美国匹兹堡大学Donald S. Burke和Hawre Jalal团队，分析了阿片类药物和其他药物过量使用产生死亡风险的年龄和世代模式。该研究于2020年5月4日在线发表在《自然-医学》上。
对661565例从1999年至2017年因用药过量而死亡的病例分析中，研究人员发现在不同出生年份的人群中年龄特异的用药过量死亡率曲线按高斯形曲线上升和下降。与之前所有出生年份的人相比，连续出生年份人群死亡率曲线上升部分加速上升。
这种加速可归因于两个不同的过程：一个稳定的高峰年龄，从一个出生年份的人群到下一个出生年份人群死亡率曲线的幅度不断增加；或死亡率曲线峰值年龄出现年轻化趋势。
过量的流行病在1945年至1964年的人群（婴儿潮）中出现并呈上升趋势，在1965年至1980年的人群（X世代）中向年轻人转移，然后在1981年至1990年的千禧一代中恢复了上升趋势。这些转变的年龄和世代模式可能是由社会经济因素和药物供应造成的，对此了解对于制定有效的药物过量预防措施至关重要。
据了解，在美国，不断发展的药物滥用趋势是复杂且动态的，在政策制定和评估时应考虑这种趋势。在美国，近40年来药物滥用造成的死亡（主要归因于阿片类药物滥用）已连续成倍增长，但这种增长的机制却鲜为人知。
附：英文原文
Title: Age and generational patterns of overdose death risk from opioids and other drugs
Author: Hawre Jalal, Jeanine M. Buchanich, David R. Sinclair, Mark S. Roberts, Donald S. Burke
Issue&Volume: 2020-05-04
Abstract: The ongoing substance misuse epidemic in the United States is complex and dynamic and should be approached as such in the development and evaluation of policy1. Drug overdose deaths (largely attributable to opioid misuse) in the United States have grown exponentially for almost four decades, but the mechanisms of this growth are poorly understood2. From analysis of 661,565 overdose deaths from 1999 to 2017, we show that the age-specific drug overdose mortality curve for each birth-year cohort rises and falls according to a Gaussian-shaped curve. The ascending portion of each successive birth-year cohort mortality curve is accelerated compared with that of all preceding birth-year cohorts. This acceleration can be attributed to either of two distinct processes: a stable peak age, with an increasing amplitude of mortality rate curves from one birth-year cohort to the next; or a youthward shift in the peak age of the mortality rate curves. The overdose epidemic emerged and increased in amplitude among the 1945–1964 cohort (Baby Boomers), shifted youthward among the 1965–1980 cohort (Generation X), and then resumed the pattern of increasing amplitude in the 1981–1990 Millennials. These shifting age and generational patterns are likely to be driven by socioeconomic factors and drug availability, the understanding of which is important for the development of effective overdose prevention measures.
DOI: 10.1038/s41591-020-0855-y
Source: https://www.nature.com/articles/s41591-020-0855-y
Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
官方网址：https://www.nature.com/nm/
投稿链接：https://mts-nmed.nature.com/cgi-bin/main.plex
本期文章：《自然—医学》：Online/在线发表
