Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States.
JAMA Netw Open
; 2(2): e187621, 2019 02 01.
Article
em En
| MEDLINE
| ID: mdl-30707224
ABSTRACT
Importance Deaths due to opioid overdose have tripled in the last decade. Efforts to curb this trend have focused on restricting the prescription opioid supply; however, the near-term effects of such efforts are unknown. Objective:
To project effects of interventions to lower prescription opioid misuse on opioid overdose deaths from 2016 to 2025. Design, Setting, andParticipants:
This system dynamics (mathematical) model of the US opioid epidemic projected outcomes of simulated individuals who engage in nonmedical prescription or illicit opioid use from 2016 to 2025. The analysis was performed in 2018 by retrospectively calibrating the model from 2002 to 2015 data from the National Survey on Drug Use and Health and the Centers for Disease Control and Prevention.Interventions:
Comparison of interventions that would lower the incidence of prescription opioid misuse from 2016 to 2025 based on historical trends (a 7.5% reduction per year) and 50% faster than historical trends (an 11.3% reduction per year), vs a circumstance in which the incidence of misuse remained constant after 2015. Main Outcomes andMeasures:
Opioid overdose deaths from prescription and illicit opioids from 2016 to 2025 under each intervention.Results:
Under the status quo, the annual number of opioid overdose deaths is projected to increase from 33â¯100 in 2015 to 81â¯700 (95% uncertainty interval [UI], 63â¯600-101â¯700) in 2025 (a 147% increase from 2015). From 2016 to 2025, 700â¯400 (95% UI, 590â¯200-817â¯100) individuals in the United States are projected to die from opioid overdose, with 80% of the deaths attributable to illicit opioids. The number of individuals using illicit opioids is projected to increase by 61%-from 0.93 million (95% UI, 0.83-1.03 million) in 2015 to 1.50 million (95% UI, 0.98-2.22 million) by 2025. Across all interventions tested, further lowering the incidence of prescription opioid misuse from 2015 levels is projected to decrease overdose deaths by only 3.0% to 5.3%. Conclusions and Relevance This study's findings suggest that interventions targeting prescription opioid misuse such as prescription monitoring programs may have a modest effect, at best, on the number of opioid overdose deaths in the near future. Additional policy interventions are urgently needed to change the course of the epidemic.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Base de dados:
MEDLINE
Assunto principal:
Overdose de Drogas
/
Uso Indevido de Medicamentos sob Prescrição
/
Analgésicos Opioides
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
JAMA Netw Open
Ano de publicação:
2019
Tipo de documento:
Article