Opioid Use Disorder and Associated Infectious Disease: The Role of the Laboratory in Addressing Health Disparities

Author(s):  
Christopher W Farnsworth ◽  
Matthew Lloyd ◽  
Sophonie Jean

Abstract Background Opioid use disorder, defined as a pattern of problematic opioid use leading to clinically significant impairment, has resulted in considerable morbidity and mortality throughout the world. This is due, at least in part, to the marginalized status of patients with opioid use disorder, limiting their access to appropriate laboratory testing, diagnosis, and treatment. Infections have long been associated with illicit drug use and contribute considerably to morbidity and mortality. However, barriers to testing and negative stigmas associated with opioid use disorder present unique challenges to infectious disease testing in this patient population. Content This review addresses the associations between opioid use disorder and infectious organisms, highlighting the health disparities encountered by patients with opioid use disorder, and the important role of laboratory testing for diagnosing and managing these patients. Summary Infections are among the most frequent and adverse complications among patients with opioid use disorder. As a result of health disparities and systemic biases, patients that misuse opioids are less likely to receive laboratory testing and treatment. However, laboratories play a crucial in identifying patients that use drugs illicitly and infections associated with illicit drug use.

Author(s):  
Katharine E Linder ◽  
Tatnai L Burnett ◽  
Chia-Sui Weng ◽  
Zaraq Khan ◽  
Kristin Mara ◽  
...  

Objective: To determine the clinical characteristics and prior medical and surgical treatments in women undergoing surgical excision of endometriosis for pelvic pain at a single institution. Methods: In this retrospective cohort study we identified 140 women with pathology-proven endometriosis who completed a preoperative standardized pain form and underwent surgery at an endometriosis center. Women were stratified into three groups for analysis: no prior surgery, 1 prior surgery, and 2+ prior surgeries. Results: The most common treatments used prior to seeking care were hormonal contraceptives (51.6%) and surgery (46.1%). More than half of women were diagnosed with pelvic floor dysfunction at time of presentation or prior to consultation. There was a significant relationship between an increasing number of surgeries (none vs 1 vs 2+) and gonadotropin-releasing hormone (GnRH) agonist use (19.0% vs 27.5% vs 56.0%, p = 0.003). Though not significant, a trend was noted between increasing surgeries and opioid use (20.6% vs 30.0% vs 40.0%, p = 0.17). There was a statistically significant relationship between multiple surgeries and illicit drug use ( p < 0.001). Conclusion: Patients with pelvic pain and endometriosis who have undergone multiple surgeries are more likely to have used GnRH agonists and report illicit drug use prior to presenting to specialized care.


1995 ◽  
Vol 25 (4) ◽  
pp. 703-722 ◽  
Author(s):  
Scott Macdonald

In the past decade, many employers have adopted drug-testing programs to reduce workplace injuries. However, little scientific evidence shows that drug use is a significant and substantial cause of total workplace injuries. The purpose of this study was to empirically assess the role of drugs and alcohol in causing workplace injuries. Questionnaires were received from 882 Ontario employees in a household survey. Results showed that many variables were significantly related to job injuries. The variables were ranked according to the relative importance of each variable's contribution to total job injuries. Alcohol problems, licit drug use, and illicit drug use ranked 7, 11, and 12 respectively among a group of 12 significant variables. In order to examine the likelihood that drug use was a cause of job injuries, the relationship between job injuries and alcohol problems, licit drug use, and illicit drug use was examined across categories of third variables. For age, the relationship between drug use and injuries remained strong for the youngest age group, but disappeared for the oldest age group. Logistic regression analysis confirmed the plausibility of noncausal explanations of job injuries for illicit drug use, but not for alcohol problems or licit drug use. Overall, the results indicated that illicit drug use does not appear to be a major cause of job injuries. The implications of these results for drug-testing programs are discussed.


2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Omid Massah ◽  
Manuchehr Azkhosh ◽  
Yousof Azami ◽  
Ali Akbar Goodiny ◽  
Younes Doostian ◽  
...  

2020 ◽  
Vol 105 ◽  
pp. 106289 ◽  
Author(s):  
Christy Kollath-Cattano ◽  
Sarah J. Hatteberg ◽  
Anna Kooper

2020 ◽  
Vol 50 (4) ◽  
pp. 550-565 ◽  
Author(s):  
Philip R. Kavanaugh ◽  
Katherine McLean

Drawing on a multisite sample of 40 persons who sell, share, or use diverted buprenorphine to manage opioid use disorder, in this study we describe why individuals seek to obtain buprenorphine outside of formal treatment contexts, and between-site variation regarding their motives and means. Findings indicate that both the provision and purchase of diverted buprenorphine support user-defined risk minimization strategies to avoid withdrawal, reduce heroin use, and satiate opioid cravings in periods of lowered tolerance. We also found that a subset of the sample used buprenorphine recreationally, and that it functioned to extend or augment illicit drug use careers. Implications of the findings are discussed in light of federal and state drug control and treatment policies.


2011 ◽  
Vol 20 (4) ◽  
pp. 412-419 ◽  
Author(s):  
Christy E. Newman ◽  
Martin Holt ◽  
Joanne Bryant ◽  
Susan C. Kippax ◽  
Dana M. Paquette ◽  
...  

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Amanda A. Westlake ◽  
Mark P. Eisenberg

Abstract In the context of an escalating opioid epidemic, infectious disease clinicians increasingly treat the infectious complications of injection drug use. In this learning unit, we review the history, pharmacology, and clinical use of buprenorphine as maintenance therapy for opioid use disorder, and we describe the process by which clinicians can obtain a buprenorphine waiver.


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