@article{ref1,
title="Evolving trends in U.S. mortality from opioid overdose: heroin and beyond",
journal="American journal of medicine",
year="2023",
author="Ghaddar, Tarek and Ferris, Allison and Mejia, Maria C. and Ravi, Srekar M. and Levine, Robert S. and Hennekens, Charles H. and Caceres, Jennifer",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE Our objective was to explore evolving trends in US drug overdose mortality overall and by age, gender, race, urbanization, and geography from 1999-2020.  Methods This is a descriptive epidemiologic study. We used the US Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research and Multiple Cause of Death files from the National Center for Health Statistics. We used crude and age-adjusted cause of death and mortality rate ratios (MRR) as measures of effects and 95% confidence limits to test for significance.  Results From 1999-2020, drug overdoses caused 1,013,852 deaths and 4.3-fold increase in MRR. Subgroup findings were gender (4.5 men, 4.0 women), race (4.6 white, 3.9 black or African American, 4.0 Asian or Pacific Islanders, 5.1 Native Americans or Alaskan Natives), age (highest 5.6 in 25-34, lowest 1.1 in 75-84, and 0.77 in 85+), geography (highest 6.0 in Midwest, lowest 2.6 in West), and urbanization (highest 6.2 in non-metro, lowest 3.7 in metro).  Conclusions Drug overdoses in the US from 1999-2020 increased 4.3-fold with the highest increase in white and Native Americans or Alaskan Natives, and Midwest and non-metro areas. The data create preventive and therapeutic challenges including restrictions on pharmaceutical industries and enhanced efforts by healthcare providers in safer prescribing. Addiction care should be integrated into all clinical practices, regardless of specialty, and into undergraduate, graduate, and continuing medical education. Targeted interventions are needed to adequately assess patients and provide care. Analytic studies designed a priori are necessary to test hypotheses formulated from these data.<p /> <p>Language: en</p>",
language="en",
issn="0002-9343",
doi="10.1016/j.amjmed.2023.08.004",
url="http://dx.doi.org/10.1016/j.amjmed.2023.08.004"
}