scholarly journals Opioid Use Initiation, Progression, and Motivations Among OEF/OIF/OND-Era Veterans in New York City: An Age-Period-Cohort Analysis

2017 ◽  
Vol 6 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Luther Elliott ◽  
Andrew Golub ◽  
Alexander Bennett
2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S99-S99
Author(s):  
Chaorui Huang ◽  
David Lucero ◽  
Denise Paone ◽  
Ellenie Tuazon ◽  
Demetre Daskalakis

Abstract Background Along with a growing opioid epidemic nationwide, opioid users often have an increased risk of severe infectious diseases including endocarditis, osteomyelitis, and central nervous system (CNS) abscess. As the largest city in the United States, New York City (NYC) may serve as a study model for opioid use and infectious diseases. We investigated the association between opioid use and hospitalizations for endocarditis, osteomyelitis, and CNS abscess in NYC. Methods Data for NYC residents aged ≥18 years discharged from New York State hospitals during 2001–2014 were analyzed using a hospital discharge dataset. We defined a hospitalization for endocarditis, osteomyelitis, and CNS abscess as one with a principal or secondary diagnosis for these conditions within the discharge record. We identified opioid users by examining principal or secondary diagnoses for opioid use within the discharge record at the time of hospitalization for endocarditis, osteomyelitis, and CNS abscess. Log-binomial model was applied among all hospitalized patients using endocarditis, osteomyelitis, and CNS abscess as the outcome, adjusting for age, sex, race, and borough. Results During 2001–2014, there were 139,392 hospitalizations in total for endocarditis, osteomyelitis, or CNS abscess, of which 8,823 (6.3%) were among opioid users. There was an increased risk of hospitalization for endocarditis [RR: 2.6 (95% CI: 2.5–2.7)], osteomyelitis [RR: 1.1 (95% CI: 1.1–1.1)], and CNS abscesses [RR: 1.9 (95% CI: 1.8–2.1)] among hospitalized opioid users compared with hospitalized nonopioid users, adjusted by age, sex, race, and borough. Hospitalized opioid users had four times the risk for endocarditis hospitalization compared with hospitalized nonopioid users in the 18–44 year age group (RR: 4.2 [95% CI: 3.9–4.5]) (Table 1). Conclusion These results provide further evidence that opioid use is associated with an increased risk of endocarditis, osteomyelitis, and CNS abscess. Efforts to combat the opioid epidemic might lower the overall incidence of endocarditis, osteomyelitis, and CNS abscess. Disclosures All authors: No reported disclosures.


2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S322-S334
Author(s):  
Ashly E Jordan ◽  
Charles M Cleland ◽  
Katarzyna Wyka ◽  
Bruce R Schackman ◽  
David C Perlman ◽  
...  

Abstract Background Hepatitis C virus (HCV) incidence has increased in the worsening opioid epidemic. We examined the HCV preventive efficacy of medication-assisted treatment (MAT), and geographic variation in HCV community viral load (CVL) and its association with HCV incidence. Methods HCV incidence was directly measured in an open cohort of patients in a MAT program in New York City between 1 January 2013 and 31 December 2016. Area-level HCV CVL was calculated. Associations of individual-level factors, and of HCV CVL, with HCV incidence were examined in separate analyses. Results Among 8352 patients, HCV prevalence was 48.7%. Among 2535 patients seronegative at first antibody test, HCV incidence was 2.25/100 person-years of observation (PYO). Incidence was 6.70/100 PYO among those reporting main drug use by injection. Female gender, drug injection, and lower MAT retention were significantly associated with higher incidence rate ratios. Female gender, drug injection, and methadone doses <60 mg were independently associated with shorter time to HCV seroconversion. HCV CVLs varied significantly by geographic area. Conclusions HCV incidence was higher among those with lower MAT retention and was lower among those receiving higher methadone doses, suggesting the need to ensure high MAT retention, adequate doses, and increased HCV prevention and treatment engagement. HCV CVLs vary geographically and merit further study as predictors of HCV incidence.


2020 ◽  
Vol 30 (1) ◽  
pp. 65-71
Author(s):  
Suky Martinez ◽  
Jermaine D. Jones ◽  
Laura Brandt ◽  
Aimee N. C. Campbell ◽  
Rebecca Abbott ◽  
...  

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Jennifer McNeely ◽  
Marc N Gourevitch ◽  
Denise Paone ◽  
Sharmila Shah ◽  
Shana Wright ◽  
...  

Author(s):  
Stefanie A. Joseph ◽  
Yueh-Hsiu Mathilda Chiu ◽  
Kathlene Tracy

2020 ◽  
Vol 58 (8) ◽  
Author(s):  
Jorge Sepulveda ◽  
Lars F. Westblade ◽  
Susan Whittier ◽  
Michael J. Satlin ◽  
William G. Greendyke ◽  
...  

ABSTRACT A surge of patients with coronavirus disease 2019 (COVID-19) presenting to New York City hospitals in March 2020 led to a sharp increase in blood culture utilization, which overwhelmed the capacity of automated blood culture instruments. We sought to evaluate the utilization and diagnostic yield of blood cultures during the COVID-19 pandemic to determine prevalence and common etiologies of bacteremia and to inform a diagnostic approach to relieve blood culture overutilization. We performed a retrospective cohort analysis of 88,201 blood cultures from 28,011 patients at a multicenter network of hospitals within New York City to evaluate order volume, positivity rate, time to positivity, and etiologies of positive cultures in COVID-19. Ordering volume increased by 34.8% in the second half of March 2020 compared to the level in the first half of the month. The rate of bacteremia was significantly lower among COVID-19 patients (3.8%) than among COVID-19-negative patients (8.0%) and those not tested (7.1%) (P < 0.001). COVID-19 patients had a high proportion of organisms reflective of commensal skin microbiota, which, when excluded, reduced the bacteremia rate to 1.6%. More than 98% of all positive cultures were detected within 4 days of incubation. Bloodstream infections are very rare for COVID-19 patients, which supports the judicious use of blood cultures in the absence of compelling evidence for bacterial coinfection. Clear communication with ordering providers is necessary to prevent overutilization of blood cultures during patient surges, and laboratories should consider shortening the incubation period from 5 days to 4 days, if necessary, to free additional capacity.


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