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首页> 美国卫生研究院文献>British Medical Journal >Impact of supervision of methadone consumption on deaths related to methadone overdose (1993-2008): analyses using OD4 index in England and Scotland
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Impact of supervision of methadone consumption on deaths related to methadone overdose (1993-2008): analyses using OD4 index in England and Scotland

机译：美沙酮摄入量监管对与美沙酮过量有关的死亡的影响（1993-2008年）：使用英格兰和苏格兰的OD4指数进行分析

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>Objective To evaluate the impact of introduction of supervision of methadone dosing on deaths related to overdose of methadone in Scotland and England between 1993 and 2008 while controlling for increased prescribing of methadone.>Design Analysis of annual trends in deaths related to overdose of methadone in relation to defined daily doses of methadone prescribed.>Setting Scotland and England.>Population Deaths in which methadone was coded as the only drug involved or as one of the drugs implicated.>Main outcome measure Annual OD4-methadone index (number of deaths with methadone implicated per million defined daily doses of methadone prescribed in that year).>Results OD4-methadone declined substantially over the four epochs of four years between 1993 and 2008. It decreased significantly (P<0.05) in 10 of 12 epoch changes: in Scotland from 19.3 (95% confidence interval 15 to 24) to 4.1 (2.8 to 5.4) and finally to 3.0 (2.4 to 3.5) for methadone only deaths (and from 58 to 29 to 14 for deaths with any mention of methadone); in England from 27.1 (25 to 29) to 24.8 (23 to 27) and finally to 5.8 (5.3 to 6.3) for methadone only deaths (and from 46 to 42 to 12 for deaths with any mention of methadone). The decreases in OD4-methadone were closely related to the introduction of supervised dosing of methadone in both countries, first in Scotland (1995-2000) and later in England (1999-2005). These declines occurred over periods of substantial increases in prescribing of methadone (18-fold increase in defined daily doses per million population annually in Scotland and sevenfold increase in England).>Conclusions Introduction of supervised methadone dosing was followed by substantial declines in deaths related to overdose of methadone in both Scotland and England. OD4-methadone index analyses, controlled for substantial increases in methadone prescribing in both countries, identified at least a fourfold reduction in deaths due to methadone related overdose per defined daily dose (OD4-methadone) over this period.
机译：>目的：在1993年至2008年间，评估引入美沙酮剂量监管对与苏格兰和英格兰美沙酮过量相关的死亡的影响，同时控制美沙酮的处方量增加。>设计与规定的美沙酮每日规定剂量相关的美沙酮过量相关的死亡年度趋势分析。>设置苏格兰和英格兰。>人口以美沙酮为唯一的死亡人数>主要结局指标年度OD4-美沙酮指数（该年处方的美沙酮每日定义的百万剂量中，与美沙酮有关的死亡人数）。>结果< / strong> OD4-美沙酮在1993年至2008年的4个时期中大幅下降。在12个时期中的10个时期中，OD4-美沙酮显着下降（P <0.05）：在苏格兰从19.3（95％置信区间15到24）降低到4.1 （2.8到5.4），最后是仅美沙酮致死的3.0（2.4至3.5）（对于提及美沙酮的死亡为58至29至14）；在英格兰，仅美沙酮致死人数从27.1（25至29）增至24.8（23至27），最终增至5.8（5.3至6.3）（提及美沙酮的死亡人数则从46至42至12）。 OD4-美沙酮的减少与两国引入美沙酮的有监督剂量密切相关，首先是在苏格兰（1995-2000年），然后是英国（1999-2005年）。这些下降发生在美沙酮处方大幅增加的时期（苏格兰每百万人口每年定义的日剂量增加18倍，英格兰每年增加7倍）。>结论随后引入了监督性美沙酮剂量在苏格兰和英格兰，与过量服用美沙酮有关的死亡人数大幅下降。在两个国家控制了美沙酮处方的大幅增加之后，OD4-美沙酮指数分析确定了这段时间内因每确定的每日剂量（OD4-美沙酮）与美沙酮有关的过量使用所致的死亡至少减少了四倍。

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