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Cross-sectional cause of death comparisons for stimulant and opioid mortality in San Francisco, 2005–2015

Turner, Caitlin et al.

Drug and alcohol dependence. Volume 185:(2018):no.; 20180401; 305-312 -- Elsevier

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  • Title:
    Cross-sectional cause of death comparisons for stimulant and opioid mortality in San Francisco, 2005–2015
  • Author: Turner, Caitlin;
    Chandrakumar, Dharsan;
    Rowe, Christopher;
    Santos, Glenn-Milo;
    Riley, Elise D.;
    Coffin, Phillip O.
  • Found In: Drug and alcohol dependence. Volume 185:(2018):no.; 20180401; 305-312
  • Journal Title: Drug and alcohol dependence
  • Subjects: Drug abuse; Alcoholism; LCSH: Drug abuse; LCSH: Alcoholism; Dewey: 616.86
  • Rights: Licensed
  • Publication Details: Elsevier
  • Abstract: HighlightsCardio/cerebrovascular causes of death were associated with higher odds of stimulant death.Cardiac significant contributing conditions were associated with higher odds of cocaine death.Most opioid or stimulant decedents were non-Hispanic Whites.Cocaine death disproportionately burdened non-Hispanic Black/African Americans.Stimulant use should be considered a cardio/cerebrovascular risk factor.AbstractBackgroundOpioids and stimulants (e.g., cocaine or methamphetamine/amphetamine [MAMP]) are major contributors to acute substance toxicity deaths. Causes of stimulant death have received little attention. We sought to characterize and compare causes of death and significant contributing conditions among persons who died from acute opioid, cocaine, or MAMP toxicity.MethodsWe identified all opioid, cocaine, or MAMP deaths in San Francisco from 2005 to 2015 through the California Electronic Death Reporting System. Multivariable logistic regression analyses were used to estimate associations between acute substance toxicity deaths (opioid versus stimulant; cocaine versus MAMP), additional reported causes of death, and significant contributing conditions most often linked to opioid and stimulant use.ResultsFrom 2005–2015, there were 1252 opioid deaths and 749 stimulant deaths. Cocaine accounted for most stimulant deaths. Decedents with cardiac or cerebral hemorrhage deaths had higher adjusted odds of death due to acute stimulant toxicity versus acute opioid toxicity (aOR = 4.79, 95%CI = 2.88–7.96, p < 0.01; aOR = 58.58, 95%CI = 21.06–162.91, p < 0.01, respectively); no statistically significant associations were found for cocaine compared to MAMP deaths. Significant contributing cardiac conditions were associated with higher adjusted odds of stimulant compared to opioid (aOR = 1.46, 95%CI = 1.19–1.79, p < 0.01) and cocaine compared to MAMP death (aOR = 1.66, 95%CI = 1.13–2.45, p = .01).ConclusionsStimulant compared to opioid deaths tended to involve cardiac or cerebrovascular causes of death, and cocaine deaths were more likely than MAMP deaths to involve significant contributing cardiac conditions. Mounting evidence suggests that stimulant use be considered a cardio/cerebrovascular risk factor and clinical care be adjusted to address this heightened risk.
  • Identifier: Journal ISSN: 0376-8716
  • Publication Date: 2018
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store
    3627.890000
  • UIN: ETOCvdc_100057872248.0x000001

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