美国耶鲁大学Balázs Kovács团队研究了美国县级大麻药房数量与阿片类药物相关死亡率之间的关系。2021年1月27日，该研究发表在《英国医学杂志》上。
该研究的目的是探讨县级医疗和娱乐性大麻商店（称为药房）的流行率与阿片相关死亡率之间的相关性。
截至2017年底，美国23个州的812个县允许合法形式的大麻药房运营。研究组使用了美国疾病控制和预防中心的死亡率数据，结合美国人口普查数据和店面药房操作，采用面板回归方法对县级数据进行分析。主要观察指标是与所有阿片类药物类型以及处方阿片类药物、海洛因和除美沙酮以外的合成阿片类药物亚类相关的对数转换、年龄调整死亡率。还分析了医务室和娱乐药房数量与年龄调整死亡率的关系。
县级药房数量（自然对数）与所有阿片类药物相关的对数转换、年龄调整死亡率呈负相关（β=−0.17）。根据这一估计，一个县从一个店面药房增加到两个店面药房，所有与阿片类药物有关的死亡率估计可降低17%。药房数量与美沙酮以外的合成阿片类药物引起的死亡呈极强的负相关（β=−0.21），随着从一个药房增加到两个药房，估计死亡率降低21%。医疗和娱乐店面药房数量与合成（非美沙酮）类阿片相关死亡率之间也存在类似的关联。
研究结果表明，医疗和娱乐店面药房数量增加与阿片类药物相关的死亡率降低有关，尤其是芬太尼等合成阿片类药物相关的死亡。
附：英文原文
Title: Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study
Author: Greta Hsu, Balázs Kovács
Issue&Volume: 2021/01/27
Abstract:
Objective To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates.
Design Panel regression methods.
Setting 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017.
Participants The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods.
Main outcome measure The main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed.
Results County level dispensary count (natural logarithm) is negatively related to the log transformed, age adjusted mortality rate associated with all opioid types (β=0.17, 95% confidence interval 0.23 to 0.11). According to this estimate, an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Dispensary count has a particularly strong negative association with deaths caused by synthetic opioids other than methadone (β=0.21, 95% confidence interval 0.27 to 0.14), with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries. Similar associations were found for medical versus recreational storefront dispensary counts on synthetic (non-methadone) opioid related mortality rates.
Conclusions Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.
DOI: 10.1136/bmj.m4957
Source: https://www.bmj.com/content/372/bmj.m4957
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
投稿链接：https://mc.manuscriptcentral.com/bmj
本期文章：《英国医学杂志》：Online/在线发表
