Trends and risk factors of adolescent opioid abuse/misuse: understanding the opioid epidemic among adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Margaret R. Spencer ◽  
Sierra Weathers
Keyword(s):  
Healthcare Providers ◽  
Opioid Abuse ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Current Crisis ◽  
Adequate Treatment ◽  
National Crisis ◽  
The Past ◽  
Income Status

AbstractOver the past decade, opioid abuse/misuse has grown from a local problem into a national crisis, causing the U.S. Health and Human Services (HSS) to declare a public health emergency. The number of those dying from opioid abuse has increased, especially among adolescents. Since 2014, death rates due to opioid overdose have been highest in persons aged 15–19 years. This systematic review examines past and present research concerning opioid abuse/misuse and seeks to bring more attention to the growing opioid epidemic affecting adolescents aged 12–25 years nationwide. Keywords such as “adolescent”, “opioid”, “overdose”, “opioid misuse”, and phrases including “opioid use and race”, “income status and opioids”, were used to find common demographic trends which can be attributed to this population. The process of gathering and disseminating information currently available on this subject helps highlight a somewhat taboo subject involving vulnerable members of our community. It is imperative that healthcare providers, in particular, those who treat adolescents, have access to current research and resources that support efforts to combat this persistent issue. In addition, this information will prove useful to those who have the ability to change policies and how this current crisis is being managed. Results from the research indicate that opioid abuse/misuse in adolescents is rising and race, gender and income play a role in the abuse/misuse of opioids. Likewise, the research proves that more opportunities for education and access to adequate treatment are paramount to ending the prevalence of opioid abuse/misuse.

scholarly journals Maternal Opioid Abuse and Neonatal Abstinence Syndrome in the United States

2020 ◽  
Vol 5 (4) ◽  
pp. p78
Author(s):  
Elizabeth Armstrong-Mensah ◽  
Deja Woolcock ◽  
Christi Lee ◽  
Morelia Torres Diaz
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Abuse ◽  
Neonatal Abstinence Syndrome ◽  
Opioid Overdose ◽  
Abstinence Syndrome ◽  
Opioid Use ◽  
The Past ◽  
Number Of Factors ◽  
Abuse During Pregnancy

In the past decade, the United States has experienced an increase in deaths related to nonmedical and medical opioid overdose. This is due to a number of factors including an increase in recreational opioid use, and the over prescription of opioids for various conditions such as during pregnancy, injury, and illness. The over utilization of opioids during pregnancy in the United States has led to an increase in adverse neonatal birth outcomes including poor fetal growth, preterm birth, stillbirth, neonatal abstinence syndrome in neonates, and an increase in maternal mortality among mothers. These are dire consequences that should not be ignored. This paper discusses opioid abuse during pregnancy and its effects on neonates in the United States. It also discusses some challenges associated with the diagnosis of neonatal abstinence syndrome and provides recommendations for addressing the issue Additionally, it discusses what mothers can do to prevent neonatal abstinence syndrome.

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 Misalignment of Stakeholder Incentives in the Opioid Crisis

2020 ◽  
Vol 17 (20) ◽  
pp. 7535
Author(s):  
Alireza Boloori ◽  
Bengt B. Arnetz ◽  
Frederi Viens ◽  
Taps Maiti ◽  
Judith E. Arnetz
Keyword(s):  
Pain Management ◽  
Management Strategies ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Current Crisis ◽  
Medical Specialties ◽  
The Cost ◽  
Payment Mechanisms ◽  
Shed Light ◽  
Opioid Substitution

The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we explore evidence in the literature for the working hypothesis that misalignment rooted in the cost, quality, or access to care can be a significant contributor to the opioid epidemic. The review identified several problems that can contribute to incentive misalignment by compromising the triple aims (cost, quality, and access) in this epidemic. Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients’ non-adherence to opioid substitution treatments. In discussing these issues, we also shed light on factors that can facilitate the alignment of incentives among stakeholders to effectively address the current crisis.

scholarly journals POLICY SERIES: ELDER ABUSE AND THE OPIOID EPIDEMIC IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S762-S762
Author(s):  
Brian W Lindberg ◽  
Robert Blancato
Keyword(s):  
Older Adults ◽  
Prescription Drugs ◽  
Elder Abuse ◽  
Multiple Chronic Conditions ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Rural America ◽  
Related Substance ◽  
National Crisis ◽  
Related Substances

Abstract Misuse of opioids is a national crisis affecting the social and economic welfare of communities throughout the U.S. and is particularly rampant in rural America. Older adults are far too frequently excluded from consideration of those who are affected by the opioid epidemic. While rural older adults may not suffer the highest per capita rate of opioid overdose deaths, they are deeply affected by the problem. In their youth and middle adulthood, many older adults used their bodies for labor. At older ages, they experience multiple chronic conditions and high rates of chronic pain for which opioids and related prescription and non-prescription drugs are often the treatment of choice. Also and far too frequently, older people become easy targets for abuse by persons needing resources to feed their addiction. This symposium focuses on elder abuse associated with opioid and related substance misuse. Zanjani’s presentation provides the context of rurality and drugs and alcohol as a precursor to elder abuse. The second paper by Teaster and colleagues examines trends in APS cases of elder abuse in which the perpetrator is a substance user and identifies perpetrator and victim characteristics predictive of different types of substantiated abuse. Using APS case notes, Roberto and colleagues characterize cases of elder abuse in rural Kentucky in which the perpetrator used opioids and related substances. Robert Blancato and Brian Lindberg will discuss presenters’ collective findings by weaving together concepts of rurality, addiction, and elder abuse and recommending strategies for prevention, intervention, and policy.

scholarly journals Co-prescription network reveals social dynamics of opioid doctor shopping

2019 ◽  
Author(s):  
Brea Louise Perry ◽  
Kai-Cheng Yang ◽  
Patrick Kaminski ◽  
Jaehyuk Park ◽  
Michelle Martel ◽  
...  
Keyword(s):  
Social Dynamics ◽  
Social Process ◽  
Healthcare Providers ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Doctor Shopping ◽  
Seeking Behavior ◽  
Occupy Central ◽  
Predicted Risk

This paper examines network prominence in a co-prescription network as an indicator of doctor shopping (i.e., fraudulent solicitation of prescriptions from multiple healthcare providers) for opioids. Using longitudinal data from a large commercially insured population, we construct a network where a tie between patients was weighted by the number of shared opioid prescribers. Given prior research suggesting that doctor shopping may be a social process, we hypothesize that active doctor shoppers will occupy central structural positions in this network. We show that network prominence, operationalized using PageRank, was associated with more opioid prescriptions, higher predicted risk for dangerous morphine dosage, opioid overdose, and opioid use disorder, controlling for number of prescribers and other variables. Moreover, as a patient’s own prominence increased over time, so did their risk for these outcomes, compared to their own average level of risk. These findings point to structural properties of co-prescription networks as a promising indicator of social or strategic drug-seeking behavior and overdose risk.

scholarly journals Opioid use disorder and treatment: challenges and opportunities

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kim A. Hoffman ◽  
Javier Ponce Terashima ◽  
Dennis McCarty
Keyword(s):  
Partial Agonist ◽  
Opioid Analgesics ◽  
Opioid Use Disorder ◽  
Psychosocial Treatment ◽  
Opioid Antagonist ◽  
Prescription Opioid ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Services Research

Abstract Background Addiction health service researchers have focused efforts on opioid use disorder (OUD) and strategies to address the emerging public health threats associated with the epidemics of opioid use and opioid overdose. The increase in OUD is associated with widespread access to prescription opioid analgesics, enhanced purity of heroin, the introduction of potent illicit fentanyl compounds, and a rising tide of opioid overdose fatalities. These deaths have become the face of the opioid epidemic. Main Text OUD is a chronic disorder that usually requires both medications for opioid use disorder (MOUD) and psychosocial treatment and support. Research has found that MOUD with an opioid receptor agonist (methadone), partial agonist (buprenorphine), or opioid antagonist (extended-release naltrexone) can support recovery. Despite compelling evidence that MOUD are effective, they remain underutilized. More research is needed on these therapies to understand the feasibility of implementation in clinic settings. Conclusion This special issue focuses on how health services research has emerged as an important contributor to efforts to control the opioid epidemic in North America and Europe.

scholarly journals Hispanics, Addictions, and the Opioid Epidemic: Brief Report

2019 ◽  
Vol 18 (1) ◽  
pp. 40-43
Author(s):  
Francisco Brenes ◽  
Federico Henriquez
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Disparities ◽  
Health Care Policy ◽  
The United States ◽  
Health Concern ◽  
Practice Research ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Opioid Use

Opioid addiction is a public health concern. Opioid overdose death rates account for one third to a half of all global substance-related deaths. Opioid mortality rates increased nearly fivefold in the United States between 1999 and 2016. Recent research has found health care disparities in the United States among minority populations with opioid use disorder, particularly Hispanics. Current literature also suggests that a number of social and cultural factors, including the stigma linked to mental illness and treatment in the Hispanic culture, may further negatively contribute to the problem. This brief report pays close attention to the opioid epidemic in the United States and addresses issues related to the crisis among Hispanics. Recommendations for clinical practice, research, and health care policy are also discussed.

scholarly journals Opioid Epidemic in the United States

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. ES9-ES38 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
Drug Use ◽  
National Survey ◽  
The United States ◽  
Prescribing Patterns ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Perceived Safety ◽  
The Past ◽  
Nonmedical Use

Over the past two decades, as the prevalence of chronic pain and health care costs have exploded, an opioid epidemic with adverse consequences has escalated. Efforts to increase opioid use and a campaign touting the alleged undertreatment of pain continue to be significant factors in the escalation. Many arguments in favor of opioids are based solely on traditions, expert opinion, practical experience and uncontrolled anecdotal observations. Over the past 20 years, the liberalization of laws governing the prescribing of opioids for the treatment of chronic non-cancer pain by the state medical boards has led to dramatic increases in opioid use. This has evolved into the present stage, with the introduction of new pain management standards by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) in 2000, an increased awareness of the right to pain relief, the support of various organizations supporting the use of opioids in large doses, and finally, aggressive marketing by the pharmaceutical industry. These positions are based on unsound science and blatant misinformation, and accompanied by the dangerous assumptions that opioids are highly effective and safe, and devoid of adverse events when prescribed by physicians. Results of the 2010 National Survey on Drug Use and Health (NSDUH) showed that an estimated 22.6 million, or 8.9% of Americans, aged 12 or older, were current or past month illicit drug users, The survey showed that just behind the 7 million people who had used marijuana, 5.1 million had used pain relievers. It has also been shown that only one in 6 or 17.3% of users of non-therapeutic opioids indicated that they received the drugs through a prescription from one doctor. The escalating use of therapeutic opioids shows hydrocodone topping all prescriptions with 136.7 million prescriptions in 2011, with all narcotic analgesics exceeding 238 million prescriptions. It has also been illustrated that opioid analgesics are now responsible for more deaths than the number of deaths from both suicide and motor vehicle crashes, or deaths from cocaine and heroin combined. A significant relationship exists between sales of opioid pain relievers and deaths. The majority of deaths (60%) occur in patients when they are given prescriptions based on prescribing guidelines by medical boards, with 20% of deaths in low dose opioid therapy of 100 mg of morphine equivalent dose or less per day and 40% in those receiving morphine of over 100 mg per day. In comparison, 40% of deaths occur in individuals abusing the drugs obtained through multiple prescriptions, doctor shopping, and drug diversion. The purpose of this comprehensive review is to describe various aspects of crisis of opioid use in the United States. The obstacles that must be surmounted are primarily inappropriate prescribing patterns, which are largely based on a lack of knowledge, perceived safety, and inaccurate belief of undertreatment of pain. Key words: Opioid abuse, opioid misuse, nonmedical use of psychotherapeutic drugs, nonmedical use of opioids, National Survey on Drug Use and Health, opioid guidelines.

Commercial Fishing as an Occupational Determinant of Opioid Overdoses and Deaths of Despair in Two Massachusetts Fishing Ports, 2000–2014

2021 ◽  
pp. 104829112110234
Author(s):  
Scott Fulmer ◽  
Shruti Jain ◽  
David Kriebel
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Death Certificate ◽  
The United States ◽  
Opioid Overdose ◽  
Commercial Fishing ◽  
Opioid Epidemic ◽  
Death Certificate Data ◽  
Deaths Of Despair

The opioid epidemic has had disproportionate effects across various sectors of the population, differentially impacting various occupations. Commercial fishing has among the highest rates of occupational fatalities in the United States. This study used death certificate data from two Massachusetts fishing ports to calculate proportionate mortality ratios of fatal opioid overdose as a cause of death in commercial fishing. Statistically significant proportionate mortality ratios revealed that commercial fishermen were greater than four times more likely to die from opioid poisoning than nonfishermen living in the same fishing ports. These important quantitative findings suggest opioid overdoses, and deaths to diseases of despair in general, deserve further study in prevention, particularly among those employed in commercial fishing.

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