scholarly journals New Opioid Analgesic Approvals and Outpatient Utilization of Opioid Analgesics in the United States, 1997 through 2015

2018 ◽  
Vol 128 (5) ◽  
pp. 953-966 ◽  
Author(s):  
Grace Chai ◽  
Jing Xu ◽  
James Osterhout ◽  
Mark A. Liberatore ◽  
Kathleen L. Miller ◽  
...  
Keyword(s):  
United States ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
The United States ◽  
New Drugs ◽  
Prescribing Patterns ◽  
Silver Spring ◽  
Primary Driver ◽  
Retail Setting ◽  
The U.S

Abstract Background The opioid epidemic, driven in part by increased prescribing, is a public health emergency. This study examines dispensed prescription patterns and approvals of new opioid analgesic products to investigate whether the introduction of these new drugs increases prescribing. Methods Prescribing patterns based on dispensed prescription claims from the U.S. retail setting were assessed with new brand and generic opioid analgesic products approved in the United States from 1997 through 2015. Results From 1997 through 2015, the U.S. Food and Drug Administration (Silver Spring, Maryland) approved 263 opioid analgesic products, including 33 brand products. Dispensed prescriptions initially increased 80% from 145 million prescriptions in 1997 to a peak of 260 million prescriptions in 2012 before decreasing by 12% to 228 million prescriptions in 2015. Morphine milligram equivalents dispensed per prescription increased from 486 in 1997 to a peak of 950 in 2010, before decreasing to 905 in 2015. In 2015, generic products accounted for 96% (218/228 million prescriptions) of all opioid analgesic prescriptions dispensed. The remaining prescriptions were dispensed for brand products, of which nearly half were dispensed for one brand product (OxyContin, Purdue, USA). Conclusions There has been a dramatic increase in prescriptions dispensed for opioid analgesics since 1997 and an increasing number of opioid analgesic approvals; however, the number of prescriptions dispensed has declined since 2012 despite an increasing number of approvals. Examination of dispensed prescriptions shows a shifting and complex market where multiple factors likely influence prescribing; the approval of new products alone may not be sufficient to be a primary driver of increased prescribing.

scholarly journals Opioid Analgesic Prescribing Practices of Dental Professionals in the United States

2017 ◽  
Vol 2 (3) ◽  
pp. 241-248 ◽  
Author(s):  
C.N. Steinmetz ◽  
C. Zheng ◽  
E. Okunseri ◽  
A. Szabo ◽  
C. Okunseri
Keyword(s):  
United States ◽  
Opioid Analgesic ◽  
Personal Characteristics ◽  
Opioid Analgesics ◽  
The United States ◽  
Medical Expenditure ◽  
Dental Procedure ◽  
Prescribing Practices ◽  
Over Time ◽  
Dental Professionals

The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19–1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17–1.41), 0.57 (95% CI, 0.47–0.70), and 0.84 (95% CI, 0.75–0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

scholarly journals Urban scaling of opioid analgesic sales in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258526
Author(s):  
Pricila H. Mullachery ◽  
Usama Bilal
Keyword(s):  
United States ◽  
Piecewise Linear ◽  
Opioid Analgesic ◽  
The United States ◽  
Prescribing Patterns ◽  
Prescription Opioid ◽  
Future Research ◽  
Health Crisis ◽  
Pill Counts ◽  
Urban Scaling

Opioid misuse is a public health crisis in the United States. The origin of this crisis is associated with a sharp increase in opioid analgesic prescribing. We used the urban scaling framework to analyze opioid prescribing patterns in US commuting zones (CZs), i.e., groups of counties based on commuting patterns. The urban scaling framework postulates that a set of scaling relations can be used to predict health outcomes and behaviors in cities. We used data from the Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS) to calculate counts of oxycodone/hydrocodone pills distributed to 607 CZs in the continental US from 2006 to 2014. We estimated the scaling coefficient of opioid pill counts by regressing log(pills) on log(population) using a piecewise linear spline with a single knot at 82,363. Our results show that CZs with populations below the knot scaled superlinearly (β = 1.36), i.e., larger CZs had disproportionally larger pill counts compared to smaller CZs. On the other hand, CZs with populations above the knot scaled sublinearly (β = 0.92), i.e., larger CZs had disproportionally smaller pill counts compared to smaller CZs. This dual scaling pattern was consistent across US census regions. For CZs with population below the knot, the superlinear scaling of pills is consistent with the explanation that an increased number of successful matches between prescribers and users will lead to higher prescribing rates. The non-linear scaling behavior observed could be the result of a combination of factors, including stronger health care systems and prescribing regulation in largely populated commuting zones, as well as high availability of other opioids such as heroin in these commuting zones. Future research should explore potential mechanisms for the non-linearity of prescription opioid pills.

Benzodiazepines

2014 ◽  
Vol 27 (1) ◽  
pp. 5-16 ◽  
Author(s):  
Michael Jann ◽  
William Klugh Kennedy ◽  
Gaylord Lopez
Keyword(s):  
Health Care ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Health Care Professionals ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
Fold Increase ◽  
The United States ◽  
Emergency Department Visits ◽  
Prescribing Patterns

The misuse and abuse of prescription medications in the United States continues to increase despite interventions by health care professionals, regulatory, and law enforcement agencies. Opioid analgesics are the leading class of prescription drugs that have caused unintentional overdose deaths. Benzodiazepines when taken alone are relatively safe agents in overdose. However, a 5-fold increase in deaths attributed to benzodiazepines occurred from 1999 to 2009. Emergency department visits related to opioid analgesics increased by 111% followed by benzodiazepines 89%. During 2003 to 2009, the 2 prescriptions drugs with the highest increase in death rates were oxycodone 264.6% and alprazolam 233.8%. Therefore, benzodiazepines have a significant impact on prescription drug unintentional overdoses second only to the opioid analgesics. The combination prescribing of benzodiazepines and opioid analgesics commonly takes place. The pharmacokinetic drug interactions between benzodiazepines and opioid analgesics are complex. The pharmacodynamic actions of these agents differ as their combined effects produce significant respiratory depression. Physician and pharmacy shopping by patients occurs, and prescription drug-monitoring programs can provide important information on benzodiazepine and opioid analgesic prescribing patterns and patient usage. Health care professionals need to inform patients and work closely with regulatory agencies and legislatures to stem the increasing fatalities from prescription drug unintentional overdoses.

scholarly journals De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions (DIODE): Trial rationale, protocol, and progress to date (Preprint)

2020 ◽  
Author(s):  
D. Brad Rindal ◽  
Stephen E. Asche ◽  
Jan Gryczynski ◽  
Sheryl M. Kane ◽  
Anjali R. Truitt ◽  
...  
Keyword(s):  
United States ◽  
Pain Management ◽  
Patient Education ◽  
Randomized Trial ◽  
Primary Outcome ◽  
Opioid Analgesics ◽  
The United States ◽  
Prescribing Patterns ◽  
Opioid Prescribing ◽  
Patient Level

BACKGROUND Overdose deaths from prescription opioid analgesics are a continuing crisis in the United States. Opioid analgesics are among the most frequently prescribed drugs by dentists. An estimated 5 million people undergo third-molar extractions in the United States each year, resulting in postoperative pain. Studies show that in most cases the combination of ibuprofen and acetaminophen is an effective alternative to commonly-prescribed opioid analgesics for the management of post-extraction pain. Nevertheless, many dentists routinely prescribe opioids after dental extractions. OBJECTIVE We describe the rationale, design, and methods for a randomized trial of interventions designed to de-implement opioid prescribing by dentists while implementing effective non-opioid analgesics following dental extractions. METHODS Using a prospective, 3-arm cluster randomized trial design with dentists as the unit randomized and patient-level prescribing data as the primary outcome, we will compare different strategies to reduce the reliance on opioids and increase the use of alternative pain management approaches utilizing information support tools aimed at both providers and their patients. The study will test the efficacy of two interventions to decrease opioid prescribing following dental extractions: Clinical Decision Support (CDS), and CDS with Patient Education (CDS-E). Providers will be randomized to CDS, CDS-E, or standard practice. Patient-level outcomes will be determined via review of comprehensive electronic health records. We will compare study arms on differential change in prescribing patterns from pre- to post-implementation of the intervention. The primary outcome of interest is a binary indicator of whether or not the patient received an opioid prescription on the day of the extraction encounter. We will also examine recommendations or prescriptions for non-opioid analgesics, patients’ perception of shared decision making, and patients’ pain experiences following the extraction. RESULTS The HealthPartners Institutional Review Board has approved the study. All study materials including the CDS and patient education materials have been developed and pilot tested and the protocol has been approved by National Institute of Dental and Craniofacial Research (NIDCR). The intervention was implemented in February 2020 and data collection has begun. CONCLUSIONS If the intervention strategies are shown to be effective, they could be implemented more broadly in dental settings with high levels of opioid prescribing. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT03584789

An American Language

2018 ◽  
Author(s):  
Rosina Lozano
Keyword(s):  
United States ◽  
National Policy ◽  
The United States ◽  
Spanish Language ◽  
Spanish Speakers ◽  
Language Recognition ◽  
Political Language ◽  
Political Issue ◽  
History Of ◽  
The U.S

An American Language is a political history of the Spanish language in the United States. The nation has always been multilingual and the Spanish language in particular has remained as an important political issue into the present. After the U.S.-Mexican War, the Spanish language became a language of politics as Spanish speakers in the U.S. Southwest used it to build territorial and state governments. In the twentieth century, Spanish became a political language where speakers and those opposed to its use clashed over what Spanish's presence in the United States meant. This book recovers this story by using evidence that includes Spanish language newspapers, letters, state and territorial session laws, and federal archives to profile the struggle and resilience of Spanish speakers who advocated for their language rights as U.S. citizens. Comparing Spanish as a language of politics and as a political language across the Southwest and noncontiguous territories provides an opportunity to measure shifts in allegiance to the nation and exposes differing forms of nationalism. Language concessions and continued use of Spanish is a measure of power. Official language recognition by federal or state officials validates Spanish speakers' claims to US citizenship. The long history of policies relating to language in the United States provides a way to measure how U.S. visions of itself have shifted due to continuous migration from Latin America. Spanish-speaking U.S. citizens are crucial arbiters of Spanish language politics and their successes have broader implications on national policy and our understanding of Americans.

Palestine Unbound

2018 ◽  
Vol 47 (3) ◽  
pp. 130-134
Keyword(s):  
United States ◽  
Human Rights ◽  
Task Force ◽  
The United States ◽  
Donald Trump ◽  
Tel Aviv ◽  
The Us ◽  
Intention To Move ◽  
Arab Israeli Conflict ◽  
The U.S

This section, updated regularly on the blog Palestine Square, covers popular conversations related to the Palestinians and the Arab-Israeli conflict during the quarter 16 November 2017 to 15 February 2018: #JerusalemIstheCapitalofPalestine went viral after U.S. president Donald Trump recognized Jerusalem as the capital of Israel and announced his intention to move the U.S. embassy there from Tel Aviv. The arrest of Palestinian teenager Ahed Tamimi for slapping an Israeli soldier also prompted a viral campaign under the hashtag #FreeAhed. A smaller campaign protested the exclusion of Palestinian human rights from the agenda of the annual Creating Change conference organized by the US-based National LGBTQ Task Force in Washington. And, UNRWA publicized its emergency funding appeal, following the decision of the United States to slash funding to the organization, with the hashtag #DignityIsPriceless.

The French Way

2011 ◽  
Author(s):  
Richard F. Kuisel
Keyword(s):  
United States ◽  
The United States ◽  
French Language ◽  
French Cinema ◽  
Free Markets ◽  
Technology Sector ◽  
Aids Epidemic ◽  
Political Reality ◽  
Politics And Culture ◽  
The U.S

There are over 1,000 McDonald's on French soil. Two Disney theme parks have opened near Paris in the last two decades. And American-inspired vocabulary such as “le weekend” has been absorbed into the French language. But as former French president Jacques Chirac put it: “The U.S. finds France unbearably pretentious. And we find the U.S. unbearably hegemonic.” Are the French fascinated or threatened by America? They Americanize yet are notorious for expressions of anti-Americanism. From McDonald's and Coca-Cola to free markets and foreign policy, this book looks closely at the conflicts and contradictions of France's relationship to American politics and culture. The book shows how the French have used America as both yardstick and foil to measure their own distinct national identity. France has charted its own path: it has welcomed America's products but rejected American policies; assailed Americ's “jungle capitalism” while liberalizing its own economy; attacked “Reaganomics” while defending French social security; and protected French cinema, television, food, and language even while ingesting American pop culture. The book examines France's role as an independent ally of the United States, but he also considers the country's failures in influencing the Reagan, Bush, and Clinton administrations. Whether investigating France's successful information technology sector or its spurning of American expertise during the AIDS epidemic, the book asks if this insistence on a French way represents a growing distance between Europe and the United States or a reaction to American globalization. Exploring cultural trends, values, public opinion, and political reality, this book delves into the complex relationship between two modern nations.

Latino Catholicism

2011 ◽  
Author(s):  
Timothy Matovina
Keyword(s):  
United States ◽  
Sixteenth Century ◽  
Catholic Church ◽  
Social Life ◽  
Social Issues ◽  
The United States ◽  
Societal Impact ◽  
Comprehensive Overview ◽  
Public Debates ◽  
The U.S

Most histories of Catholicism in the United States focus on the experience of Euro-American Catholics, whose views on social issues have dominated public debates. This book provides a comprehensive overview of the Latino Catholic experience in America from the sixteenth century to today, and offers the most in-depth examination to date of the important ways the U.S. Catholic Church, its evolving Latino majority, and American culture are mutually transforming one another. This book highlights the vital contributions of Latinos to American religious and social life, demonstrating in particular how their engagement with the U.S. cultural milieu is the most significant factor behind their ecclesial and societal impact.

Sign in / Sign up

Export Citation Format

Share Document