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首页> 外文期刊>Journal of substance abuse treatment >Comparison between buprenorphine provider availability and opioid deaths among US counties
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Comparison between buprenorphine provider availability and opioid deaths among US counties

机译：Buprenorphine提供者可用性和美国县中阿片类药物的比较

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BackgroundBuprenorphine is an effective medication for the treatment of opioid addiction, but current barriers to buprenorphine access limit treatment availability for many patients. We identify and characterize regions within the United States (US) with poor buprenorphine access relative to the observed burden of overdose deaths. MethodsThis cross sectional study includes US county-level data on the number of available buprenorphine providers (Substance Abuse and Mental Health Services Administration Buprenorphine Treatment Practitioner Locator) and the number of opioid-related overdose deaths between 2013 and 2015 (Centers for Disease Control and Prevention WONDER Database). Counties with fewer than 10 deaths during this time period were excluded to maintain patient privacy. Population-adjusted county death rates and provider availability were compared to identify locations with high disease burdens and limited buprenorphine access. The presence of significant clustering across the dataset was evaluated using Global Moran's I and zones of significant spatial clusters and anomalies were identified using Local Indicator of Spatial Autocorrelation. ResultsCounty data were available for 846 counties from 49 states and the District of Columbia, comprising 83% of the US population. The median number of opioid overdose deaths per county was 20.0 deaths per 100,000 residents (interquartile range 13.4–29.9, range 2.9 to 108.8). The number of buprenorphine providers per 100,000 county residents ranged from 0 to 45, with a median of 5.9 (interquartile range 3.2 to 9.5). Global Moran's I analysis yielded significant clustering in the distribution of both providers and deaths, with notable significant clusters of higher than average providers and deaths in the Northeast, and scattered mismatched regions of lower-than-average providers and higher-than-average deaths across the Southern, Midwestern, and Western US. Graphical analysis of buprenorphine provider availability and overdose burden reveals limited treatment access relative to overdose deaths throughout much of the Midwestern and Southern US. ConclusionsSubstantial county-level imbalances between the availability of buprenorphine providers and the burden of opioid overdose deaths are present within the US.
机译：背景布丙酮是一种有效的药物治疗阿片类药物成瘾，但对丁丙诺啡进入的目前的障碍限制了许多患者的限制治疗可用性。我们在美国（美国）内的地区识别和描述了相对于观察到的过量死亡负担的贫困博伦啡因。方法横断面研究包括美国县级数据，关于可用的百伦滨提供者数量（药物滥用和精神卫生服务给予丁丙诺啡治疗从业者定位员）和2013年至2015年的阿片类药物相关过量死亡人数（疾病控制和预防的中心）奇迹数据库）。在此时间段内少于10人死亡的县被排除在外，以维持患者隐私。比较人口调整的县死亡率和提供商可用性，以确定具有高疾病负担和有限的丁甲啡进入的地点。使用全球莫兰的I以及使用局部空间自相关的局部指标来识别全球莫兰的I以及大量空间簇的I和异常区域进行大规模聚类的存在。结果，可在49个州和哥伦比亚区的846个县提供，包括83％的美国人口。每县的阿片类药物过量死亡的中位数为20.0人死亡，每10万名居民（第13.4-29.9，范围为2.9至108.8）。每10万县居民的Buprenorphine提供者的数量从0到45次，中位数为5.9（第3.2至9.5分）。 Global Moran的I分析在供应商和死亡的分布中产生了显着的聚类，具有高于东北部的平均水平和死亡的显着显着的显着集群，并分散了低于平均水平的提供者的不匹配区域和跨越平均的死亡区域南部，中西部和西部美国。 Buprenorphine提供者可用性和过量负担的图形分析显示了有限的治疗机会，相对于在美国中西部和南部的大部分时间内过量死亡。结论在美国南京甲丙啡供应商的可用性与阿片类药物过量死亡的可用性之间存在的腹层级失衡。

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