scholarly journals Using Twitter to Surveil the Opioid Epidemic in North Carolina: An Exploratory Study (Preprint)

2019 ◽  
Author(s):  
Mohd Anwar ◽  
Dalia Khoury ◽  
Arnie P Aldridge ◽  
Stephanie J Parker ◽  
Kevin P Conway
Keyword(s):  
North Carolina ◽  
Language Processing ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Least Squares Regression ◽  
Online Data ◽  
Synthetic Opioids ◽  
Opioid Crisis ◽  
Twitter Data

BACKGROUND Over the last two decades, deaths associated with opioids have escalated in number and geographic spread, impacting more and more individuals, families, and communities. Reflecting on the shifting nature of the opioid overdose crisis, Dasgupta, Beletsky, and Ciccarone offer a triphasic framework to explain that opioid overdose deaths (OODs) shifted from prescription opioids for pain (beginning in 2000), to heroin (2010 to 2015), and then to synthetic opioids (beginning in 2013). Given the rapidly shifting nature of OODs, timelier surveillance data are critical to inform strategies that combat the opioid crisis. Using easily accessible and near real-time social media data to improve public health surveillance efforts related to the opioid crisis is a promising area of research. OBJECTIVE This study explored the potential of using Twitter data to monitor the opioid epidemic. Specifically, this study investigated the extent to which the content of opioid-related tweets corresponds with the triphasic nature of the opioid crisis and correlates with OODs in North Carolina between 2009 and 2017. METHODS Opioid-related Twitter posts were obtained using Crimson Hexagon, and were classified as relating to prescription opioids, heroin, and synthetic opioids using natural language processing. This process resulted in a corpus of 100,777 posts consisting of tweets, retweets, mentions, and replies. Using a random sample of 10,000 posts from the corpus, we identified opioid-related terms by analyzing word frequency for each year. OODs were obtained from the Multiple Cause of Death database from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Least squares regression and Granger tests compared patterns of opioid-related posts with OODs. RESULTS The pattern of tweets related to prescription opioids, heroin, and synthetic opioids resembled the triphasic nature of OODs. For prescription opioids, tweet counts and OODs were statistically unrelated. Tweets mentioning heroin and synthetic opioids were significantly associated with heroin OODs and synthetic OODs in the same year (<i>P</i>=.01 and <i>P</i>&lt;.001, respectively), as well as in the following year (<i>P</i>=.03 and <i>P</i>=.01, respectively). Moreover, heroin tweets in a given year predicted heroin deaths better than lagged heroin OODs alone (<i>P</i>=.03). CONCLUSIONS Findings support using Twitter data as a timely indicator of opioid overdose mortality, especially for heroin.

scholarly journals Using Twitter to Surveil the Opioid Epidemic in North Carolina: An Exploratory Study

10.2196/17574 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e17574
Author(s):  
Mohd Anwar ◽  
Dalia Khoury ◽  
Arnie P Aldridge ◽  
Stephanie J Parker ◽  
Kevin P Conway
Keyword(s):  
North Carolina ◽  
Language Processing ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Least Squares Regression ◽  
Online Data ◽  
Synthetic Opioids ◽  
Opioid Crisis ◽  
Twitter Data

Background Over the last two decades, deaths associated with opioids have escalated in number and geographic spread, impacting more and more individuals, families, and communities. Reflecting on the shifting nature of the opioid overdose crisis, Dasgupta, Beletsky, and Ciccarone offer a triphasic framework to explain that opioid overdose deaths (OODs) shifted from prescription opioids for pain (beginning in 2000), to heroin (2010 to 2015), and then to synthetic opioids (beginning in 2013). Given the rapidly shifting nature of OODs, timelier surveillance data are critical to inform strategies that combat the opioid crisis. Using easily accessible and near real-time social media data to improve public health surveillance efforts related to the opioid crisis is a promising area of research. Objective This study explored the potential of using Twitter data to monitor the opioid epidemic. Specifically, this study investigated the extent to which the content of opioid-related tweets corresponds with the triphasic nature of the opioid crisis and correlates with OODs in North Carolina between 2009 and 2017. Methods Opioid-related Twitter posts were obtained using Crimson Hexagon, and were classified as relating to prescription opioids, heroin, and synthetic opioids using natural language processing. This process resulted in a corpus of 100,777 posts consisting of tweets, retweets, mentions, and replies. Using a random sample of 10,000 posts from the corpus, we identified opioid-related terms by analyzing word frequency for each year. OODs were obtained from the Multiple Cause of Death database from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Least squares regression and Granger tests compared patterns of opioid-related posts with OODs. Results The pattern of tweets related to prescription opioids, heroin, and synthetic opioids resembled the triphasic nature of OODs. For prescription opioids, tweet counts and OODs were statistically unrelated. Tweets mentioning heroin and synthetic opioids were significantly associated with heroin OODs and synthetic OODs in the same year (P=.01 and P<.001, respectively), as well as in the following year (P=.03 and P=.01, respectively). Moreover, heroin tweets in a given year predicted heroin deaths better than lagged heroin OODs alone (P=.03). Conclusions Findings support using Twitter data as a timely indicator of opioid overdose mortality, especially for heroin.

Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic

2018 ◽  
Vol 1 (21;1) ◽  
pp. 309-326 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Synthetic Opioids ◽  
Opioid Crisis ◽  
Electronic Reporting ◽  
Number Of Patients ◽  
Overdose Deaths

The opioid epidemic has been called the “most consequential preventable public health problem in the United States.” Though there is wide recognition of the role of prescription opioids in the epidemic, evidence has shown that heroin and synthetic opioids contribute to the majority of opioid overdose deaths. It is essential to reframe the preventive strategies in place against the opioid crisis with attention to factors surrounding the illicit use of fentanyl and heroin. Data on opioid overdose deaths shows 42,000 deaths in 2016. Of these, synthetic opioids other than methadone were responsible for over 20,000, heroin for over 15,000, and natural and semisynthetic opioids other than methadone responsible for over 14,000. Fentanyl deaths increased 520% from 2009 to 2016 (increased by 87.7% annually between 2013 and 2016), and heroin deaths increased 533% from 2000 to 2016. Prescription opioid deaths increased by 18% overall between 2009 and 2016. The Drug Enforcement Administration (DEA) mandated reductions in opioid production by 25% in 2017 and 20% in 2018. The number of prescriptions for opioids declined significantly from 252 million in 2013 to 196 million in 2017 (9% annual decline over this period), falling below the number of prescriptions in 2006. In addition, data from 2017 shows significant reductions in the milligram equivalence of morphine by 12.2% and in the number of patients receiving high dose opioids by 16.1%. This manuscript describes the escalation of opioid use in the United States, discussing the roles played by drug manufacturers and distributors, liberalization by the DEA, the Food and Drug Administration (FDA), licensure boards and legislatures, poor science, and misuse of evidencebased medicine. Moreover, we describe how the influence of pharma, improper advocacy by physician groups, and the promotion of literature considered peer-reviewed led to the explosive use of illicit drugs arising from the issues surrounding prescription opioids. This manuscript describes a 3-tier approach presented to Congress. Tier 1 includes an aggressive education campaign geared toward the public, physicians, and patients. Tier 2 includes facilitation of easier access to non-opioid techniques and the establishment of a National All Schedules Prescription Electronic Reporting Act (NASPER). Finally, Tier 3 focuses on making buprenorphine more available for chronic pain management as well as for medication-assisted treatment. Key words: Opioid epidemic, fentanyl and heroin epidemic, prescription opioids, National All Schedules Prescription Electronic Reporting Act (NASPER), Prescription Drug Monitoring Programs (PDMPs)

The Evolving Overdose Epidemic: Synthetic Opioids And Rising Stimulant-Related Harms

2020 ◽  
Author(s):  
Christopher M Jones ◽  
Faraah Bekheet ◽  
Ju Nyeong Park ◽  
G Caleb Alexander
Keyword(s):  
Illicit Drug ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Drug Supply ◽  
Synthetic Opioids ◽  
Key Stakeholders ◽  
Public Health Challenges ◽  
Concomitant Exposure ◽  
Over Time ◽  
Key Questions

Abstract The opioid overdose epidemic is typically described as having occurred in three waves, with morbidity and mortality accruing over time principally from prescription opioids (1999-2010), heroin (2011-2013) and illicit fentanyl and other synthetic opioids (2014-present). However, the increasing presence of synthetic opioids mixed into the illicit drug supply, including with stimulants such as cocaine and methamphetamine, as well as rising stimulant-related deaths, reflects the rapidly evolving nature of the overdose epidemic posing urgent and novel public health challenges. We synthesize the evidence underlying these trends, consider key questions such as where and how concomitant exposure to fentanyl and stimulants is occurring, and identify actions for key stakeholders regarding how these emerging threats, and continued evolution of the overdose epidemic, can best be addressed.

Accidental Overdose Deaths in Oklahoma, 2002–2017: Opioid and Methamphetamine Trends

2020 ◽  
Vol 44 (7) ◽  
pp. 672-678
Author(s):  
Rachel Bonk ◽  
Ross J Miller ◽  
Joshua Lanter ◽  
Cheryl Niblo ◽  
Jesse Kemp ◽  
...  
Keyword(s):  
Drug Overdose ◽  
Sharp Increase ◽  
The State ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Death Rates ◽  
Synthetic Opioids ◽  
Accidental Overdose ◽  
Overdose Deaths

Abstract To evaluate trends related to accidental overdose deaths in Oklahoma, with a focus on opioids and methamphetamine. All accidental drug overdose deaths in the state of Oklahoma from 2002 to 2017 were reviewed. Opioids were grouped into the following categories: all opioids, prescription opioids, synthetic opioids and heroin. Age-adjusted death rates for methamphetamine and each opioid category were calculated and analyzed. Accidental overdoses accounted for 9,936 deaths during the study period. Of these, opioids were seen in 62.9%, with prescription opioids comprising 53.8%, synthetic opioids 10.3% and heroin 2.8%. Synthetic opioids, despite a recent upward nationwide trend, showed a slight overall decrease (−6.8%) from 2009 to 2017. In contrast, methamphetamine showed a 402.2% increase from 2009 to 2017 and an overall increase of 1,526.7%. Methamphetamine was involved in the most overdoses (1,963), followed by oxycodone (1,724). Opioid-related deaths were most common among white individuals (90.3%) and showed a slight male predilection (56.9%). With the intent of assessing the opioid epidemic as it relates to accidental overdoses in Oklahoma, this study suggests that opioid-related overdoses have slowed in recent years amidst a sharp increase in methamphetamine deaths.

scholarly journals At-a-glance - The local response to the Canadian opioid epidemic in the Kingston, Frontenac, and Lennox and Addington communities

2019 ◽  
Vol 39 (12) ◽  
pp. 333-336
Author(s):  
Anees Bahji ◽  
Daenis Camiré
Keyword(s):  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Local Response ◽  
Opioid Crisis ◽  
Queen's University

Canada is facing a national opioid overdose epidemic, with deaths due to opioid overdoses continuing to rise dramatically. To that end, the opioid experiences of the Kingston, Frontenac, and Lennox and Addington communities, the regional hub for southeastern Ontario and the home of Queen’s University, may provide meaningful insights. This article provides a description of recent activities to address the local opioid crisis, a rationale for their adoption and the context in which they are being undertaken.

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 Guilford County Solution to the Opioid Problem (GCSTOP): A Model for University/Community Partnerships

2018 ◽  
Vol 1 (2) ◽  
pp. 5
Author(s):  
Stephen J Sills ◽  
Chase N Holleman ◽  
Kenneth J Gruber
Keyword(s):  
North Carolina ◽  
High Risk ◽  
Health Education ◽  
Community Partnerships ◽  
Opioid Overdose ◽  
Community Resources ◽  
Opioid Epidemic ◽  
Evaluation Design ◽  
Community Health Education ◽  
The University

There were over 700 overdoses and 180 deaths from opioids in Guilford County, NC in 2017. The Guilford Solution to the Opioid Problem (GSTOP) project leverages funds allocated by the STOP-Act to design, implement, and evaluate a rapid response program intended to decrease mortality from opioid overdoses. The program engages citizens who overdose in harm reduction practices, distributes naloxone kits to high-risk users, conducts community health education, coordinates community resources through the CURE Triad collaborative, and builds relationships focused on ending opioid overdose. This presentation will review the development of the partnership between Guilford County Emergency Medical Services and the University of North Carolina at Greensboro that has resulted in the GSTOP demonstration project. The presentation included background on the opioid epidemic in Guilford County, the development of CURE Triad (a community coalition to address overdoses) and the implementation of GSTOP, the unique features of hosting such a program within a university, the evaluation design, and preliminary outcomes of the program.

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 Increases in Naloxone Administrations by Emergency Medical Services Providers During the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Dalia Khoury ◽  
Alexander Preiss ◽  
Paul Geiger ◽  
Mohd Anwar ◽  
Kevin Paul Conway
Keyword(s):  
United States ◽  
North Carolina ◽  
Emergency Medical Service ◽  
Medical Service ◽  
The United States ◽  
Opioid Overdose ◽  
Opioid Crisis ◽  
Control Distribution ◽  
Emergency Medical ◽  
Past Data

BACKGROUND The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. OBJECTIVE The current study examines changes in naloxone administrations during Emergency Medical Service (EMS) runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina. METHODS A period-over-period approach was used to explore EMS data from Guilford County, North Carolina on opioid overdose-related runs. We compared trends in the frequency of opioid-related EMS runs, naloxone administrations (NAs), and multiple naloxone administrations (MNAs) 29 weeks before and during the COVID-19 pandemic. Furthermore, past data were used to generate a quasi-control distribution of period-over-period changes to compare the change observed during the COVID-19 period to each 29-week period back to January 1, 2014. RESULTS All outcomes increased during the COVID-19 period. Compared to the previous 29 weeks, we observed significant proportional increases in mean number of opioid-related EMS runs (37.4%), NAs (57.8%), and MNAs (84.8%). Compared to each previous 29-week period, the COVID-19 period saw increases across all outcomes that were greater than 91% of all past period-over-period changes. CONCLUSIONS The current study is the first to report increases in both incidence (NAs) and severity (MNAs) of opioid overdoses during the COVID-19 pandemic. For a host of reasons that need to be explored, the COVID-19 pandemic appears to markedly increase the occurrence and lethality of the opioid crisis in Guilford County, NC.

scholarly journals YouTube viewers’ comments on the opioid epidemic offer solutions to help chronic pain patients

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Bacon ◽  
L Ivanitskaya ◽  
E Erzikova ◽  
T Veverka
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Control ◽  
Alternative Therapies ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstract Background Approximately 34.3 million people used prescription opioids for non-medical reasons globally in 2016. In addition, many of the 1.5 billion people worldwide who suffer from chronic pain use opioids. According to the United Nations Office on Drugs and Crime, 76% of overdose deaths are caused by prescription and non-prescription opioids. Opioid use disorder and addiction encompass many aspects; such as, economic forces, cultural forces and individual genetic makeup. Because of this complexity, policymakers will have to address chronic pain and social determinants of health. Understanding the public's perspectives on the opioid epidemic is critical for policymakers to create awareness and treatment programs to decrease opioid related deaths while treating pain. Methods This inductive, iterative approach to content analysis of secondary data collected 8,761 comments posted by viewers on ten videos regarding the opioid epidemic on CNN's YouTube Channel and ten videos on Fox News' YouTube channel posted between January 1, 2017 and December 31, 2018. Results After analyzing 8,761 comments, from 20 videos, results indicated 618 (7%) were pain patients, 926 (10.6%) of the comments indicated stigma, (54.5% social stigma and 30% structural stigma). 5,453 (62.2%) of the comments posted claims regarding the opioid epidemic and 1,881 (21.5%) offered solutions. Three of the major solutions offered include legalizing cannabis (608, 7%), developing alternative therapies (174, 1.9%), and kratom (105, 1.2%). Conclusions Reducing access to opioids is harming legitimate pain patients. Policymakers need to take the public's opinions into consideration when developing policies and programs that help reduce opioid overdose. These policies must ensure that the 1.5 billion chronic pain patients worldwide receive adequate pain control in order to have a good quality of life that allows them to be contributing members of society. Key messages Worldwide, 1.5 billion people suffer from chronic pain, many without access to adequate pain control. Solutions posted by viewers include cannabis, alternative therapies and kratom. Understanding the public’s perspectives will help policymakers create programs that improve quality of life for chronic pain patients that minimize social, internalized and structural stigma.

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