Abstract:
BACKGROUND:Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. OBJECTIVES:The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or more of the following key constructs: prevalence, time trends, mortality rates, and correlates. The term "overdose" as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of nonmajor MeSH terms: "street drugs" and "overdose" yielded 180, "death" and "overdose" yielded 114, and "poisoning" and "drug users" yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. RESULTS:We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n = 17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. CONCLUSIONS:There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Martins SS,Sampson L,Cerdá M,Galea Sdoi
10.2105/AJPH.2015.302843subject
Has Abstractpub_date
2015-11-01 00:00:00pages
e29-49issue
11eissn
0090-0036issn
1541-0048journal_volume
105pub_type
杂志文章,评审abstract:OBJECTIVES:To inform prevention policy, we estimated the economic benefits to health, production, and leisure in the 2008 Australian population of a realistic target reduction in per capita annual adult alcohol consumption. METHODS:We chose a target of 6.4 liters annually per capita on average. We modeled lifetime hea...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300453
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:This study evaluated the effectiveness of a community coalition to prevent severe injuries to children in Central Harlem, New York, NY. It was hypothesized that injury incidence rates would decline during the intervention (1989 through 1991) relative to preintervention years (1983 through 1988); that the dec...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.84.4.580
更新日期:1994-04-01 00:00:00
abstract::Five years after the Three Mile Island nuclear accident, the mental health of women who had been pregnant and living within 10 miles of Three Mile Island at the time of the accident was similar to that of women from the same area who became pregnant after the accident. Ratings of the development of the two groups of c...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.81.3.384
更新日期:1991-03-01 00:00:00
abstract::A case of rubella in a male obstetrics-gynecology house staff member exposed 170 staff members and 11 prenatal patients to the clinical disease. Of 163 staff members tested within one week of exposure, 132 (80 per cent) were not susceptibles. Repeat titres three weeks later on 28 susceptibles remained negative. Of the...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.69.3.287
更新日期:1979-03-01 00:00:00
abstract:OBJECTIVE:This study reports the results of a behavior change intervention offered to women at high risk for human immunodeficiency virus (HIV) infection seen in an urban primary health care clinic. METHODS:Participants were 197 women randomly assigned to either an HIV/acquired immunodeficiency syndrome (AIDS) risk re...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.84.12.1918
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVES:We examined individual, friend or family, and community or tribe correlates of suicidality in a representative on-reserve sample of First Nations adolescents. METHODS:Data came from the 2002-2003 Manitoba First Nations Regional Longitudinal Health Survey of Youth. Interviews were conducted with adolescents ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300385
更新日期:2012-07-01 00:00:00
abstract::We conducted in-depth interviews in May to July 2012 to evaluate the effect of Alabama's 2011 omnibus immigration law on Latina immigrants and their US- and foreign-born children's access to and use of health services. The predominant effect of the law on access was a reduction in service availability. Affordability a...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301560
更新日期:2014-03-01 00:00:00
abstract::We investigated links between police brutality and poor health outcomes among Blacks and identified five intersecting pathways: (1) fatal injuries that increase population-specific mortality rates; (2) adverse physiological responses that increase morbidity; (3) racist public reactions that cause stress; (4) arrests, ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2017.303691
更新日期:2017-05-01 00:00:00
abstract::Intensification of polio eradication efforts worldwide raises concerns about costs and benefits for poor countries. A major argument for global funding is the high benefit-cost ratio of eradication; however, financial benefits are greatest for rich countries. By contrast, the greatest costs are borne by poor countries...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.87.6.922
更新日期:1997-06-01 00:00:00
abstract::Public health asks of systems science, as it did of sociology 40 years ago, that it help us unravel the complexity of causal forces in our varied populations and the ecologically layered community and societal circumstances of public health practice. We seek a more evidence-based public health practice, but too much o...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.066035
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:I examined how sexual minority status, as indicated by sex of sexual partners, is associated with self-rated health and how socioeconomic status suppresses and age and sex moderate this association. METHODS:I used multinomial logistic regression to analyze aggregated data from the 1991 to 2010 General Socia...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.301040
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:This study assessed the contribution of age and other risk factors to racial disparities in rates of moderately low birthweight (MLBW; 1500-2499 g) and very low birthweight (VLBW; <1500 g). METHODS:Logistic regression models were developed to determine the effects on MLBW and VLBW of maternal age, race, and...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.91.11.1815
更新日期:2001-11-01 00:00:00
abstract::The relationships of high-density lipoprotein (HDL) cholesterol with body composition, leisure-time physical activity, cigarette smoking, and education were examined in a community-based sample of 480 Black and 1337 White women. Univariate and multivariate analyses indicated inverse associations of HDL with body mass ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.84.1.98
更新日期:1994-01-01 00:00:00
abstract::This commentary argues that 100 years after the deadly Spanish flu, the public health emergency community's responses to much more limited pandemics and outbreaks demonstrate a critical shortage of personnel and resources. Rather than relying on nonpharmaceutical interventions, such as quarantine, the United States mu...
journal_title:American journal of public health
pub_type: 历史文章,杂志文章
doi:10.2105/AJPH.2018.304682
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:Using data from a large cohort of adults aged 45 to 84 years-old, we investigated whether availability of recreational resources is related to physical activity levels. METHODS:Data from a multiethnic sample of 2723 adult residents of New York City, NY; Baltimore, Md; and Forsyth County, NC, were linked to ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2006.087734
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.1.29
更新日期:1992-01-01 00:00:00
abstract::Public health clients in an Ontario community 65 years of age or older were randomly allocated to receive an intervention by a public health nurse during a home visit promoting either influenza immunization or safety measures. There was no statistically significant differences in influenza immunization rates between t...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.83.12.1751
更新日期:1993-12-01 00:00:00
abstract::Cigarette smoking histories, reported depth of inhalation, number of pipe and cigars (PC) smoked, serum thiocyanate (SCN) and expired air carbon monoxide (CO) levels were examined in PC male smokers enrolled in the Multiple Risk Factor Intervention Trial (MRFIT). Serum SCN levels for all PC smokers were higher than fo...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.77.11.1412
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVES:After conducting a media campaign focusing on the importance of oral and pharyngeal cancer (OPC) examinations, we assessed mechanisms of behavior change among individuals receiving an OPC examination for the first time. METHODS:We used data from 2 waves of telephone surveys of individuals residing in 36 rur...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302516
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVES:We assessed shifts in patterns of mortality during a hot weather event in greater Vancouver, British Columbia. METHODS:We used a case-only analysis to compare characteristics of individuals who died during the hottest week of 2009 with those who died (1) during earlier summer weeks in 2009 and (2) during th...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.300670
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:A 10-month direct mail campaign was implemented to increase use of emergency medical services via 911 calls and to reduce prehospital delay for individuals experiencing acute myocardial infarction symptoms. METHODS:This prospective, randomized, controlled trial involved three intervention groups (receiving ...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.87.10.1705
更新日期:1997-10-01 00:00:00
abstract::Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, effor...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.180489
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:This study determined factors associated with drug resistance among 3496 patients with tuberculosis who resided in Texas counties along the Mexican border. METHODS:Univariate and logistic regression analyses were performed to identify risk factors associated with drug resistance. RESULTS:Among patients wit...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.90.2.271
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:We assessed the distribution of immunization records among 3 health care delivery sectors and the impact of a regional immunization registry on "up to date" rates. METHODS:Immunization registry records in 2 regions were categorized as having originated in private practices, community health centers, or publ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.94.6.967
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:This study examined trends and differentials in US childhood mortality from 1950 through 1993 according to sex, race/ethnicity, education, family income, and cause of death. METHODS:Log-linear, multiple regression, and Cox proportional hazards regression models were applied to the data from the National Vit...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.86.4.505
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVES:We determined racial/ethnic differences in social support and exposure to violence and transphobia, and explored correlates of depression among male-to-female transgender women with a history of sex work (THSW). METHODS:A total of 573 THSW who worked or resided in San Francisco or Oakland, California, were ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2010.197285
更新日期:2011-10-01 00:00:00
abstract::Members of the Reorganized Church of Jesus Christ of Latter-Day Saints (RLDS) are dissuaded from the use of tobacco, alcohol, and hot drinks. A well-balanced diet is also stressed. This study compares the 1972-78 mortality experience of the Missouri RLDS with three other population groups. The findings show Missouri R...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.71.12.1350
更新日期:1981-12-01 00:00:00
abstract:OBJECTIVES:The Centers for Disease Control and Prevention's HIV/AIDS Prevention Research Synthesis Team conducted a systematic review of US-based HIV behavioral intervention research literature from 2000 through 2004 to identify interventions demonstrating best evidence of efficacy for reducing HIV risk. METHODS:Stand...
journal_title:American journal of public health
pub_type: 杂志文章,评审
doi:10.2105/AJPH.2005.076182
更新日期:2007-01-01 00:00:00
abstract::A case control study was conducted in North Carolina to explore the relation between individual exposure to sunlight and the risk of cataracts. One hundred thirteen cases and 161 controls aged 40-69 at diagnosis were studied. Sunlight exposure was inferred from interview data on residency and time spent in the sun, co...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.78.11.1459
更新日期:1988-11-01 00:00:00
abstract::Occupational lead poisoning and environmental contamination were evaluated at a lead scrap smelter. Thirty of 37 employees (81 per cent) has blood lead levels of greater than or equal to 80 mug/100 ml, indicating unacceptable absorption, and 35 had free erythrocyte protoporphyrin (FEP) levels greater than 60mug/100ml ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.66.6.548
更新日期:1976-06-01 00:00:00