scholarly journals Opioids and Infectious Diseases: A Converging Public Health Crisis

2019 ◽  
Vol 220 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Tara A Schwetz ◽  
Thomas Calder ◽  
Elana Rosenthal ◽  
Sarah Kattakuzhy ◽  
Anthony S Fauci
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Opioid Use Disorder ◽  
Soft Tissue Infections ◽  
Opioid Use ◽  
Therapeutic Approaches ◽  
Predisposing Factor ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Immunodeficiency Virus

Abstract A converging public health crisis is emerging because the opioid epidemic is fueling a surge in infectious diseases, such as human immunodeficiency virus infection with or without AIDS, the viral hepatitides, infective endocarditis, and skin and soft-tissue infections. An integrated strategy is needed to tailor preventive and therapeutic approaches toward infectious diseases in people who misuse and/or are addicted to opioids and to concurrently address the underlying predisposing factor for the infections—opioid use disorder. This commentary highlights the unique and complementary roles that the infectious diseases and substance use disorder communities can play in addressing this crisis of dual public health concerns.

scholarly journals Alternatives to Arrest for Illicit Opioid Use: A Joint Criminal Justice and Healthcare Treatment Collaboration

2020 ◽  
Vol 14 ◽  
pp. 117822182095339
Author(s):  
Andrea J Yatsco ◽  
Rachel D Garza ◽  
Tiffany Champagne-Langabeer ◽  
James R Langabeer
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
Law Enforcement ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
The Us ◽  
History Of ◽  
Illicit Opioid Use

Opioid overdoses continue to be a leading cause of death in the US. This public health crisis warrants innovative responses to help prevent fatal overdose. There is continued advocacy for collaborations between public health partners to create joint responses. The high correlation between persons with opioid use disorder who have a history of involvement in the criminal justice system is widely recognized, and allows for treatment intervention opportunities. Law enforcement-led treatment initiatives are still relatively new, with a few sparse early programs emerging almost a decade ago and only gaining popularity in the past few years. A lack of published methodologies creates a gap in the knowledge of applied programs that are effective and can be duplicated. This article seeks to outline an interagency relationship between police and healthcare that illustrates arrest is not the only option that law enforcement may utilize when encountering persons who use illicit substances. Program methods of a joint initiative between law enforcement and healthcare in a large, metropolitan area will be reviewed, supplemented with law enforcement overdose data and statistics on law enforcement treatment referrals.

A history of opioid abuse: Why buprenorphine is superior for the management of opioid use disorder and pain

2021 ◽  
Vol 17 (7) ◽  
pp. 43-50
Author(s):  
Michael D. Komrowski, MS ◽  
Nitin K. Sekhri, MD
Keyword(s):  
Public Health ◽  
Opioid Use Disorder ◽  
Opioid Abuse ◽  
Common Side Effect ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
History Of ◽  
Opioid Medications ◽  
Regulatory Economic

Opioid abuse represents a public health crisis that has significant associated morbidity and mortality. Since beginning in the early 1990’s, the opioid abuse epidemic has been difficult to control due to regulatory, economic, and psychosocial factors that have perpetuated its existence. This era of opioid abuse has been punctuated by three distinct rises in mortality, precipitated by unique public health problems that needed to be addressed. Patients affected by opioid abuse have been historically treated with either methadone or naltrexone. While these agents have clinical utility supported by robust literature, we the authors posit that buprenorphine is a superior therapy for both opioid use disorder (OUD) as well as pain. This primacy is due to the pharmacological properties of buprenorphine which render it unique among other opioid medications. One such property is buprenorphine’s ceiling effect of respiratory depression, a common side effect and complicating factor in the administration of many classical opioid medications. This profile renders buprenorphine safer, while simultaneously retaining therapeutic utility in the medical practitioner’s pharmacopeia for the treatment of opioid use disorder and pain.

scholarly journals How To Prepare for the Unexpected: a Public Health Laboratory Response

2021 ◽  
Vol 34 (3) ◽  
Author(s):  
Carmen L. Charlton ◽  
Noah Hull ◽  
Cari Roark Sloma ◽  
Mary Bonifas ◽  
Matthew Johnson ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Natural Disasters ◽  
Subject Matter ◽  
Subject Matter Experts ◽  
Health Crisis ◽  
Direct Involvement ◽  
Public Health Crisis ◽  
Selection Of ◽  
Increased Pressure

SUMMARY Public health laboratories (PHLs) continue to face internal and external challenges to their abilities to provide successful, timely responses to public health crises and emerging threats. These laboratories are mandated to maintain the health of their communities by identifying, diagnosing, and warning constituents of potential and real health emergencies. Due to the changing characteristics of public health threats and their cross-jurisdictional nature, laboratories are facing increased pressure to ensure that they respond in a consistent and coordinated manner. Here, the Association of Public Health Laboratories (APHL) Emerging Leader Program Cohort 11 members have compiled stories from subject matter experts (SMEs) at PHLs with direct involvement in crises to determine the characteristics of a successful response. Experts examined a diverse selection of emerging threats from across PHLs, including infectious diseases, opioids, natural disasters, and government shutdowns. While no public health crisis will be identical to another, overarching themes were consistent across subjects. Experiences from SMEs that could improve future responses to emerging threats are highlighted.

Pandemic Tales

2020 ◽  
pp. 22-45
Author(s):  
Mark Davis ◽  
Davina Lohm
Keyword(s):  
Public Health ◽  
At Risk ◽  
Infectious Diseases ◽  
Health Communication ◽  
News Media ◽  
Narrative Theory ◽  
Health Crisis ◽  
Narrative Approaches ◽  
Public Health Crisis ◽  
Coming To Know

Chapter 2 considers in more detail the growing significance of narrative approaches to health communication on pandemic threats, reflecting on the conceptual bases for this turn in light of perspectives from narrative theory and biopolitical accounts of infectious diseases. Key themes are the folk-tale undercurrents of pandemic narratives that appear in news media and in the advice of experts and therefore also their significance for the individuals who engage with them. A key point is that narrative and its mediations are a primary point of contact for publics coming to know of a rapidly emerging public health crisis. In this respect, we introduce Sarah’s story of how she realized that she was herself possibly at risk of the virus, in part because of stories on the pandemic circulated in media she consumed.

scholarly journals Association between Participation in Counseling and Retention in a Buprenorphine-Assisted Treatment Program for People Experiencing Homelessness with Opioid Use Disorder

2021 ◽  
Vol 18 (21) ◽  
pp. 11072
Author(s):  
Amanda R. W. Berry ◽  
Tracy L. Finlayson ◽  
Luke M. Mellis ◽  
Lianne A. Urada
Keyword(s):  
Public Health ◽  
Cohort Analysis ◽  
Retention In Care ◽  
Opioid Use Disorder ◽  
San Diego County ◽  
Opioid Use ◽  
Health Crisis ◽  
Medication Assisted Treatment ◽  
Retrospective Cohort Analysis ◽  
Human Habitation

The opioid epidemic is a public health crisis that disproportionately affects our unsheltered neighbors. Because medication-assisted treatment (MAT) is effective for preventing deaths from drug overdose and retention is associated with better health outcomes, there is a clear need for more research on factors impacting retention in care. This retrospective cohort analysis examines the relationship between attendance in counseling and retention on buprenorphine for three or more months for individuals experiencing homelessness being treated at a Federally Qualified Health Center (FQHC) and Public Health Service Act §330(h) Health Care for the Homeless Program grantee in San Diego County, California. The cohort included 306 adults experiencing homelessness who had at least one prescription for buprenorphine and participated in a MAT program between 2017 and 2019. The sample included 64.4% men, almost exclusively white, and 35% lived in a place not meant for human habitation. Of the sample, 97 patients were retained at 3 months and 209 were not. Results from a logistic regression model showed that counseling appointments were positively associated with retention at three months (OR = 1.57, p < 0.001). Findings from this study inform future MAT program design components for people experiencing homelessness.

scholarly journals The state of naloxone: Access amid a public health crisis

2019 ◽  
Vol 3 ◽  
pp. 239920261984763
Author(s):  
Jeffrey Fudin ◽  
Amelia L Persico ◽  
Jeffrey J Bettinger ◽  
Erica L Wegrzyn
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Mitigation Strategies ◽  
Patient Specific ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Risk Patients

Over the past decade, opioid use has been at the forefront of a public health crisis throughout the United States. In response to the tremendous negative societal, personal, and economic impacts that the growing opioid crisis has caused, several governmental agencies began to respond. These efforts include declaration of a nationwide public health emergency, increased public health surveillance of the epidemic, research support for pain and addiction, and increased access to overdose-reversing drugs such as naloxone. Naloxone access, in particular, has become a priority. In the United States, pharmacists have had the opportunity to play a crucial role in promoting access to naloxone. Since initial approval by the Food and Drug Administration (FDA) in 1971 as an antidote to opioid agonist overdose, naloxone access has evolved significantly. Today many states have authorized standing orders for naloxone, allowing it to be dispensed by pharmacists without a patient-specific prescription, and all 50 states and the District of Columbia allow medical providers to prescribe take-home naloxone to at-risk patients. While the opioid epidemic itself remains a contentious topic of political, ethical, and medical debate, it is widely acknowledged that mitigation strategies that could lessen morbidity and mortality are essential. Improved access to naloxone is one such strategy which remains at the forefront during this public health crisis.

CAEP Position Statement: Emergency department management of people with opioid use disorder

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 768-771
Author(s):  
Justin J. Koh ◽  
Michelle Klaiman ◽  
Isabelle Miles ◽  
Jolene Cook ◽  
Thara Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Position Statement ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Health Crisis ◽  
Canadian Youth ◽  
National Public Health ◽  
Problematic Substance ◽  
Emergency Department Management

Deaths due to opioid overdose have reached unprecedented levels in Canada; over 12,800 opioid-related deaths occurred between January 2016 and March 2019, and overdose death rates increased by approximately 50% from 2016 to 2018.1 In 2016, Health Canada declared the opioid epidemic a national public health crisis,2 and life expectancy increases have halted in Canada for the first time in decades.3 Children are not exempt from this crisis, and the Chief Public Health Officer of Canada has recently prioritized the prevention of problematic substance use among Canadian youth.4

scholarly journals 311 service requests as indicators of neighborhood distress and opioid use disorder

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuchen Li ◽  
Ayaz Hyder ◽  
Lauren T. Southerland ◽  
Gretchen Hammond ◽  
Adam Porr ◽  
...  
Keyword(s):  
Public Health ◽  
Census Data ◽  
Predictive Accuracy ◽  
Basic Research ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Health Crisis ◽  
The City

Abstract Opioid use disorder and overdose deaths is a public health crisis in the United States, and there is increasing recognition that its etiology is rooted in part by social determinants such as poverty, isolation and social upheaval. Limiting research and policy interventions is the low temporal and spatial resolution of publicly available administrative data such as census data. We explore the use of municipal service requests (also known as “311” requests) as high resolution spatial and temporal indicators of neighborhood social distress and opioid misuse. We analyze the spatial associations between georeferenced opioid overdose event (OOE) data from emergency medical service responders and 311 service request data from the City of Columbus, OH, USA for the time period 2008–2017. We find 10 out of 21 types of 311 requests spatially associate with OOEs and also characterize neighborhoods with lower socio-economic status in the city, both consistently over time. We also demonstrate that the 311 indicators are capable of predicting OOE hotspots at the neighborhood-level: our results show code violation, public health, and street lighting were the top three accurate predictors with predictive accuracy as 0.92, 0.89 and 0.83, respectively. Since 311 requests are publicly available with high spatial and temporal resolution, they can be effective as opioid overdose surveillance indicators for basic research and applied policy.

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