|Titre :||The global epidemiology and burden of psychostimulant dependence: findings from the Global Burden of Disease Study 2010 (2014)|
|Auteurs :||L. DEGENHARDT ; A. J. BAXTER ; Y. Y. LEE ; W. HALL ; G. E. SARA ; N. JOHNS ; A. D. FLAXMAN ; H. A. WHITEFORD ; T. VOS|
|Type de document :||Article : Périodique|
|Dans :||Drug and Alcohol Dependence (Vol.137, April 2014)|
|Article en page(s) :||36-47|
|Discipline :||EPI (Epidémiologie / Epidemiology)|
Thésaurus TOXIBASEEPIDEMIOLOGIE ; DEPENDANCE ; COCAINE ; AMPHETAMINES ; COMORBIDITE ; PREVALENCE ; MODELE STATISTIQUE
AIMS: To estimate the global prevalence of cocaine and amphetamine dependence and the burden of disease attributable to these disorders.
METHODS: An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years (DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010.
RESULTS: In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million amphetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for amphetamines. There were 37.6 amphetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between amphetamines and cocaine in the geographic distribution of crude DALYs. Over half of amphetamine dependence DALYs were in Asian regions (52%), whereas almost half of cocaine dependence DALYs were in the Americas (44%, with 23% in North America High Income).
CONCLUSION: Dependence upon psychostimulants is a substantial contributor to global disease burden; the contribution of cocaine and amphetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden.
|Domaine :||Drogues illicites / Illicit drugs|
|Affiliation :||National Drug and Alcohol Research Centre, University of New South Wales, Australia|