scholarly journals Using Patient Voice to Personalize the Opioid Epidemic: An Evaluation of 2 Educational Interventions

2020 ◽  
Vol 7 (6) ◽  
pp. 964-968
Author(s):  
Jeffrey Schlaudecker ◽  
Olivia Zamudio ◽  
Keesha Goodnow ◽  
Harini Pallerla ◽  
Saundra Regan
Keyword(s):  
Attitude Change ◽  
Educational Interventions ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Voice Change ◽  
Patient Voice ◽  
Barriers To Change ◽  
Provider Role ◽  
The Voice

Despite rising opioid fatalities, attitudes remain indifferent toward those with opioid use disorder (OUD). Utilizing patient voice may be one way to move providers to action. We included persons with OUD in 2 educational sessions as an important tool of attitude change. Post-session surveys demonstrate increased compassion, deeper understanding of challenges, and positive change in attitude. Inclusion of patient voice was identified as the most useful feature of both educational sessions. Four themes emerged: value of patient voice; change in attitude; barriers to change; and enhanced provider role. Future educational sessions should include the voice of persons living with OUD.

scholarly journals “Don’t Label Them as Addicts!” Student Pharmacists’ Views on the Stigma Associated with Opioid use Disorder

2021 ◽  
Vol 12 (2) ◽  
pp. 21
Author(s):  
Alina Cernasev ◽  
Kelsey D. Frederick ◽  
Elizabeth A. Hall ◽  
Michael P. Veve ◽  
Kenneth C. Hohmeier
Keyword(s):  
Focus Groups ◽  
Thematic Analysis ◽  
Cognitive Theory ◽  
Educational Interventions ◽  
Opioid Use Disorder ◽  
Future Research ◽  
Opioid Use ◽  
Unconscious Bias ◽  
Pharmacy Curriculum ◽  
Opioid Users

Background: Student pharmacists represent an important potential population for targeted educational interventions focused on skill and confidence development in order to improve interactions with opioid users and to decrease stigma. The objective of this study was to understand student pharmacists’ perceptions of opioid users. Methods: Focus groups were conducted with student pharmacists across Tennessee over two months in 2020. Concepts from the Transtheoretical Mode, Social Cognitive Theory, stigma, and results from a survey sent to student pharmacists were used to develop the open-ended questions. Thematic analysis was conducted to inductively identify main themes. The recruitment of student pharmacists continued until thematic saturation was obtained. Results: Three focus groups were conducted with a total of 16 student pharmacists in second, third, and fourth professional years. Thematic analysis revealed two themes: Don’t label them as addicts, Student Insight into OUD-Associated Stigma and five sub-themes: developing a judgment-free environment; unconscious bias; a possible connection between physical appearance and addiction; socio-cultural factors, addiction, and isolation; and motivators to decrease stigma. This study not only presents the pharmacy students experiences and their significance, but also reports their recommendations for addressing the stigma associated with OUD in the pharmacy curriculum. Conclusions: These findings highlight the need to normalize appropriate language when describing patients with OUD and avoid negative labels such as “addict.” The findings also indicate where the roots of stigma lie and provide some of the tools to fight stigma on different fronts. Future research should explore and address potential implicit biases throughout pharmacy curriculum.

scholarly journals What Strategies Are Hospitals Adopting to Address the Opioid Epidemic? Evidence From a National Sample of Nonprofit Hospitals

2020 ◽  
pp. 003335492096880
Author(s):  
Berkeley Franz ◽  
Cory E. Cronin ◽  
Jose A. Pagan
Keyword(s):  
The United States ◽  
National Sample ◽  
Opioid Use Disorder ◽  
Opioid Abuse ◽  
Public Health Issue ◽  
Evidence Based ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Nonprofit Hospitals ◽  
Community Benefit

Objectives Hospitals are on the front lines of the opioid epidemic, seeing patients who overdose or have complicated infections, but the extent of services offered or whether services are evidence-based is not known. The objective of our study was to assess the extent to which nonprofit hospitals are addressing opioid abuse, a critical public health issue, through their community benefit work and to identify which evidence-based strategies they adopt. Methods We reviewed community benefit documents from January 1, 2015, through December 31, 2018, for a sample (N = 446) of all nonprofit hospitals in the United States. We classified hospital opioid-related strategies into 9 categories. Using logistic regression, we predicted the likelihood of hospitals adopting various strategies to address opioid abuse. Results Of the 446 nonprofit hospitals in our sample, 49.1% (n = 219) adopted ≥1 clinical strategy to address opioid use disorder in their community. Approximately one-quarter (26.5%; n = 118) of hospitals adopted a strategy related to treatment services for substance use disorder; 28.2% (n = 126) had ≥1 program focused on connecting patients to a primary care medical home, and 14.6% (n = 65) focused on caring for patients with opioid-related overdoses in the emergency department. We also identified factors that predicted involvement in programs that were less common than clinical strategies, but potentially effective, such as harm reduction and prescriber initiatives (both 6.3% of hospitals). Conclusions Evidence-based prevention and treatment require strong collaboration between health care and community institutions at all levels. Effective policy interventions may exist to encourage various types and sizes of nonprofit hospitals to adopt evidence-based interventions to address opioid abuse in their communities.

Epidemiology of Substance Use Disorders

2020 ◽  
pp. 3-28
Author(s):  
L. Morgan Snell ◽  
Andrew J. Barnes ◽  
Peter Cunningham
Keyword(s):  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Provider Education ◽  
Opioid Use ◽  
Prescribing Practices ◽  
The Us ◽  
Overdose Deaths

Nearly 3 million Americans have a current or previous opioid use disorder, and recent data indicate that 10.2% of US adults have ever misused pain relievers. In 2015, approximately 800,000 individuals used heroin, while 4 million misused prescription opioids. Although use of other drugs such as alcohol and cannabis is more prevalent, opioid use contributes to significant morbidity, mortality, and social and economic costs. While the current US opioid overdose epidemic began with prescription opioids, since 2015, heroin and synthetic opioids (e.g., fentanyl) have driven continued increases in opioid overdose deaths, contributing to a recent decline in overall life expectancy in the United States. Policies to address the opioid epidemic by changing clinical practice include provider education, monitoring prescribing practices, and expanding the clinical workforce necessary to treat opioid use disorders. The opioid epidemic appears to be largely a US phenomenon and a consequence of both structural challenges in the US healthcare system and growing socioeconomic disparities, and thus it will require policies including and beyond delivery system reforms to resolve it.

scholarly journals Infectious Disease (ID) Learning Unit: What the ID Clinician Needs to Know About Buprenorphine Treatment for Opioid Use Disorder

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Amanda A. Westlake ◽  
Mark P. Eisenberg
Keyword(s):  
Infectious Disease ◽  
Drug Use ◽  
Maintenance Therapy ◽  
Injection Drug Use ◽  
Infectious Complications ◽  
Opioid Use Disorder ◽  
Clinical Use ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Buprenorphine Treatment

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.

scholarly journals Partnering with State Health Departments to Address Injection-Related Infections during the Opioid Epidemic: Experience at a Safety Net Hospital

2021 ◽  
Author(s):  
Rebecca H Burns ◽  
Cassandra M Pierre ◽  
Jai G Marathe ◽  
Glorimar Ruiz-Mercado ◽  
Jessica L Taylor ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Medical Center ◽  
Safety Net ◽  
Opioid Use Disorder ◽  
Lessons Learned ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Persons Who Inject Drugs ◽  
Curative Therapy ◽  
Safety Net Hospital

Abstract Massachusetts is one of the epicenters of the opioid epidemic and has been severely impacted by injection-related viral and bacterial infections. A recent increase in newly diagnosed human immunodeficiency virus (HIV) infections among persons who inject drugs in the state highlights the urgent need to address and bridge the overlapping epidemics of opioid use disorder (OUD) and injection-related infections. Building on an established relationship between the Massachusetts Department of Public Health (MDPH) and Boston Medical Center (BMC), the Infectious Diseases section has contributed to the development and implementation of a cohesive response involving ambulatory, inpatient, emergency department and community-based services. We describe this comprehensive approach including the rapid delivery of antimicrobials for the prevention and treatment of HIV, sexually transmitted diseases, systemic infections such as endocarditis, bone and joint infections, as well as curative therapy for chronic hepatitis C virus (HCV) in a manner that is accessible to patients on the addiction-recovery continuum. We also provide an overview of programs that provide access to medications for opioid use disorder (MOUD), harm reduction services including overdose education and distribution of naloxone. Finally, we outline lessons learned to inform initiatives in other settings.

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 Tales from the frontlines: An alarming rise in hospitalizations related to opioid use disorder in the era of COVID-19

2021 ◽  
Vol 17 (1) ◽  
pp. 5-7
Author(s):  
Noel Ivey, MD ◽  
Dana Cooley Clifton, MD
Keyword(s):  
Hospital Setting ◽  
Primary Care Providers ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Care Providers ◽  
Opioid Use ◽  
Sharp Rise ◽  
Negative Effect ◽  
Additional Education ◽  
Harmful Effects

The coronavirus disease 2019 (COVID-19) pandemic has had harmful effects on the opioid epidemic. While a negative effect was predicted, we report on this reality in the hospital setting. We have seen a sharp rise in hospitalized patients with opioid use disorder (OUD). Our data should encourage ongoing efforts to reduce barriers in accessing medications for treatment, harm reduction interventions and additional education for trainees, primary care providers, and hospitalists alike. In the current climate, these interventions are critical to save the lives of patients with OUD.

Responding to the Opioid Epidemic

2021 ◽  
pp. 77-91
Keyword(s):  
Rural Areas ◽  
Complex Disease ◽  
Opioid Use Disorder ◽  
Opioid Addiction ◽  
Rural Populations ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Correctional Settings ◽  
Opioid Use Disorders

Chapter 6 examines the complex disease of opioid use disorder and the barriers that exist within the very system designed to help. It also highlights some promising pockets of progress, focusing especially on two environments hit hard by opioid addiction: correctional settings and rural areas. Elizabeth Connolly argues that medication-assisted treatment (MAT) improves outcomes for incarcerated individuals with opioid use disorders and presents examples of successful MAT programs in Massachusetts and Colorado. John Gale explains the complex factors that contribute to opioid addiction among rural populations and why those communities are disproportionately impacted by this epidemic. The chapter concludes with a look at why more progress has not been made.

scholarly journals Current status of opioid epidemic in the United Kingdom and strategies for treatment optimisation in chronic pain

2020 ◽  
Author(s):  
Aziza Alenezi ◽  
Asma Yahyouche ◽  
Vibhu Paudyal
Keyword(s):  
Chronic Pain ◽  
United Kingdom ◽  
The United States ◽  
Opioid Use Disorder ◽  
Morbidity And Mortality ◽  
Current Status ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
The United Kingdom ◽  
Treatment Optimisation

AbstractThe increase in opioid prescriptions in the United States has been accompanied by an increase in misuse as well as overdose and toxicity related morbidity and mortality. However, the extent of the increased opioid use, including misuse in the United Kingdom, currently remains less debated. Recent studies in the United Kingdom have shown a rise in opioid use and attributed deaths, particularly in areas with higher deprivation. There are also large variations amongst the devolved nations; Scotland has the highest drug-related deaths and year-on-year increase within Europe. Better clinical guidelines that can enable person-centred management of chronic pain, medicines optimisation, and early diagnosis and treatment of opioid use disorder are crucial to addressing opioid-related morbidity and mortality in the United Kingdom.

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