对导致过量用药危机的社会和行为因素的批判性回顾。
A Critical Review of the Social and Behavioral Contributions to the Overdose Epidemic.
机构信息
Center for Opioid Epidemiology and Policy, Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA; email:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10027, USA; email:
出版信息
Annu Rev Public Health. 2021 Apr 1;42:95-114. doi: 10.1146/annurev-publhealth-090419-102727. Epub 2021 Nov 30.
More than 750,000 people in the United States died from an overdose between 1999 and 2018; two-thirds of those deaths involved an opioid. In this review, we present trends in opioid overdose rates during this period and discuss how the proliferation of opioid prescribing to treat chronic pain, changes in the heroin and illegally manufactured opioid synthetics markets, and social factors, including deindustrialization and concentrated poverty, contributed to the rise of the overdose epidemic. We also examine how current policies implemented to address the overdose epidemic may have contributed to reducing prescription opioid overdoses but increased overdoses involving illegal opioids. Finally, we identify new directions for research to understand the causes and solutions to this critical public health problem, including research on heterogeneous policy effects across social groups, effective approaches to reduce overdoses of illegal opioids, and the role of social contexts in shaping policy implementation and impact.
在 1999 年至 2018 年期间，美国有超过 75 万人死于药物过量；其中三分之二的死亡与阿片类药物有关。在这篇综述中，我们介绍了在此期间阿片类药物过量率的趋势，并讨论了阿片类药物处方治疗慢性疼痛的扩散、海洛因和非法制造的阿片类合成药物市场的变化以及包括去工业化和集中贫困在内的社会因素是如何导致药物过量流行的。我们还研究了目前为应对药物过量流行而实施的政策如何可能有助于减少处方类阿片类药物的过量使用，但却增加了涉及非法阿片类药物的过量使用。最后，我们确定了研究这一关键公共卫生问题的新方向，包括研究社会群体之间异质政策效果、减少非法阿片类药物过量的有效方法，以及社会环境在塑造政策实施和影响方面的作用。
Zotero 插件