scholarly journals Predictors of Medication Utilization for Opioid Use Disorder Among Medicaid‐Insured HIV Patients in New York

2020 ◽  
Vol 29 (2) ◽  
pp. 151-154
Author(s):  
Sugy Choi ◽  
Rajeev Yerneni ◽  
Shannon Healy ◽  
Mona Goyal ◽  
Charles J. Neighbors
Keyword(s):  
New York ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Hiv Patients ◽  
Medication Utilization

Pre-existing opioid use disorder and postoperative outcomes after appendectomy or cholecystectomy: A multi-state analysis, 2007-2014

2019 ◽  
Vol 15 (3) ◽  
pp. 235-251
Author(s):  
Alina Boltunova, MD ◽  
Robert S. White, MD, MS ◽  
Selaiman Noori, MD ◽  
Stephanie A. Chen, BA ◽  
Licia K. Gaber-Baylis, BA ◽  
...  
Keyword(s):  
New York ◽  
Postoperative Complications ◽  
Hospital Mortality ◽  
Hospital Readmission ◽  
Opioid Use Disorder ◽  
Postoperative Outcomes ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Surgical Patient ◽  
Opioid Use

Introduction and objectives: Opioid use disorder has become increasingly prevalent in recent years. Previous studies have shown that patients with opioid use disorder undergoing orthopedic, elective abdominopelvic, and cardiac procedures have poorer postoperative outcomes. The aim of this study was to examine the effect of pre-existing opioid use disorder on postoperative outcomes including in-hospital mortality, hospital length of stay (LOS), hospital readmission, and postoperative complications in patients undergoing appendectomy or cholecystectomy.Methods: The authors used administrative data from the State Inpatient Databases of the Healthcare Cost and Utilization Project for the years 2007-2014 from California, Florida, Kentucky, Maryland, and New York. The authors compared unadjusted rates of in-hospital mortality, postoperative complications, LOS, and 30-day and 90-day readmission status. The authors calculated the adjusted odds ratio (OR) for their outcomes using logistic regression models.Results: In all, 488,981 appendectomy patients and 790,491 cholecystectomy patients aged ≥ 18 years were included in the analysis. Appendectomy (OR 2.26) but not cholecystectomy patients with opioid use disorder had statistically significant adjusted odds of in-hospital death. Patients with opioid use disorder (overall reported, and by each procedure separately) had higher adjusted odds of postoperative complication (OR 1.46), 30-day readmission (OR 1.80), 90-day readmission (OR 1.98), and longer LOS (OR 1.37).Conclusions: The authors found higher unadjusted rates and adjusted ORs of in-patient mortality, hospital readmission, and postoperative complications in patients with opioid use disorder undergoing common abdominal surgeries. The authors’ study shows that opioid use disorder is a risk factor for poorer postoperative outcomes in this surgical patient population.

CommunityStat: A Public Health Intervention to Reduce Opioid Overdose Deaths in Burlington, Vermont, 2017–2020

2021 ◽  
pp. 009145092110521
Author(s):  
Brandon del Pozo
Keyword(s):  
Public Health ◽  
New York ◽  
Performance Metrics ◽  
Public Health Intervention ◽  
Police Department ◽  
Opioid Use Disorder ◽  
Health Staff ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Overdose Deaths

From 2017 to early 2020, the US city of Burlington, Vermont led a county-wide effort to reduce opioid overdose deaths by concentrating on the widespread, low-barrier distribution of medications for opioid use disorder. As a small city without a public health staff, the initiative was led out of the police department—with an understanding that it would not be enforcement-oriented—and centered on a local adaptation of CompStat, a management and accountability program developed by the New York City Police Department that has been cited as both yielding improvements in public safety and overemphasizing counterproductive police performance metrics if not carefully directed. The initiative was instrumental to the implementation of several novel interventions: low-threshold buprenorphine prescribing at the city’s syringe service program, induction into buprenorphine-based treatment at the local hospital emergency department, elimination of the regional waiting list for medications for opioid use disorder (MOUD), and the de-facto decriminalization of diverted buprenorphine by the chief of police and county prosecutor. An effort by local legislators resulted in a state law requiring all inmates with opioid use disorder be provided with MOUD as well. By the end of 2018, these interventions were collectively associated with a 50% (17 vs. 34) reduction in the county’s fatal overdose deaths, while deaths increased 20% in the remainder of Vermont. The reduction was sustained through the end of 2019. This article describes the effort undertaken by officials in Burlington to implement these interventions. It provides an example that other municipalities can use to take an evidence-based approach to reducing opioid deaths, provided stakeholders assent to sustained collaboration in the furtherance of a commitment to save lives. In doing so, it highlights that police-led public health interventions are the exception, and addressing the overdose crisis will require reform that shifts away from criminalization as a community’s default framework for substance use.

scholarly journals The Increasing Prevalence of Fentanyl: A Urinalysis‐Based Study Among Individuals With Opioid Use Disorder in New York City

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

scholarly journals Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: Cross-sectional Study in New York State at Census Tract Level

10.2196/23426 ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. e23426
Author(s):  
Anthony Xiang ◽  
Wei Hou ◽  
Sina Rashidian ◽  
Richard N Rosenthal ◽  
Kayley Abell-Hart ◽  
...  
Keyword(s):  
New York ◽  
Regression Model ◽  
Census Tract ◽  
New York State ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Cross Sectional ◽  
York State ◽  
Census Tract Level

Background Opioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD). Objective We aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State. Methods This cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation. Results Several areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (P<.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors. Conclusions At the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic.

scholarly journals Association of co-occurring opioid or other substance use disorders with increased healthcare utilization in patients with depression

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Veer Vekaria ◽  
Budhaditya Bose ◽  
Sean M. Murphy ◽  
Jonathan Avery ◽  
George Alexopoulos ◽  
...  
Keyword(s):  
New York ◽  
Mental Illness ◽  
Substance Use ◽  
Healthcare Utilization ◽  
Substance Use Disorders ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Related Services ◽  
Comparison Groups ◽  
Utilization Patterns

AbstractSubstance use disorders (SUDs) commonly co-occur with mental illness. However, the ongoing addiction crisis raises the question of how opioid use disorder (OUD) impacts healthcare utilization relative to other SUDs. This study examines the utilization patterns of patients with major depressive disorder (MDD) and: (1) co-occurring OUD (MDD-OUD); (2) a co-occurring SUD other than OUD (MDD-NOUD); and (3) no co-occurring SUD (MDD-NSUD). We analyzed electronic health records (EHRs) derived from multiple health systems across the New York City (NYC) metropolitan area between January 2008 and December 2017. 11,275 patients aged ≥18 years with a gap of 30–180 days between 2 consecutive MDD diagnoses and an antidepressant prescribed 0–180 days after any MDD diagnosis were selected, and prevalence of any SUD was 24%. Individuals were stratified into comparison groups and matched on age, gender, and select underlying comorbidities. Prevalence rates and encounter frequencies were measured and compared across outpatient, inpatient, and emergency department (ED) settings. Our key findings showed that relative to other co-occurring SUDs, OUD was associated with larger increases in the rates and odds of using substance-use-related services in all settings, as well as services that integrate mental health and substance abuse treatments in inpatient and ED settings. OUD was also associated with larger increases in total encounters across all settings. These findings and our proposed policy recommendations could inform efforts towards targeted OUD interventions, particularly for individuals with underlying mental illness whose treatment and recovery are often more challenging.

scholarly journals Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: A Cross-Sectional Study in New York State at Census Tract Level

2020 ◽  
Author(s):  
Anthony Xiang ◽  
Sina Rashidian ◽  
Wei Hou ◽  
Richard N Rosenthal ◽  
Kayley Abell-Hart ◽  
...  
Keyword(s):  
New York ◽  
Census Tract ◽  
New York State ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Cross Sectional ◽  
York State ◽  
Census Tract Level ◽  
Demographic Features

Background: Opioid overdose related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD). Objective: We aimed to discover geospatial patterns in problematic opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State. Methods: This cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one opioid use disorder (OUD) diagnosis between 2010 and 2016, and 36,004 patients with at least one opioid poisoning (OP) diagnosis between 2012 and 2016. A logistic regression model was used to determine the associations between patient level characteristics (sex, age group, race, and payment type) and OUD and OP patient rates at census tract level. Results: Several areas shared similar patterns of OUD rates and Republican vote: census tracts in Western New York, Central New York, and Suffolk County. The Spearman rank correlation between OUD rates and the Republican vote was 0.38 (P < 0.0001). A multiple regression model of census tract level demographic and socioeconomic factors explains 29% of the variance in OUD rates, with disability and republican vote the biggest predictors. Conclusions: At the census tract level, opioid use disorder rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic features explain a large portion of the association between the Republican vote and opioid use disorder. Together, these findings underscore the importance of socioeconomic interventions in combatting the opioid epidemic.

scholarly journals Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: Cross-sectional Study in New York State at Census Tract Level (Preprint)

2020 ◽  
Author(s):  
Anthony Xiang ◽  
Wei Hou ◽  
Sina Rashidian ◽  
Richard N Rosenthal ◽  
Kayley Abell-Hart ◽  
...  
Keyword(s):  
New York ◽  
Regression Model ◽  
Census Tract ◽  
New York State ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Cross Sectional ◽  
York State ◽  
Census Tract Level

BACKGROUND Opioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD). OBJECTIVE We aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State. METHODS This cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation. RESULTS Several areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (<i>P</i>&lt;.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors. CONCLUSIONS At the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic.

scholarly journals Using Telecare to Treat Opioid Use Disorder: An Ethnographic Study in New York During COVID-19

2021 ◽  
pp. 009145092110467
Author(s):  
Christopher P. Caulfield
Keyword(s):  
New York ◽  
Science And Technology Studies ◽  
New York State ◽  
Opioid Use Disorder ◽  
Ethnographic Study ◽  
Opioid Use ◽  
Resistance Strategies ◽  
The Us ◽  
Key Barrier ◽  
To Receive

This paper presents an in-person and digital ethnography of people in New York State who use drugs and seek treatment for opioid use disorder (OUD) using phone or video connection to receive healthcare (telecare) including interviews prior to and during the COVID-19 pandemic. This article leverages a Feminist and Science and Technology Studies (STS) approach to elucidate how the framing of the opioid crisis shapes the interconnections that are discernable, providing a heuristic to understand the increased rates of deaths due to drug overdose during the pandemic. The narratives of people seeking treatment are analyzed through the theoretical lenses of Nelly Oudshoorn’s concept of the technogeography of care, Nancy Campbell’s concept of technologies of suspicion, and Nancy Fraser’s analysis of the US juridical-administrative-therapeutic in/justice system. This paper traces and problematizes how telecare contributes to redefining the experience of familiar places, such as home, into spaces of both care and surveillance, and how the technology of telecare presents both affordances and foreclosures to accessing care as people struggle to conform with its requirements in order to receive care. Key findings are, (1) the significance of hugs and tactile connection that is sorely missed by people using telecare for group therapy, (2) the critical importance of proximity to in-person services even while using telecare, (3) the resistance strategies of telecare users to surveillance mechanisms, and (4) the continued stigmatization of drug use and treatment acts as a key barrier to people who are striving to produce the identity of a patient who is clinically stable for take-home medication.

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