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Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder

机译：阿片类药物使用障碍的瑞典人群事件和致命阿片类药物过量的社会经济相关性

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摘要

Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD. We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005–December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates. Univariate analysis showed that several covariates were associated with incident and fatal opioid OD. In the multivariate analysis, incident opioid OD was associated with educational attainment (Hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94–0.97), having received social welfare (HR 1.31; 95% CI 1.22–1.39), and criminal conviction (HR 1.53; 95% CI 1.42–1.65). Fatal opioid OD was also associated with criminal conviction (HR 1.93; 95% CI 1.61–2.32). Individuals with low education and receipt of social welfare had higher risks of incident opioid OD and individuals with criminal conviction were identified as a risk group for both incident and fatal opioid OD. Our findings should raise attention among health prevention policy makers in general, and among decision-makers within the criminal justice system and social services in particular.
机译：阿片化过量（OD）和阿片类药物死亡对阿片类药物使用障碍（OUD）的主要健康威胁。社会经济因素是非阿片异常的潜在决定因素。在这项研究中，我们评估了社会经济和其他因素及其与事件和致命阿片类药物的协会，其中由22,079名与Oud组成的队列。我们在2017年1月至2017年1月期间进行了基于瑞典国家登记数据的回顾性的纵向研究。我们使用Cox比例危险模型来调查事件和致命阿片类药物的风险，作为几个个人，父母和邻里协变量的职能。单变量分析表明，几次协变量与事件和致命的阿片类药物相关。在多变量分析中，事件阿片类药物与教育程度有关（危害比[HR] 0.96; 95％置信区间[CI] 0.94-0.97），获得社会福利（HR 1.31; 95％CI 1.22-1.39），和刑事定罪（HR 1.53; 95％CI 1.42-1.65）。致命阿片类药物也与刑事定罪有关（HR 1.93; 95％CI 1.61-2.32）。受到高等教育和社会福利的个人对事件opioid的风险较高，并且犯罪定罪的个人被确定为事故和致命阿片异常的风险组。我们的调查结果应在刑事预防政策制定者以及刑事司法系统和社会服务中的决策者中提出关注。

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