Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017

This chapter addresses the pharmaceutical industry’s direct-to-physician marketing of opioids, a factor that has fueled the current addiction epidemic. A 2019 study sought to understand the relationship between mortality from opioid overdose and the pharmaceutical industry’s direct marketing of opioids to physicians. The study analyzed the association between three factors in every US county: the amount of marketing payments pharmaceutical companies made to physicians, opioid prescribing rates, and the number of overdose deaths. Researchers found that direct marketing of opioids to physicians was associated with increased opioid prescribing rates and increased overdose mortality 1 year after marketing engagements. As such, the national response to the opioid epidemic has focused in part on reducing the number of opioids prescribed by physicians. Additionally, the Physician Payments Sunshine Act promotes financial transparency between pharmaceutical companies and health care providers. By increasing regulation around pharmaceutical direct-to-physician marketing, and by making reports of pharmaceutical company payments to physicians available to the public, states have the potential to reduce overdose mortality.

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Opioid overdose deaths can occur in patients with naltrexone implants

The Medical Journal of Australia ◽

10.5694/j.1326-5377.2007.tb01124.x ◽

2007 ◽

Vol 187 (1) ◽

pp. 56-56 ◽

Cited By ~ 2

Author(s):

Nikolaj Kunøe ◽

Helge Waal

Keyword(s):

Opioid Overdose ◽

Overdose Deaths

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A Thematic Analysis of Overdose Prevention and Response Efforts in States Experiencing Declines in Rates of Opioid-Involved Overdose Deaths

Public Health Reports ◽

10.1177/00333549211026816 ◽

2021 ◽

pp. 003335492110268

Author(s):

Amber B. Robinson ◽

Nida Ali ◽

Olga Costa ◽

Cherie Rooks-Peck ◽

Amy Sorensen-Alawad ◽

...

Keyword(s):

Thematic Analysis ◽

Prevention Program ◽

Data Access ◽

Mortality Rates ◽

Opioid Overdose ◽

Overdose Prevention ◽

Core Elements ◽

Specific Activities ◽

Context Specific ◽

Overdose Deaths

Objective To address the opioid overdose epidemic, it is important to understand the broad scope of efforts under way in states, particularly states in which the rate of opioid-involved overdose deaths is declining. The primary objective of this study was to examine core elements of overdose prevention activities in 4 states with a high rate of opioid-involved overdose deaths that experienced a decrease in opioid-involved overdose deaths from 2016 to 2017. Methods We identified 5 states experiencing decreases in age-adjusted mortality rates for opioid-involved overdoses from 2016 to 2017 and examined their overdose prevention programs via program narratives developed with collaborators from each state’s overdose prevention program. These program narratives used 10 predetermined categories to organize activities: legislative policies; strategic planning; data access, capacity, and dissemination; capacity building; public-facing resources (eg, web-based dashboards); training resources; enhancements and improvements to prescription drug monitoring programs; linkage to care; treatment; and community-focused initiatives. Using qualitative thematic analysis techniques, core elements and context-specific activities emerged. Results In the predetermined categories of programmatic activities, we identified the following core elements of overdose prevention and response: comprehensive state policies; strategic planning; local engagement; data access, capacity, and dissemination; training of professional audiences (eg, prescribers); treatment infrastructure; and harm reduction. Conclusions The identification of core elements and context-specific activities underscores the importance of implementation and adaptation of evidence-based prevention strategies, interdisciplinary partnerships, and collaborations to address opioid overdose. Further evaluation of these state programs and other overdose prevention efforts in states where mortality rates for opioid-involved overdoses declined should focus on impact, optimal timing, and combinations of program activities during the life span of an overdose prevention program.

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Comparing Attitudes Toward Stigmatized Deaths: Suicide and Opioid Overdose Deaths

International Journal of Mental Health and Addiction ◽

10.1007/s11469-021-00514-1 ◽

2021 ◽

Author(s):

Athena Kheibari ◽

Julie Cerel ◽

Grant Victor

Keyword(s):

Opioid Overdose ◽

Overdose Deaths

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Meaning and purpose in the context of opioid overdose deaths

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108528 ◽

2021 ◽

Vol 219 ◽

pp. 108528

Author(s):

Eric C. Strain

Keyword(s):

Opioid Overdose ◽

Meaning And Purpose ◽

Overdose Deaths

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Quantifying prescribed high dose opioids in the community and risk of overdose

BMC Public Health ◽

10.1186/s12889-021-11162-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joe Schofield ◽

Deborah Steven ◽

Rebecca Foster ◽

Catriona Matheson ◽

Alexander Baldacchino ◽

...

Keyword(s):

Risk Factors ◽

Service Improvement ◽

High Dose ◽

Opioid Overdose ◽

Opioid Prescribing ◽

Patient Level ◽

Strong Opioid ◽

High Doses ◽

Strong Opioids ◽

Very High

Abstract Background Opioid prescribing for a range of health issues is increasing globally. The risk of fatal and non-fatal overdose is increased among people prescribed strong opioids: in high doses in the context of polypharmacy (the use of multiple medications at the same time), especially with other sedatives; and among people with multiple morbidities including cardiorespiratory, hepatic and renal conditions. This study described and quantified the prescribing of strong opioids, comorbidities and other overdose risk factors among those prescribed strong opioids, and factors associated with high/very high opioid dosage in a regional health authority in Scotland as part of a wider service improvement exercise. Methods Participating practices ran searches to identify patients prescribed strong opioids and their characteristics, polypharmacy, and other overdose risk factors. Data were anonymised before being analysed at practice and patient-level. Morphine Equivalent Doses were calculated for patients based on drug/dose information and classed as Low/Medium/High/Very High. Descriptive statistics were generated on the strong opioid patient population and overdose risk factors. The relationship between the prescribing of strong opioids and practice/patient-level factors was investigated using linear and logistic regression models. Results Eighty-five percent (46/54) of GP practices participated. 12.4% (42,382/341,240) of individuals in participating practices were prescribed opioids and, of these, one third (14,079/42,382) were prescribed strong opioids. The most common comorbidities and overdose risk factors among strong opioid recipients were pain (67.2%), cardiovascular disease (43.2%), and mental health problems (39.3%). There was a positive significant relationship between level of social deprivation among practice caseload and level of strong opioid prescribing (p < 0.001). People prescribed strong opioids tended to be older (mean 59.7 years) and female (8638, 61.4%) and, among a subset of patients, age, gender and opioid drug class were significantly associated with prescribing of High/Very High doses. Conclusions Our findings have identified a large population at potential risk of prescription opioid overdose. There is a need to explore pragmatic models of tailored interventions which may reduce the risk of overdose within this group and clinical practice may need to be tightened to minimise overdose risk for individuals prescribed high dose opioids.

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