Drugs involved in Kentucky drug poisoning deaths and relation with antecedent controlled substance prescription dispensing

Substance Abuse Treatment, Prevention, and Policy

Research

Krassimir Slavov¹  Svetla Slavova²  Edward Freeman³  Patricia R. Freeman⁴  Douglas R. Oyler⁴  Dustin Miracle⁴  Nabarun Dasgupta⁵  Sarah Hargrove⁶  Candice Collins⁷  Jana McAninch⁷ 

[1] Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA;Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA;Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA;Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA;Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA;Injury Prevention Research Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA;Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA;Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA;

关键词: Drug poisoning;    Overdose death;    Opioid;    Prescription monitoring program;    Stimulant;   

DOI  :  10.1186/s13011-023-00561-y

 received in 2023-06-27, accepted in 2023-08-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe shift from prescription to illicit drugs involved in drug poisoning deaths raises questions about the current utility of prescription drug monitoring program (PDMP) data to inform drug poisoning (overdose) prevention efforts. In this study, we describe relations between specific drugs involved in Kentucky drug poisoning deaths and antecedent controlled substance (CS) dispensing.MethodsThe study used linked death certificates and PDMP data for 2,248 Kentucky resident drug poisoning deaths in 2021. Death certificate literal text analysis identified drugs mentioned with involvement (DMI) in drug poisoning deaths. We characterized the concordance between each DMI and the CS dispensing history for this drug at varying timepoints since 2008.ResultsOverall, 25.5% of all decedents had dispensed CS in the month before fatal drug poisoning. Over 80% of decedents were dispensed opioid(s) since 2008; the percentage was similar regardless of opioid involvement in the poisoning death. One-third of decedents had dispensed buprenorphine for treatment of opioid use disorder since 2008, but only 6.1% had dispensed buprenorphine in the month preceding death. Fentanyl/fentanyl analogs were DMI in 1,568 (69.8%) deaths, yet only 3% had received a fentanyl prescription since 2008. The highest concordance in the month preceding death was observed for clonazepam (43.6%).ConclusionOverall, concordance between CS dispensing history and the drugs involved in poisoning deaths was low, suggesting a need to reevaluate the complex relationships between prescription medication exposure and overdose death and to expand harm reduction interventions both within and outside the healthcare system to reduce drug poisoning mortality.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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