Trends in Fatal Poisoning Among Drug Users in France From 2011 to 2021
- Type de publi. : Article dans une revue
- Date de publi. : 30/08/2023
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Auteurs :
Bruno RevolThéo WillemanMarc ManceauVéronique Dumestre-TouletJean-Michel GaulierNathalie Fouilhé Sam-LaïHélène Eysseric-GuérinChadi AbbaraDelphine AllorgeJean-Claude AlvarezAlice AmelineAurélie AquizerateAnne BarretEmilie BerlandCélian BertinThierry BesnardFabien BevalotCamille Billet-ChatenayÉmilie BouquetJoanna BourgineBertrand BrunetAnne-Sylvie CaousAlexandre CesbronLeila ChaouachiCécile ChevallierMarjorie ChezeAntony Citterio-QuentinPhilippe Collon-FabieEric DaillyAmélie DaveluyGrégory DeffontaineMartine DelageXavier DelavenneFlorence DescampsJuliette DescoeurGuillaume DeslandesMarc DeveauxBernadette DevosChristophe DocheCéline EidenAurélie FouleyYvan GaillardNicolas GambierCatherine GanièreJean-Pierre GoulléPascal GuerardGuillaume HoizeyLuc HumbertLaurent ImbertMarie-France KerguerisPascal KintzFlorian KlinzigLaurence Labat-DeveauxBruno LacarelleChristian LacroixDenis LamiableMichel LavitReynald Le BoisselierAnne Le BouilCatherine Le MeurSandrine LefeuvreBénédicte LelièvreVéronique Lelong-BoulouardAnne-Sophie Lemaire-HurtelJuliana Lima-TournebizeMagalie LoilierVincent LopezClaire Martin-MolinsHélène MartyOlivier MathieuJean-Claude Mathieu-DaudéYves MaurasNathalie MilanAurélie MoalIsabelle MorelPatrick MuraAnne-Laure Pelissier-AlicotGilbert PépinMartine PerrinAnne PeyreAlain PineauRop PokCatherine Ragoucy-SenglerRaphaël RayerEmilie RomanCarine RousselAnne RoussinSandrine SabiniElodie SaussereauJulien Scala-BertolaPauline SibilleMichel SpadariKarine TitierAlain TurcantPierrick VacherNicolas VenisseOphélie VieiraPascale Visinoni
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Organismes :
Université Grenoble Alpes - UFR Médecine
Centre Hospitalier Universitaire [CHU Grenoble]
Hypoxie et PhysioPathologie
Centre Hospitalier Universitaire [CHU Grenoble]
Department of Biosystems Science and Engineering [ETH Zürich]
Laboratoire ToxGen
Impact de l'environnement chimique sur la santé humaine - ULR 4483
Centre Hospitalier Universitaire [CHU Grenoble]
Centre Hospitalier Universitaire [CHU Grenoble]
Centre Hospitalier Universitaire d'Angers
Impact de l'environnement chimique sur la santé humaine - ULR 4483
Centre de recherche en épidémiologie et santé des populations
Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
Institut de Médecine Légale [Strasbourg]
Laboratoire de pharmacologie et toxicologie neurocardiovasculaire
Centre d'évaluation et d'information sur la pharmacodépendance-addictovigilance [CHU de Nantes]
Centre Hospitalier Universitaire [CHU Grenoble]
Service National de la Police Scientifique
CHU Clermont-Ferrand
Neuro-Dol
Laboratoire Lat Lumtox
Centre d’évaluation et d’information sur la pharmacodépendance – addictovigilance de Poitiers [CHU de Poitiers]
Laboratoire de neurosciences expérimentales et cliniques [U 1084]
CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
Département de Pharmacologie [CHU Caen]
CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 0802)
Centre Hospitalier Régional Universitaire [CHU Lille]
Centre d’Evaluation et d’Information sur la Pharmacodépendance (CEIP-A) et d’Addictovigilance de Paris
Centre antipoison et de toxicovigilance (Lyon)
Laboratoire de Pharmacologie et Toxicologie
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
Cibles et Médicaments des Infections et de l'Immunité - UR 1155
Bordeaux population health
Service de Biochimie et d'Hormonologie [CHU Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Université Jean Monnet - Saint-Étienne
Santé Ingénierie Biologie Saint-Etienne
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
École Pratique des Hautes Études
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
Infections Respiratoires Fongiques
SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques
- Publié dans JAMA Network Open le 29/10/2020
Résumé : Importance: The DRAMES (Décès en Relation avec l’Abus de Médicaments Et de Substances) register is a database of drug-related deaths with the aim of identifying the psychoactive substances associated with and estimating the trends in these deaths. Our novel approach is based on the collection of data on all deaths for which toxicology experts have performed analyses.
Objective: To describe drug-related deaths in France and report trends over an 11-year period.
Design, Setting, and Participants: This case series used a national register to assess 4460 drug-related deaths that occurred from 2011 to 2021 in France. Data analyses were performed from January 1, 2012, to December 31, 2022.
Main Outcomes and Measures: Demographic characteristics; medical and substance abuse history; forensic autopsy findings; and toxicology reports.
Results: Among the 4460 deceased individuals (mean [SD] age, 37.8 [10.5] years), the mortality rate was highest among men (sex ratio, 4.4:1). Of the deaths involving a single or predominant drug, the legal substitution product, methadone, was the leading cause of death during the entire study period, ahead of heroin—44.7% and 35.9% for methadone vs 15.8% and 21.8% for heroin in 2011 and 2021, respectively. Between 2011 and 2021, most of the drug-related deaths shifted from licit to illicit drugs, and statistically significant variations were found for buprenorphine, cocaine, heroin, methadone, and other licit opioids. Deaths related to polydrug use increased from 23.2% in 2011 to 30.6% in 2021. In this context, opioids remained associated with most deaths, with at least 1 opioid being involved in approximately 9 of 10 cases (85.9%) in 2021. However, the main trend was the dramatic increase in drug combinations with cocaine, from less than one-third of cases in 2011 (30.8%) to more than half in 2021 (57.8%).
Conclusions and Relevance: This case series assessment of 4460 drug-related deaths found that opioids used alone or in combination were the main contributor to drug-related deaths, despite having a lower prevalence than other drugs. This finding is similar to that of other countries; however, in France licit methadone was the leading cause of opioid-related deaths (ahead of heroin) during the study period. Deaths associated with use of cannabis, new psychoactive substances, and stimulants (including amphetamine-type stimulants and cocaine, especially in combination) have increased and should be closely monitored.
Fichiers liés :
revol_2023_oi_230912_1692815036.31231.pdf
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