背景:随着时间的推移,在高密度的亚洲城市中,个人水平和社区水平的药物中毒死亡模式的变化被低估了,尽管它们为基于社区的监测和干预提供了必要的信息。
方法:仅病例分析,16岁,全港,我们采用香港基于人群的登记处对2001年至2010年与2011年至2016年的药物中毒死亡病例进行了比较.药物中毒死亡,从海洛因死亡和其他阿片类药物(可待因或吗啡)死亡被提取(ICD编码:T36-T50,T40.1,T40.2).二项回归用于估计死亡率模式的变化。
结果:在3069例药物中毒死亡中,尽管香港的死亡率呈下降趋势,但发现死亡率模式发生了显著变化.总的来说,药物中毒死亡转向中年人/年轻人,丧偶/离婚,经济活跃,白领和非本地出生。自2011年以来,更多死于海洛因的人是老年人和非本地出生的,但更少的人从未结婚,在经济上不活跃。其他阿片类药物导致的死亡更多是中年人,年纪轻轻,离婚了。特别是,大多数死者转向年轻人,尤其是死于其他阿片类药物。与2001-2010年期间的死亡相比,自2021年以来,年龄≥60岁的人因海洛因死亡和因其他阿片类药物死亡的人数分别增加了3.72倍和6.50倍(OR:3.72[2.37,5.86],6.50[3.97,10.65]),分别。此外,药物中毒死亡转移到社区贫困较少的地区(更多的高等教育个人和私人/公共住房居民的混合),尤其是死于其他阿片类药物。
结论:滥用注册药物(例如阿片类止痛药)可能是香港除非法使用毒品(海洛因)以外的脆弱人群中的上升趋势。卫生官员应在药物信息方面提供更多建议和支持。具体来说,应向中/高收入和当地出生的个人提供改善的卫生系统,并进行有关适当使用注册药物进行医疗的教育。
The shifts in individual-level and neighborhood-level patterns of drug poisoning deaths in a high-density Asian city over time have been underestimated, although they provide essential information for community-based surveillance and interventions.
A case-only analysis with a 16-y, territory-wide, population-based registry in Hong Kong was applied to compare drug poisoning deaths from 2001 to 2010 with 2011 to 2016. Drug poisoning deaths, deaths from heroin and deaths from other opioids (codeine or morphine) were extracted (ICD codes: T36-T50, T40.1, T40.2). Binomial regressions were used to estimate the shifts in mortality patterns.
Among 3069 drug poisoning deaths, a significant shift in mortality patterns was found despite a decreasing mortality trend in Hong Kong. Overall, drug poisoning deaths shifted towards middle-aged/young-old, widowed/divorced, economically active, white collar and non-local born. Since 2011, more deaths from heroin were in older ages and non-local born, but less were never married and economically inactive. More deaths from other opioids were middle-aged, young-old and divorced. In particular, most decedents shifted towards young-old, especially deaths from other opioids. Compared with deaths during 2001-2010, there were 3.72- and 6.50-fold more deaths from heroin and deaths from other opioids in those aged ≥60 y since 2021 (ORs: 3.72 [2.37, 5.86], 6.50 [3.97, 10.65]), respectively. Additionally, drug poisoning deaths shifted towards areas with less neighborhood deprivation (more high-education individuals and a mix of private/public housing residents), especially deaths from other opioids.
Misuse of registered drugs (e.g. opioid pain relievers) could be a rising trend among vulnerable subpopulations in Hong Kong other than illegal drug use (heroin). Health officials should provide more advice and support on drug information. Specifically, an improved health system with education regarding the appropriate use of registered drugs for medical treatments should be provided to mid-/high-income and local-born individuals.