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35th AM (2025) - Poster Session
Trends in Alcohol and Psychoactive-Substance Morta ...
Trends in Alcohol and Psychoactive-Substance Mortality among Brazilians, from 2010 to 2023
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Pdf Summary
This retrospective ecological study analyzed mortality trends related to alcohol and psychoactive substances in Brazil from 2010 to 2023, covering all Brazilian states. Using death records coded by ICD-10 for alcohol (F10) and other psychoactive substances (F11–F19), the study examined age- and sex-specific mortality rates and temporal trends through segmented log-linear Poisson regression.<br /><br />Key findings include a plateauing of alcohol-related deaths since 2019 after a prior decline, while deaths from stimulants and synthetic opioids doubled, contributing to a narrowing mortality gap from a 4:1 ratio (alcohol to drugs) in 2010 to 2:1 in 2023. Men consistently experienced higher mortality than women, though trends were similar across sexes. Importantly, mortality shifted toward older adults: alcohol deaths doubled and drug-related deaths tripled in those aged 60 and above. The study represents the first post-pandemic national analysis isolating underlying causes for alcohol and specific substances, providing an open dataset and code for replicable research in other middle-income countries.<br /><br />Current clinical practice gaps were identified, such as a predominant focus on alcohol use alone, limited expertise in geriatric addiction, underutilization of new pharmacotherapies, and inconsistent harm reduction approaches. Treatment access remains uneven, often relying on outdated evidence.<br /><br />The authors recommend implementing nationwide, age- and substance-specific surveillance to guide policy and clinical care. Dual screening for alcohol and other substances across all patient visits is vital, alongside adapting treatment protocols to address the unique needs of older adults. Improved mortality tracking with linked toxicology data can better evaluate policy effects. Continued enforcement of drink-driving laws and expansion of psychosocial care services, real-time mortality monitoring dashboards, and targeted harm reduction funding are needed to respond to evolving substance-related mortality patterns in Brazil.<br /><br />In summary, the study highlights a concerning rise in drug-related deaths, stalled progress in reducing alcohol mortality, and increasing impacts among older populations, calling for more comprehensive, dynamic public health and clinical strategies.
Keywords
alcohol-related mortality
psychoactive substances
Brazil
2010-2023
age-specific trends
sex-specific mortality
stimulants and synthetic opioids
geriatric addiction
harm reduction
public health policy
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