Analyzing the drug overdose epidemic in the United States

Background: The opioid crisis has led to a dramatic increase in the number of drug overdose deaths in the United States. Little is known about the effect of the opioid crisis on the kidney transplant donor pool, particularly on hepatitis C virus (HCV)-infected donors. Methods: This is a retrospective analysis of the data from the Organ Procurement and Transplantation Network from 2010 to 2016. We determined the changes in characteristics of kidney transplant donors and evaluated which changes may be directly related to the opioid crisis. Results: Between 2010 and 2016, we found a 26% increase in overall donors, including a 277% increase in the number of donors who died from drug overdose. Nineteen percent of donors who died of drug overdose had HCV infection. Donors who die from drug overdose and donors with HCV infection are younger, less likely to have diabetes or hypertension, and have favorable kidney donor profile index scores compared to average donors. Despite these favorable characteristics, HCV-infected donors appear to be notably underutilized, with substantially lower kidneys per donor being transplanted compared to HCV uninfected donors. Conclusion: The opioid crisis in the United States has substantially altered the kidney donor pool. Strategies to increase utilization of all potentially viable kidneys for transplant are needed, particularly in this era of new, highly effective, direct-acting antiviral therapy for HCV infection.

Download Full-text

A case of a mixed overdose involving kratom (Mitragyna speciosa) leading to serotonin syndrome

Medical Science and Discovery ◽

10.36472/msd.v8i12.626 ◽

2021 ◽

Vol 8 (12) ◽

pp. 689-691

Author(s):

H. Reid Zweifel ◽

Jonathan Browne ◽

Jeffrey M Levine

Keyword(s):

United States ◽

Drug Overdose ◽

Serotonin Syndrome ◽

The United States ◽

Opiate Withdrawal ◽

The Past ◽

Mitragyna Speciosa ◽

Overdose Deaths ◽

Acute Intake ◽

Μ Receptor

Objective: Drug overdose deaths have risen precipitously over the past two years in the United States. Polysubstance overdose with opiates and amphetamines have been of particular concern. Kratom (Mitragyna speciosa) is an unregulated widely available herb with both stimulant and opiate μ-receptor activity. Studies suggest that its use is quickly increasing. Case: We describe a patient who presented to a psychiatric hospital with a mixed toxic syndrome due to chronic kratom and prescribed SSRI use compounded by acute intake of methamphetamine. The patient displayed psychosis, tremulousness, myoclonus, and extreme anxiety. Her clinical picture was consistent with both serotonin syndrome and opiate withdrawal. Conclusion: We call attention to this case because polysubstance overdoses are common, and kratom is widely available. Complex toxic presentations that involve kratom are likely to be increasingly encountered.

Download Full-text

The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00423-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Sameer Imtiaz ◽

Frishta Nafeh ◽

Cayley Russell ◽

Farihah Ali ◽

Tara Elton-Marshall ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

Drug Overdose ◽

Observational Studies ◽

Public Health Surveillance ◽

The United States ◽

Health Surveillance ◽

The Novel ◽

Novel Coronavirus ◽

The Impact

Abstract Background There are preliminary indications that the trajectory of drug overdose-related deaths in North America has been exacerbated due to the novel coronavirus disease pandemic (COVID-19). As such, the impact of COVID-19 on drug overdose-related deaths was examined through a systematic review of the literature and percentage change analyses of surveillance data. Methods Systematic searches in electronic databases were conducted, a topical issue brief and bibliography were reviewed, reference lists of included studies were searched and expert consultations were held to identify studies (Registration # CRD42021230223). Observational studies from the United States and Canada were eligible for inclusion if drug overdose-related deaths were assessed in quantitative or qualitative analyses onwards from at least March 2020. In addition, percentage changes comparing drug overdose-related deaths in the second annual quarter (Q2 2020 [April to June]) with the first annual quarter (Q1 2020 [January to March]) were generated using national and subnational data from public health surveillance systems and reports from jurisdictions in the United States and Canada. Results Nine studies were included in the systematic review, eight from the United States and one from Canada. The maximum outcome assessment period in the included studies extended until September 2020. Drug overdose-related deaths after the onset of COVID-19 were higher compared with the months leading up to the pandemic in 2020 and the comparative months in 2019. In additional percentage change analyses, drug overdose-related deaths increased by 2 to 60% in jurisdictions in the United States and by 58% in Canada when comparing Q2 2020 with Q1 2020. Conclusions Drug overdose-related deaths increased after the onset of COVID-19. The current situation necessitates a multi-pronged approach, encompassing expanded access to substance use disorder treatment, undisrupted access to harm reduction services, emphasis on risk reduction strategies, provision of a safe drug supply and decriminalization of drug use.

Download Full-text

NIOSH Responds to the U.S. Drug Overdose Epidemic

NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy ◽

10.1177/10482911211040754 ◽

2021 ◽

pp. 104829112110407

Author(s):

Jamie C. Osborne ◽

L. Casey Chosewood

Keyword(s):

United States ◽

Substance Use ◽

Drug Overdose ◽

Drug Users ◽

Illicit Drugs ◽

Occupational Safety ◽

The United States ◽

Opioid Use Disorder ◽

Opioid Overdose ◽

Opioid Use

The United States is experiencing an evolving and worsening drug overdose epidemic. Although the rate of drug use among workers has remained relatively stable, the risk of overdose and death among drug users has not, as illicit drugs have increased in potency and lethality. The cumulative impacts of COVID-19 and the opioid crisis increase the likelihood of illness and death among workers with opioid use disorder. Workplaces represent a critical point of contact for people living in the United States who are struggling with or recovering from a substance use disorder, and employment is a vital source of recovery “capital.” The benefits of addressing substance use in the workplace, supporting treatment, and employing workers in recovery are evident. The National Institute for Occupational Safety and Health has published research to inform policy and practice toward prevention efforts and has developed accessible resources and toolkits to support workers, employers, and workplaces in combatting the opioid overdose crisis and creating safer, healthier communities.

Download Full-text

Prescription Medication Misuse

Seminars in Neurology ◽

10.1055/s-0038-1673691 ◽

2018 ◽

Vol 38 (06) ◽

pp. 654-664 ◽

Cited By ~ 1

Author(s):

Jeoffrey Hill ◽

Daniel Alford

Keyword(s):

United States ◽

Drug Overdose ◽

Prescription Medication ◽

The United States ◽

Prescription Medications ◽

Medication Misuse ◽

Illicit Market ◽

Number Of Individuals ◽

Overdose Deaths ◽

Related Harm

AbstractIn the United States, there is a prescription medication misuse crisis including increases in unintentional drug overdose deaths, medications obtained on the illicit market (i.e., diversion), and in the number of individuals seeking treatment for addiction to prescription medications. Neurologists manage patients suffering from conditions (e.g., pain, seizures, spasticity) where the prescriptions of medications with misuse potential are indicated. It is therefore imperative that neurologists understand which medications are liable to misuse and institute strategies to minimize the harm associated with these medications. The authors review the most common medications prescribed by neurologist with misuse potential, and briefly discuss the behaviors that are suggestive of medication misuse and tools for monitoring patients to minimize medication-related harm from misuse.

Download Full-text

The Drug Overdose Epidemic and Deceased-Donor Transplantation in the United States

Annals of Internal Medicine ◽

10.7326/m17-2451 ◽

2018 ◽

Vol 168 (10) ◽

pp. 702 ◽

Cited By ~ 90

Author(s):

Christine M. Durand ◽

Mary G. Bowring ◽

Alvin G. Thomas ◽

Lauren M. Kucirka ◽

Allan B. Massie ◽

...

Keyword(s):

United States ◽

Drug Overdose ◽

Deceased Donor ◽

The United States

Download Full-text

Drug Overdose Deaths in the United States, 1999–2020

10.15620/cdc:112644 ◽

2021 ◽

Author(s):

Holly Hedegaard ◽

Arialdi M. Miniño ◽

Merianne Rose Spencer ◽

Margaret Warner

Keyword(s):

United States ◽

Drug Overdose ◽

The United States ◽

Vital Statistics ◽

Demographic Group ◽

Overdose Deaths

This report uses the most recent data from the National Vital Statistics System (NVSS) to update statistics on deaths from drug overdose in the United States, showing rates by demographic group and by specific types of drugs involved (such as opioids or stimulants), with a focus on changes from 2019 to 2020.

Download Full-text

Pandemic meets epidemic: Co-location of COVID-19 and drug overdose deaths in the United States

Journal of Community Safety and Well-Being ◽

10.35502/jcswb.216 ◽

2021 ◽

Vol 6 (4) ◽

pp. 174-178

Author(s):

Navya Tripathi ◽

Nancy Hardt

Keyword(s):

United States ◽

Spatial Correlation ◽

Drug Overdose ◽

Hot Spot ◽

State Level ◽

The United States ◽

Time Step ◽

Access To Treatment ◽

Control And Prevention ◽

Overdose Deaths

Drug overdose deaths (DOD) in the last two decades have increased over 300 percent. In 2019 alone, 71,000 deaths represented a 7% increase from the previous year. According to recent data released by the Center for Disease Control and Prevention (CDC), 81,230 overdose deaths occurred in the United States from June 2019 to May 2020, the highest number of DOD recorded in a 12-month period. Early 2020 saw the spread of the COVID-19 pandemic in the United States, which CDC suggests has amplified the previously alarming rise in drug-related mortalities. A hot spot analysis of COVID-19 and DOD rates, as well as a spatial correlation between the two datasets at the state level on a monthly time step, showed a significant increase in DOD during the COVID-19 pandemic. This study, conducted for the period of March through July 2021, showed a spatial correlation between the two types of mortalities in the initial months of 2020. Furthermore, the hot spots for both types of mortalities were concentrated in the northeastern states. The COVID-19 mortalities shifted southeast in July 2020, but DOD data was unavailable for further analysis. Since DOD are a leading contributor to preventable deaths, the results of the study may help focus the efforts of effective and innovative programs to reduce substance use disorder and related mortality through increased access to treatment. During the pandemic, access to such facilities was reduced.

Download Full-text