Descriptive, observational study of pharmaceutical and non-pharmaceutical arrests, use, and overdoses in Maine.

Autor:	Simpson KJ; Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA., Moran MT; Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA., Foster ML; Diversion Alert, Houlton, Maine, USA., Shah DT; Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA., Chung DY; Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA., Nichols SD; Pharmacy Practice, Husson University, Bangor, Maine, USA., McCall KL; Pharmacy Practice, University of New England College of Pharmacy, Portland, Maine, USA., Piper BJ; Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Apr 29; Vol. 9 (4), pp. e027117. Date of Electronic Publication: 2019 Apr 29.
DOI:	10.1136/bmjopen-2018-027117
Abstrakt:	Objectives: The Maine Diversion Alert Program grants healthcare providers access to law enforcement data on drug charges. The objectives of this report were to analyse variations in drug charges by demographics and examine recent trends in arrests, prescriptions of controlled substances and overdoses. Design: Observational. Setting: Arrests, controlled prescription medication distribution and overdoses in Maine. Participants: Drug arrestees (n=1272) and decedents (n=2432). Primary Outcome Measures: Arrestees were analysed by sex and age. Substances involved in arrests were reported by schedule (I-V or non-controlled prescription) and into opioids, stimulants or other classes. Controlled substances reported to the Drug Enforcement Administration (2007-2017) were evaluated. Drug-induced deaths (2007-2017) reported to the medical examiner were examined by the substance(s) identified. Results: Males were more commonly arrested for stimulants and schedule II substances. More than two-thirds of arrests involved individuals under the age of 40. Individuals age > 60 were elevated for oxycodone arrests. Over three-fifths (63.38%) of arrests involved schedule II-IV substances. Opioids accounted for almost half (44.6%) of arrests followed by stimulants (32.5%) and sedatives (9.1%). Arrests involving buprenorphine exceeded those for oxycodone, hydrocodone, methadone, tramadol and morphine, combined. Prescriptions for hydrocodone (-56.0%) and oxycodone (-46.9%) declined while buprenorphine increased (+58.1%) between 2012 and 2017. Deaths from 2007 to 2017 tripled. Acetylfentanyl and furanylfentanyl were the most common fentanyl analogues identified. Conclusions: Although the overall profile of those arrested for drug crimes in 2017 involve males, age <40 and heroin, exceptions (oxycodone for older adults) were observed. Most prescription opioids are decreasing while deaths involving opioids continue to increase in Maine. Competing Interests: Competing interests: This research and KJS, MTM and SDN were supported by the Fahs-Beck Fund for Research and Experimentation, a non-profit organisation. MLF was an employee of Diversion Alert. BJP has received research support and travel related to medical marijuana. The other authors have no relevant disclosures. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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