scholarly journals Opioid overdose death in Wales: A linked data autopsy study

2020 ◽  
Author(s):  
Matthew Balquin Jones ◽  
Ceri Bradshaw ◽  
Gordon Fuller ◽  
Ann John ◽  
Jenna Jones ◽  
...  
Keyword(s):  
High Risk ◽  
Service Use ◽  
Public Health Problem ◽  
Demographic Characteristics ◽  
Opioid Overdose ◽  
Autopsy Study ◽  
Service Usage ◽  
Overdose Death ◽  
The Uk ◽  
Opioid Users

Abstract BackgroundFatal opioid overdose is a growing public health problem, the incidence of which is rising in the UK and in other western countries. We sought to describe factors associated with deaths, demographic characteristics, and service usage patterns of decedents of opioid overdose in a nation of the UK.MethodsWe carried out a retrospective cross-sectional analysis of opioid related deaths between 01/01/2012 and 11/10/2018 in Wales, UK, as identified from Office for National Statistics data. In addition to ONS records, the Welsh Demographic Service and National Health Service datasets were interrogated for records spanning the preceding three years. Records were linked on an individual basis using a deterministic algorithm. Decedents’ circumstances of death, demographic characteristics, and residency and service use patterns were described. Additionally, data pertaining to circumstances of death were briefly analysed.Results638 people died of opioid overdose in Wales between 01/01/2012 and 11/10/2018. Decedents were mostly male and around 50 years of age. Incidence per head of population was higher at the end of this period, peaking in 2015. In the 3 years prior to death the majority of decedents changed address at least once, but rarely moved far geographically. Over 80% of decedents visited the ED, the majority via emergency ambulance; over 60% were admitted to hospital; and over 30% visited specialist drug services on one or more occasion. Decedents who did not attend drug services were more likely to have died intentionally.ConclusionsHigh risk opioid users are often men of around 50 years of age living peripatetic lifestyles. It appears that those at high risk of dying from opioid overdose death use emergency medical services and are admitted to hospital comparatively often. They are less likely to visit specialist drug services however. Group differences between high risk opioid users who visit specialist drug services and those who do not appear to exist in relation to suicidality. Further research is needed in to delivering abstinence focussed or harm reduction based interventions via emergency services or inpatient hospital settings, and in understanding differences in suicidality between drug service attenders and non-attenders.

scholarly journals Schizophrenia in high risk opioid users: A short communication on an autopsy study

2019 ◽  
Vol 276 ◽  
pp. 112-114 ◽  
Author(s):  
Alan Watkins ◽  
Ann John ◽  
Ceri Bradshaw ◽  
Jenna Jones ◽  
Matthew Jones
Keyword(s):  
High Risk ◽  
Short Communication ◽  
Autopsy Study ◽  
Opioid Users

scholarly journals 03 Opioid overdose death in wales from 2012 to 2015: a linked data autopsy study

2019 ◽  
Vol 36 (10) ◽  
pp. e3.1-e3
Author(s):  
Matthew Jones ◽  
Alan Watkins ◽  
Jenna Bulger ◽  
Ann John ◽  
Helen Snooks ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Service Use ◽  
Mental Health Problems ◽  
Public Health Problem ◽  
Opioid Overdose ◽  
Care Providers ◽  
National Statistics ◽  
Treatment Services ◽  
Overdose Deaths ◽  
Observation Period

BackgroundOpioids account for more fatalities by overdose than any other drug. Fatal opioid overdose is a growing public health problem, with incidence rising in western countries especially. We sought to describe the deaths, sociodemographic characteristics, and service usage patterns of decedents of opioid overdose in Wales.MethodsWe carried out a retrospective cross-sectional analysis of opioid related deaths in Wales identified from Office for National Statistics data between 01/01/2012 and 31/12/2015, in Wales, UK.Routine data were captured from Office of National Statistics (ONS), the Welsh Demographic Service and National Health Service datasets for the preceding three years and linked using a deterministic algorithm. Demographic, socioeconomic, clinical and service use characteristics were detailed using descriptive statistics.ResultsThe majority of opioid overdose deaths (n=312) occurred at home (n=253, 81.09%) and were accidental (n=262, 83.97%). A third (31.09%) involved heroin as the main object of injury (n=97). Decedents were mostly male (n=228, 73.1%) and lived in socioeconomically deprived (lacking in material and social opportunities and/or resources) areas at the time of their death (n=199, 63.75%). The majority of decedents changed address at least once during the 36 month observation period prior to death (n=169, 53.85%), but rarely moved far geographically (e.g. were resident in more than two postcode areas). The majority of decedents visited the emergency department (n=227, 72.76%), were admitted to hospital (n=199, 63.78%) – usually for mental health problems – and were recorded at least one General Practitioner episode (n=258, 82.69%) during the observation period. A minority of decedents used drug treatment services (n=72, 23.08%).ConclusionsOpioid overdose deaths occur most commonly secondary to heroin use. Decedents demonstrate a peripatetic lifestyle and are rarely engaged with drug treatment services. Frequent contact with unscheduled care providers might present a target for preventative interventions.

scholarly journals Primary Care Service Utilization Among People at High Risk of Fatal Opioid Overdose: A Short Communication on an Autopsy Study

2020 ◽  
Vol 11 ◽  
pp. 215013272092595
Author(s):  
Matthew Jones ◽  
Ceri Bradshaw ◽  
Jenna Jones ◽  
Ann John ◽  
Helen Snooks ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Service Utilization ◽  
Care Service ◽  
Median Number ◽  
Primary Care Service ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Autopsy Study ◽  
Drug Dependent

Objectives: We sought to explore the sociodemographics and primary care service utilization among people who died from opioid overdose and to assess the possibility of using this information to identify those at high risk of opioid overdose using routine linked data. Methods: Data related to decedents of opioid overdose between January 1, 2012 and December 31, 2015 were linked with general practitioner (GP) records over a period of 36 months prior to death. Results: Of n = 312 decedents of opioid overdose, 73% were male (n = 228). Average age at death was 40.72 (SD 11.92) years. A total of 63.8% of the decedents were living in the 2 most deprived quintiles according to the Welsh Index of Multiple Deprivation. Over 80% (n = 258) of the decedents were recorded as having at least 1 GP episode during the 36-month observation period prior to death. The median number of episodes per decedent was 75 [38-118]. Overall, 31.8% (n = 82) of decedents with at least 1 GP episode received a prescription for a proton pump inhibitor and 31% (n = 80) were prescribed a broad-spectrum antibiotic. According to their GP records, less than 10% were referred to or receiving specialist drug treatment (n = 24, 9.3%); or were known to be drug dependent (n = 21, 8.14%), or a drug user (n = 5, 1.94%). In all, 81% were recorded as smokers (n = 209) and 10.5% as ex-smokers (n = 27). Conclusions: The majority of decedents of opioid overdose were in contact with GP services prior to death. GPs are either often unaware of high-risk opioid use, or rarely record details of opioid use in patient notes. It is possible that GP awareness of high-risk opioid use could be increased. For example, awareness of the risks associated with opioid use, and the relationship between the sociodemographic and clinical characteristics of opioid overdose decedents could be raised using educational materials prominently displayed in waiting areas. Clinicians in primary care may be in an excellent position to intervene in problematic opioid use.

Exploring opioid addictions and responsibilities: almost lost in the midst of the Covid-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Alan David Smith
Keyword(s):  
Death Rate ◽  
Design Methodology ◽  
Family Members ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Income Loss ◽  
Overdose Death ◽  
Content Type ◽  
Opioid Crisis ◽  
Opioid Users

Purpose The purpose of this study is to highlight the overshadowing of the opioid crisis due to Covid-19 pandemic. Opioids are affecting increasing numbers as the current opioid overdose death rate is increasing to 209 per day. While there appears light shining on the end of the Covid-19 pandemic with the advent of a fourth vaccine, there is no such light for the opioid epidemic. Based on a sample of 603 relatively educated adults in NE Ohio, the health harm caused by both crises, prescribing physician blaming, high levels of income loss and physical and emotional burdens shared by the respondents were obvious and striking. Design/methodology/approach Using Bertram et al. (2014) theory of the blame model, the number of results concerning gender and personally involvement of friends and family members, including men empathy increased with greater knowledge of numbers of addicted opioid users in their personal contracts. Findings Unfortunately, many women had to remain home taking care of children and elderly loved ones at greater percentages than their male counterparts may account for less empathy as such addicted users have become a burden to economically impaired families. This tendency for placing blame for circumstances with twin crises appears to follow a relatively predictable path as modeled by Bertram et al. (2014) (i.e. denial, justification and excuse). Originality/value These are few studies that are studying the amplification effects of the Covid-19 pandemic context on the current opioid crisis.

scholarly journals 3142 U.S. Counties with High Opioid-Overdose Mortality and Low Capacity to Deliver Medications for Opioid Use Disorder: an Observational Study

2019 ◽  
Vol 3 (s1) ◽  
pp. 129-129
Author(s):  
Rebecca Haffajee ◽  
Lewei Allison Lin ◽  
Amy S.B. Bohnert ◽  
Jason E. Goldstick
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Extended Release ◽  
Primary Care Providers ◽  
Outcome Variable ◽  
Opioid Overdose ◽  
Care Providers ◽  
Overdose Death ◽  
South Central ◽  
Rural Counties

OBJECTIVES/SPECIFIC AIMS: To identify characteristics of counties with persistently high opioid-overdose rates and low capacity to deliver medications for OUD (MOUD). METHODS/STUDY POPULATION: Setting: County-level opioid-overdose death data, 2013-2016, and 2017 publicly-available treatment provider data for MOUD: buprenorphine-waivered providers, opioid treatment programs (OTPs), and extended-release naltrexone providers. Participants: Populations in 3,142 U.S. counties. 24,851 buprenorphine-waivered providers; 1,517 OTPs; and 5,222 extended-release naltrexone providers. Measurements: The outcome variable, “opioid high-risk county”, was a binary indicator of high (above average) opioid-overdose rates with low (below median) MOUD availability rates. We used spatial logistic regression models to determine correlates of being a high-risk county. RESULTS/ANTICIPATED RESULTS: 46.4% of all counties, and 71.2% of rural counties, lacked a publicly-available MOUD provider in 2017. In adjusted models, rural counties had 53% greater odds of being high-risk than urban counties. Counties in the East South Central, West South Central, and South Atlantic divisions had over twice the odds of being high-risk than counties in the West North Central division. Primary care provider density, greater traversability, and a higher proportion of the population under age 25 were all protective against a county being opioid high-risk. DISCUSSION/SIGNIFICANCE OF IMPACT: Counties with both low MOUD provider availability and high opioid-overdose death rates are significantly more likely to be rural, have less primary care providers per capita, and in the southern regions. Strategies to increase MOUD must account for these factors.

Medical, psychosocial, and treatment predictors of opioid overdose among high risk opioid users

2018 ◽  
Vol 86 ◽  
pp. 51-55 ◽  
Author(s):  
Samantha Schiavon ◽  
Kathleen Hodgin ◽  
Aaron Sellers ◽  
Margaret Word ◽  
James W. Galbraith ◽  
...  
Keyword(s):  
High Risk ◽  
Opioid Overdose ◽  
Treatment Predictors ◽  
Opioid Users

Knowledge and Perceptions of Alzheimer’s Disease in the United Kingdom

2021 ◽  
Author(s):  
Aysegul Humeyra Kafadar ◽  
Kei Long Cheung
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Ethnic Groups ◽  
Information Needs ◽  
Cultural Beliefs ◽  
Public Health Problem ◽  
Demographic Characteristics ◽  
Ageing Population ◽  
Knowledge Level ◽  
The Uk

Abstract Background: Alzheimer’s disease (AD) is a global public health problem with an ageing population. Knowledge is essential to avoid AD's risk factors and promote early awareness, diagnosis and treatment of AD symptoms. AD knowledge is influenced by many cultural factors including cultural beliefs, attitudes and language barriers. This study aims: (1) to define AD knowledge level and perceptions amongst the general UK population; (2) to compare knowledge and perceptions of AD among three main ethnic groups (Asian, Blacks, and Whites); and (3) to assess potential associations of age, gender, education level, affinity with older people (65 or over), family history and caregiving history on AD knowledge.Methods: Data was collected from 190 participants who were living in the UK from three different ethnicities, which were Asian (15.8%), Black (16.3%), and White (67.9%). Demographic characteristics of participants and AD knowledge correlation were assessed by the 30-item Alzheimer’s Disease Knowledge Scale (ADKS), comprising 7 content domains. Data analysis included bivariate correlations to show associations between demographic characteristics of participants and their ADKS score, and multivariate analysis using ANOVA to illustrate potential correlations between ethnicity groups and ADKS score.Results: The general knowledge was found to be less than half, with 45.3% answering correctly out of all respondents. No significant differences were found for the total ADKS score between White, Black, and Asian participants. However, there were significant knowledge differences for ADKS domain scores. While Black participants had significantly more information about AD assessment and diagnosis (p=0.038), White respondents more likely to know about AD symptoms than their counterparts (p=0.009).Conclusion: The study's findings suggest that the AD knowledge level is not adequate for all ethnic groups. Moreover, ethnic groups differ in their AD knowledge and perceptions, and therefore, differ in their needs regards health communication. The study contributes to an understanding of ethnicity differences in AD knowledge in the UK population, and may also provide input into an intervention plan for different ethnicities’ information needs.

Co-Occurring Mood Problems in Autism Spectrum Disorder

2020 ◽  
pp. 27-51
Author(s):  
Virginia Carter Leno ◽  
Emily Simonoff
Keyword(s):  
Autism Spectrum Disorder ◽  
Service Use ◽  
Bipolar Depression ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Public Health Problem ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Autism Spectrum ◽  
Spectrum Disorder

Recent evidence suggests that individuals with autism spectrum disorder (ASD) experience depression at rates approximately four times greater than the general population. Co-occurring mood problems, including depressive and bipolar disorders, are associated with negative outcomes such as lower quality of life, increased adaptive behavior impairments, and greater service use. This chapter discusses what is known about the presentation of unipolar and bipolar depression in people with ASD and describes challenges to establishing sound prevalence estimates of mood disorders in ASD as they relate to methodological design issues and diagnostic assessment practices. It also provides an overview of potential vulnerability factors in the development of depression in this population; these areas of vulnerability include characteristics such as chronological age, cognitive ability, and ASD symptom severity, as well as those individual differences that may represent more direct mechanisms, for example, maladaptive coping styles, attentional biases, social reward profiles, and predisposition to rumination. The current research on interventions specifically designed to treat mood in people with ASD is very limited. However, promising treatments include adapted cognitive behavioral therapy and mindfulness-based approaches. Though most of this chapter focuses on unipolar depression in ASD as the more well-studied mood disorder, the chapter also summarizes the small research base on bipolar disorder in the context of ASD. It ends with a call for improved screening, assessment, and evidence-based treatment options to address this significant public health problem in this special population.

Sign in / Sign up

Export Citation Format

Share Document