Overdose charges in Colombia involving unlawful opioids, hallucinogens, stimulants and sedative psychotropic medicine elevated enormously throughout 2018-2021, primarily brought on by overdoses in younger ladies, based on a examine at Columbia College Mailman College of Public Well being. Drug overdoses elevated by 356 p.c from 8.5 to 40.5 p.c per 100,000 people from 2010 to 2021. The findings are revealed within the American Journal of Public Well being.
The examine is the primary to explain nationwide tendencies in overdose charges together with prescribed and unlawful substances and alcohol, throughout completely different inhabitants teams in Colombia.
The pandemic specifically contributed to greater ranges of misery and psychological well being issues together with despair and anxiousness in Colombia, much like different international locations.”
Silvia Martins, MD, PhD, Professor of Epidemiology at Columbia Mailman College and senior writer of the examine
Greater prescriptions charges, and use of tranquilizers/sedatives/antidepressants in Colombia, through the pandemic, as a result of experiences of upper ranges of hysteria, disappointment, and difficulties to sleep, might have led to the overuse of medicine. This was extra pronounced amongst ladies.”
Almost 14 p.c of individuals utilizing substances in 2020 met standards for a substance use-related dysfunction.
Based mostly on outcomes from the 2019 Nationwide Survey on Substance Use (CNSSU, Estudio Nacional de Consumo de Sustancias Psicoactivas de Colombia, 2019), the researchers discovered that substance use elevated for many substances within the nation up to now three a long time, with solely a small discount within the prevalence of alcohol, hashish, and cocaine use in 2019 in comparison with 2013.
To look at tendencies in overdose charges from 2010 to 2021, by kind of substance, intercourse, age-group and intent in addition to sociodemographic traits the researchers additionally used information from SIVIGILA –a nationwide public well being surveillance system, from 2010 to 2021, a compulsory notification system to find out well being occasions.
The SIVIGILA information included 127,087 substance-use-related overdoses amongst folks ages 10 and older, of which 54 p.c had been males, 75 p.c had been individuals aged 10-34, 72 p.c had at the least some highschool schooling or greater, and 51 p.c and 38 p.c respectively had been people who both contributed to the well being system or who had been backed.
Info was used to group overdoses by substance kind within the following classes: hallucinogens; stimulants (together with prescription stimulants, cocaine, and methamphetamine); opioids (together with prescription opioids, heroin, methadone and buprenorphine); inhalants; tranquilizers, sedatives and antidepressants; in addition to hashish. The researchers recognized essentially the most frequent combos of a number of substances throughout the examine interval and the variety of overdoses brought on by these combos.
Probably the most incessantly reported substances had been tranquilizers/sedatives/antidepressants (43 p.c), hashish (16 p.c)), stimulants (16 p.c), alcohol (16 p.c), and opioids (6 p.c). The bulk (95 p.c), of stimulant overdoses had been as a result of cocaine, whereas opioid overdoses had been largely as a result of prescription opioids (74 p.c).
Overdose charges involving tranquilizers/sedatives/antidepressants and people involving opioids elevated over the examine interval, rising at a sooner price after 2018. Drug overdoses involving hashish and stimulants additionally elevated till 2017 however decreased afterwards. Amongst ladies, the sharpest improve in overdose charges had been for tranquilizers/sedatives/antidepressants, which elevated sooner from 2018 to 2021 (from 12 to 33 per 100,000, respectively).
Extra analysis on threat elements, motivations to be used, and sources of those medicines is required to enhance hurt discount interventions and insurance policies,” noticed Julian Santaella-Tenorio, DrPH, professor at Universidad Pontificia Javeriana in Cali, Colombia, former Columbia DrPH scholar, and first writer of the examine. “We additionally imagine that suicide threat screening and entry to complementary psychological well being care addressing suicidal ideation or habits might enhance well being outcomes amongst people being prescribed these medicines and people having lately skilled an overdose.”
“Addressing substance use challenges, together with the emergence of novel medication and of polysubstance use, is a fancy activity that requires a superb understanding of the magnitude of the issue and the burden it imposes on populations and the well being system,” stated Martins and Santaella-Tenorio.
It’s attainable that the lower within the prevalence of hashish and stimulants use in youthful populations could be attributed to mobility restrictions through the COVID pandemic; reductions in these overdose charges could also be additionally associated to adjustments in consumption patterns which can be much less more likely to end in overdose, famous the researchers.
In accordance with Martins and Santaella, survey information seemingly underestimates the prevalence of drug use provided that the CNSSU is a family survey that excludes populations with high-risk of drug use – i.e. homeless and incarcerated populations. As well as, overdoses not handled at well being services usually are not included within the SIVIGILA information.
Over the previous three a long time, Colombia has transitioned to a human rights and public health-approach regulatory framework concerning substance use, an method that’s aligned with The United Nations Workplace on Medicine and Crime pointers.
The findings counsel that further prevention efforts are obligatory, together with hurt discount and community-based packages, and higher entry to remedy companies that may cut back the danger on overdose within the inhabitants.
“Well being surveillance methods are an essential software that may information overdose prevention efforts in international locations with restricted information sources. Whereas this specific examine focuses on Colombia, their surveillance methods methodology can generate info for public well being prevention efforts in different resource-poor international locations,” famous Martins.
Co-authors are Jhoan Sebastian Zapata Lopez, Pontificia Universidad Javeriana, Colombia, Luis E. Segura, Columbia College Division of Epidemiology, Magdalena Cerda, NYU Division of Inhabitants Well being, Thiago Fidalgo and Vitor Tardelli, Universidade Federal de São Paulo (UNIFESP), Brazil.
The examine was partially supported by a Columbia College World Innovation Fund.
Supply:
Columbia College’s Mailman College of Public Well being
Journal reference:
Santaella-Tenorio, T., et al. (2024) Developments in Nonfatal Overdose Charges On account of Alcohol and Prescription and Unlawful Substances in Colombia, 2010–2021. doi.org/10.2105/AJPH.2024.307786.
