New Data on Marijuana Laws, Opioid Use, and Opioid Overdose

2018 ◽  
Vol 24 (9) ◽  
pp. 106
Keyword(s):  
Opioid Overdose ◽  
Opioid Use

scholarly journals Assessing the Relationships Between COVID-19 Stay-at-Home Orders and Opioid Overdoses in the State of Pennsylvania

2021 ◽  
pp. 002204262110063
Author(s):  
Brian King ◽  
Ruchi Patel ◽  
Andrea Rishworth
Keyword(s):  
Age Groups ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Policy Recommendations ◽  
Opioid Use ◽  
Fentanyl Analogs ◽  
Measure Change ◽  
Using Data ◽  
At Home

COVID-19 is compounding opioid use disorder throughout the United States. While recent commentaries provide useful policy recommendations, few studies examine the intersection of COVID-19 policy responses and patterns of opioid overdose. We examine opioid overdoses prior to and following the Pennsylvania stay-at-home order implemented on April 1, 2020. Using data from the Pennsylvania Overdose Information Network, we measure change in monthly incidents of opioid-related overdose pre- versus post-April 1, and the significance of change by gender, age, race, drug class, and naloxone doses administered. Findings demonstrate statistically significant increases in overdose incidents among both men and women, White and Black groups, and several age groups, most notably the 30–39 and 40–49 ranges, following April 1. Significant increases were observed for overdoses involving heroin, fentanyl, fentanyl analogs or other synthetic opioids, pharmaceutical opioids, and carfentanil. The study emphasizes the need for opioid use to be addressed alongside efforts to mitigate and manage COVID-19 infection.

Predicting Opioid Overdose Readmission and Opioid Use Disorder with Machine Learning

2020 ◽  
Author(s):  
Sarah McDougall ◽  
Priyanka Annapureddy ◽  
Praveen Madiraju ◽  
Nicole Fumo ◽  
Stephen Hargarten
Keyword(s):  
Machine Learning ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use

Conversations About Opioids: Impact of the Opioid Overdose Epidemic on Social Interactions for People Who Live With Chronic Pain

2021 ◽  
pp. 104973232110030
Author(s):  
Lise Dassieu ◽  
Angela Heino ◽  
Élise Develay ◽  
Jean-Luc Kaboré ◽  
M. Gabrielle Pagé ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Media Coverage ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Negative Effects ◽  
Self Advocacy ◽  
Social Lives ◽  
The Social ◽  
The Impact ◽  
Depth Interviews

The objective of this study was to understand the impact of the opioid overdose epidemic on the social lives of people suffering from chronic pain, focusing on interactions within their personal and professional circles. The study was based on 22 in-depth interviews with people living with chronic pain in Canada. Using thematic analysis, we documented three main impacts of the opioid overdose epidemic: (a) increased worries of people in pain and their families regarding the dangers of opioids; (b) prejudices, stigma, and discrimination faced during conversations about opioids; and (c) stigma management attempts, which include self-advocacy and concealment of opioid use. This study represents important knowledge advancement on how people manage stigma and communicate about chronic disease during everyday life interactions. By showing negative effects of the epidemic’s media coverage on the social experiences of people with chronic pain, we underscore needs for destigmatizing approaches in public communication regarding opioids.

scholarly journals Willingness to use a wearable device capable of detecting and reversing overdose among people who use opioids in Philadelphia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Katie Kanter ◽  
Ryan Gallagher ◽  
Feyisope Eweje ◽  
Alexander Lee ◽  
David Gordon ◽  
...  
Keyword(s):  
Structured Interview ◽  
Wearable Device ◽  
Urban Setting ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Cross Sectional Survey ◽  
Reversal Agent ◽  
Response Options ◽  
History Of ◽  
Willingness To Use

Abstract Background The incidence of opioid-related overdose deaths has been rising for 30 years and has been further exacerbated amidst the COVID-19 pandemic. Naloxone can reverse opioid overdose, lower death rates, and enable a transition to medication for opioid use disorder. Though current formulations for community use of naloxone have been shown to be safe and effective public health interventions, they rely on bystander presence. We sought to understand the preferences and minimum necessary conditions for wearing a device capable of sensing and reversing opioid overdose among people who regularly use opioids. Methods We conducted a combined cross-sectional survey and semi-structured interview at a respite center, shelter, and syringe exchange drop-in program in Philadelphia, Pennsylvania, USA, during the COVID-19 pandemic in August and September 2020. The primary aim was to explore the proportion of participants who would use a wearable device to detect and reverse overdose. Preferences regarding designs and functionalities were collected via a questionnaire with items having Likert-based response options and a semi-structured interview intended to elicit feedback on prototype designs. Independent variables included demographics, opioid use habits, and previous experience with overdose. Results A total of 97 adults with an opioid use history of at least 3 months were interviewed. A majority of survey participants (76%) reported a willingness to use a device capable of detecting an overdose and automatically administering a reversal agent upon initial survey. When reflecting on the prototype, most respondents (75.5%) reported that they would wear the device always or most of the time. Respondents indicated discreetness and comfort as important factors that increased their chance of uptake. Respondents suggested that people experiencing homelessness and those with low tolerance for opioids would be in greatest need of the device. Conclusions The majority of people sampled with a history of opioid use in an urban setting were interested in having access to a device capable of detecting and reversing an opioid overdose. Participants emphasized privacy and comfort as the most important factors influencing their willingness to use such a device. Trial registration NCT04530591.

Preparing pharmacists to increase naloxone dispensing within community pharmacies under the Pennsylvania standing order

2020 ◽  
Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  
Keyword(s):  
Community Pharmacists ◽  
The United States ◽  
Health Concern ◽  
Community Pharmacies ◽  
Opioid Overdose ◽  
Patient Counseling ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Standing Order ◽  
Overdose Deaths

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.

scholarly journals Evaluation of a Medicaid performance improvement project to reduce high-dose opioid prescriptions

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel M. Hartung ◽  
Jonah Geddes ◽  
Sara E. Hallvik ◽  
P. Todd Korthuis ◽  
Luke Middleton ◽  
...  
Keyword(s):  
Performance Improvement ◽  
Emergency Department Visits ◽  
Prescription Opioid ◽  
High Dose ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Improvement Project ◽  
Opioid Prescribing ◽  
Percentage Points ◽  
Prescription Opioid Use

Abstract Background In 2015, Oregon’s Medicaid program implemented a performance improvement project to reduce high-dose opioid prescribing across its 16 coordinated care organizations (CCOs). The objective of this study was to evaluate the effect of that program on prescription opioid use and outcomes. Methods Using Medicaid claims data from 2014 to 2017, we conducted interrupted time-series analyses to examine changes in the prescription opioid use and overdose rates before (July 2014 to June 2015) and after (January 2016 to December 2017) implementation of Oregon’s high-dose policy initiative (July 2015 to December 2015). Prescribing outcomes were: 1) total opioid prescriptions 2) high-dose [> 90 morphine milligram equivalents per day] opioid prescriptions, and 3) proportion of opioid prescriptions that were high-dose. Opioid overdose outcomes included emergency department visits or hospitalizations that involved an opioid-related poisoning (total, heroin-involved, non-heroin involved). Analyses were performed at the state and CCO level. Results There was an immediate reduction in high dose opioid prescriptions after the program was implemented (− 1.55 prescription per 1000 enrollee; 95% CI − 2.26 to − 0.84; p < 0.01). Program implementation was also associated with an immediate drop (− 1.29 percentage points; 95% CI − 1.94 to − 0.64 percentage points; p < 0.01) and trend reduction (− 0.23 percentage point per month; 95% CI − 0.33 to − 0.14 percentage points; p < 0.01) in the monthly proportion of high-dose opioid prescriptions. The trend in total, heroin-involved, and non-heroin overdose rates increased significantly following implementation of the program. Conclusions Although Oregon’s high-dose opioid performance improvement project was associated with declines in high-dose opioid prescriptions, rates of opioid overdose did not decrease. Policy efforts to reduce opioid prescribing risks may not be sufficient to address the growing opioid crisis.

Training to improve responder attitudes and knowledge of opioid overdose

2021 ◽  
Vol 13 (8) ◽  
pp. 1-18
Author(s):  
Matthew Thomas ◽  
Laura Brady ◽  
Monika Wozniak ◽  
Elizabeth Terranova ◽  
Cheryll Moore ◽  
...  
Keyword(s):  
Training Session ◽  
Educational Background ◽  
Public Health Issue ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Major Public Health Issue ◽  
Knowledge And Attitudes ◽  
Before And After ◽  
Attitudes And Knowledge ◽  
The Impact

Background: Opioid use is a major public health issue and opioid overdose requires rapid response with naloxone. Aims: This study assesses the impact of a training session on the knowledge and attitudes of first responders and members of the community regarding opioid overdose recognition and naloxone use. Methods: A training session was delivered to 2327 participants between July 2019 and March 2020. The study used a paired, pre-/post-analysis to quantify changes. Findings: Nearly all (99.7%) participants completed a survey before and after training. Statistically significant improvements were observed in nearly all attitude and knowledge items. Conclusion: An education session delivered to an educationally and professionally diverse group can improve trainees' knowledge and attitudes. There were some significant differences between sub-groups, particularly regarding their professional and educational background, and whether the location was urban or rural. Further study is needed to examine whether trainees would benefit from a course tailored toward their education and professional experience.

scholarly journals Opioid-Related Diagnoses and Concurrent Claims for HIV, HBV, or HCV among Medicare Beneficiaries, United States, 2015

2019 ◽  
Vol 8 (11) ◽  
pp. 1768 ◽  
Author(s):  
Man-Huei Chang ◽  
Ramal Moonesinghe ◽  
Lyna Z. Schieber ◽  
Benedict I. Truman
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Opioid Overdose ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Cross Sectional ◽  
Using Data ◽  
Chronic Hcv ◽  
Demographic Attributes

Unsterile opioid injection increases risk for infection transmission, including HIV, hepatitis B virus (HBV), or hepatitis C virus (HCV). We assess prevalence of and risk factors associated with opioid overdose and infections with HIV, HBV, or HCV among Medicare beneficiaries with opioid-related fee-for-service claims during 2015. We conducted a cross-sectional analysis to estimate claims for opioid use and overdose and HIV, HBV, or HCV infections, using data from US Medicare fee-for-service claims. Beneficiaries with opioid-related claims had increased odds for HIV (2.3; 95% confidence interval (CI), 2.3–2.4), acute HBV (6.7; 95% CI, 6.3–7.1), chronic HBV (5.0; 95% CI, 4.7–5.4), acute HCV (9.6; 95% CI, 9.2–10.0), and chronic HCV (8.9; 95% CI, 8.7–9.1). Beneficiaries with opioid-related claims and for HIV, HBV, or HCV infection, respectively, had a 1.1–1.9-fold odds for having a claim for opioid overdose. Independent risk factors for opioid overdose and each selected infection outcome included age, sex, race/ethnicity, region, and residence in a high-vulnerability county. Having opioid-related claims and selected demographic attributes were independent, significant risk factors for having HIV, HBV, or HCV claims among US Medicare beneficiaries. These results might help guide interventions intended to reduce incidences of HIV, HCV, and HBV infections among beneficiaries with opioid-related claims.

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