻辑回归来估计未调整和调整的比值比。结果：在894例合格的过量死亡中，大多数是白人/非西班牙裔(72%)，平均年龄是43岁,大多数居住在普罗维登斯县（69％）。共有39例（4％）涉及精神兴奋剂。在调整死亡年份和性别匹配后，年龄,和居住县，与对照组相比,病例在过去一年中接受处方兴奋剂的几率为4.1倍(95%置信区间:1.6,10.6).结论：我们的研究结果表明，有一个强大的，接受处方精神兴奋剂和精神兴奋剂致死性过量之间的正相关。为了应对不断发展的多物质使用环境，目前的减害措施，包括纳洛酮训练,芬太尼试纸分布,和过量教育，应该扩大到包括接受精神兴奋剂处方的患者。
