scholarly journals Web-Based Discussion and Illicit Street Sales of Tapentadol and Oxycodone in Australia: Epidemiological Surveillance Study (Preprint)

2021 ◽  
Author(s):  
Joshua Black ◽  
Zachary R Margolin ◽  
Gabrielle Bau ◽  
Richard Olson ◽  
Janetta L Iwanicki ◽  
...  
Keyword(s):  
Side Effects ◽  
Surveillance System ◽  
Geometric Mean ◽  
Monitoring Program ◽  
Opioid Use Disorder ◽  
Epidemiological Surveillance ◽  
Health Concern ◽  
Opioid Use ◽  
Street Price ◽  
The Web

BACKGROUND Opioid use disorder and its consequences are a persistent public health concern for Australians. Web activity has been used to understand the perception of drug safety and diversion of drugs in contexts outside of Australia. The anonymity of the internet offers several advantages for surveilling and inquiring about specific covert behaviors, such as diversion or discussion of sensitive subjects where traditional surveillance approaches might be limited. OBJECTIVE This study aims to characterize the content of web posts and compare reports of illicit sales of tapentadol and oxycodone from sources originating in Australia. First, post content is evaluated to determine whether internet discussion encourages or discourages proper therapeutic use of the drugs. Second, we hypothesize that tapentadol would have lower street price and fewer illicit sales than oxycodone. METHODS Web posts originating in Australia between 2017 and 2019 were collected using the Researched Abuse, Diversion, and Addiction-Related Surveillance System Web Monitoring Program. Using a manual coding process, unstructured post content from social media, blogs, and forums was categorized into topics of discussion related to the harms and behaviors that could lead to harm. Illicit sales data in a structured format were collected through a crowdsourcing website between 2016 and 2019 using the Researched Abuse, Diversion, and Addiction-Related Surveillance System StreetRx Program. In total, 2 multivariable regression models assessed the differences in illicit price and number of sales. RESULTS A total of 4.7% (28/600) of tapentadol posts discussed an adverse event, whereas 10.27% (95% CI 9.32-11.21) of oxycodone posts discussed this topic. A total of 10% (60/600) of tapentadol posts discussed unsafe use or side effects, whereas 20.17% (95% CI 18.92-21.41) of oxycodone posts discussed unsafe use or side effects. There were 31 illicit sales reports for tapentadol (geometric mean price per milligram: Aus $0.12 [US $0.09]) and 756 illicit sales reports for oxycodone (Aus $1.28 [US $0.91]). Models detected no differences in the street price or number of sales between the drugs when covariates were included, although the potency of the pill significantly predicted the street price (<i>P</i>&lt;.001) and availability predicted the number of sales (<i>P</i>=.03). CONCLUSIONS Australians searching the web for opinions could judge tapentadol as safer than oxycodone because of the web post content. The illicit sales market for tapentadol was smaller than that of oxycodone, and drug potency and licit availability are likely important factors influencing the illicit market.

scholarly journals Web-Based Discussion and Illicit Street Sales of Tapentadol and Oxycodone in Australia: Epidemiological Surveillance Study

10.2196/29187 ◽  
2021 ◽  
Vol 7 (12) ◽  
pp. e29187
Author(s):  
Joshua Black ◽  
Zachary R Margolin ◽  
Gabrielle Bau ◽  
Richard Olson ◽  
Janetta L Iwanicki ◽  
...  
Keyword(s):  
Side Effects ◽  
Surveillance System ◽  
Geometric Mean ◽  
Monitoring Program ◽  
Opioid Use Disorder ◽  
Epidemiological Surveillance ◽  
Health Concern ◽  
Opioid Use ◽  
Street Price ◽  
The Web

Background Opioid use disorder and its consequences are a persistent public health concern for Australians. Web activity has been used to understand the perception of drug safety and diversion of drugs in contexts outside of Australia. The anonymity of the internet offers several advantages for surveilling and inquiring about specific covert behaviors, such as diversion or discussion of sensitive subjects where traditional surveillance approaches might be limited. Objective This study aims to characterize the content of web posts and compare reports of illicit sales of tapentadol and oxycodone from sources originating in Australia. First, post content is evaluated to determine whether internet discussion encourages or discourages proper therapeutic use of the drugs. Second, we hypothesize that tapentadol would have lower street price and fewer illicit sales than oxycodone. Methods Web posts originating in Australia between 2017 and 2019 were collected using the Researched Abuse, Diversion, and Addiction-Related Surveillance System Web Monitoring Program. Using a manual coding process, unstructured post content from social media, blogs, and forums was categorized into topics of discussion related to the harms and behaviors that could lead to harm. Illicit sales data in a structured format were collected through a crowdsourcing website between 2016 and 2019 using the Researched Abuse, Diversion, and Addiction-Related Surveillance System StreetRx Program. In total, 2 multivariable regression models assessed the differences in illicit price and number of sales. Results A total of 4.7% (28/600) of tapentadol posts discussed an adverse event, whereas 10.27% (95% CI 9.32-11.21) of oxycodone posts discussed this topic. A total of 10% (60/600) of tapentadol posts discussed unsafe use or side effects, whereas 20.17% (95% CI 18.92-21.41) of oxycodone posts discussed unsafe use or side effects. There were 31 illicit sales reports for tapentadol (geometric mean price per milligram: Aus $0.12 [US $0.09]) and 756 illicit sales reports for oxycodone (Aus $1.28 [US $0.91]). Models detected no differences in the street price or number of sales between the drugs when covariates were included, although the potency of the pill significantly predicted the street price (P<.001) and availability predicted the number of sales (P=.03). Conclusions Australians searching the web for opinions could judge tapentadol as safer than oxycodone because of the web post content. The illicit sales market for tapentadol was smaller than that of oxycodone, and drug potency and licit availability are likely important factors influencing the illicit market.

scholarly journals The association between cannabis use and outcome in pharmacological treatment for opioid use disorder

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tea Rosic ◽  
Raveena Kapoor ◽  
Balpreet Panesar ◽  
Leen Naji ◽  
Darren B. Chai ◽  
...  
Keyword(s):  
Side Effects ◽  
Pharmacological Treatment ◽  
Addiction Treatment ◽  
Age Of Onset ◽  
Opioid Use Disorder ◽  
Cannabis Use ◽  
Self Report ◽  
Opioid Use ◽  
Differential Outcomes ◽  
Urine Drug

Abstract Background With the ongoing opioid crisis and policy changes regarding legalization of cannabis occurring around the world, it is necessary to consider cannabis use in the context of opioid use disorder (OUD) and its treatment. We aimed to examine (1) past-month cannabis use in patients with OUD, (2) self-reported cannabis-related side effects and craving, and (3) the association between specific characteristics of cannabis use and opioid use during treatment in cannabis users. Methods Participants receiving pharmacological treatment for OUD (n = 2315) were recruited from community-based addiction treatment clinics in Ontario, Canada, and provided information on past-month cannabis use (self-report). Participants were followed for 3 months with routine urine drug screens in order to assess opioid use during treatment. We used logistic regression analysis to explore (1) the association between any cannabis use and opioid use during treatment, and (2) amongst cannabis-users, specific cannabis use characteristics associated with opioid use. Qualitative methods were used to examine responses to the question: “What effect does marijuana have on your treatment?”. Results Past-month cannabis use was reported by 51% of participants (n = 1178). Any cannabis use compared to non-use was not associated with opioid use (OR = 1.03, 95% CI 0.87–1.23, p = 0.703). Amongst cannabis users, nearly 70% reported daily use, and half reported experiencing cannabis-related side effects, with the most common side effects being slower thought process (26.2%) and lack of motivation (17.3%). For cannabis users, daily cannabis use was associated with lower odds of opioid use, when compared  with occasional use (OR = 0.61, 95% CI 0.47–0.79, p < 0.001) as was older age of onset of cannabis use (OR = 0.97, 95% CI 0.94, 0.99, p = 0.032), and reporting cannabis-related side effects (OR = 0.67, 95% CI 0.51, 0.85, p = 0.001). Altogether, 75% of cannabis users perceived no impact of cannabis on their OUD treatment. Conclusion Past-month cannabis use was not associated with more or less opioid use during treatment. For patients who use cannabis, we identified specific characteristics of cannabis use associated with differential outcomes. Further examination of characteristics and patterns of cannabis use is warranted and may inform more tailored assessments and treatment recommendations.

scholarly journals Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder

2017 ◽  
Vol 25 (5) ◽  
pp. 508-516 ◽  
Author(s):  
Kathryn Hawk ◽  
Gail D'Onofrio ◽  
David A. Fiellin ◽  
Marek C. Chawarski ◽  
Patrick G. O'Connor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Prescription Drug Monitoring Program

scholarly journals The Pennsylvania Prescription Drug Monitoring Program: Reducing the Misuse of Prescription Opioids

Commonwealth ◽  
2018 ◽  
Vol 20 (2-3) ◽  
Author(s):  
Lynn S. Mirigian ◽  
Laura A. Hendrick ◽  
Janice L. Pringle ◽  
Michael A. Zemaitis
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Opioid Use Disorder ◽  
Prescribing Patterns ◽  
Opioid Overdose ◽  
Opioid Use ◽  
University Of Pittsburgh ◽  
Drug Enforcement Administration ◽  
Prescription Drug Monitoring Program

In 2016, 4,642 Pennsylvanians died from a drug overdose and 85% of these deaths were due to an opioid overdose (U.S. Drug Enforcement Administration and University of Pittsburgh School of Pharmacy 2017). With a 37% increase in deaths from 2015, the Commonwealth’s response to this epidemic has come from several fronts. One valuable resource has been the modernization and implementation of Pennsylvania’s Prescription Drug Monitoring Program (PDMP). PDMPs are state-­run programs that record dispensing of most controlled substances and provide this data to physicians and pharmacists (among others) to inform their practice about possible opioid use disorder by a given patient. This article discusses the role of Pennsylvania’s PDMP in patient care and law enforcement to reduce opioid overdoses in the Commonwealth. Recent evidence is discussed that demonstrates the effectiveness of state-­run PDMPs and their impact on opioid misuse and prescribing patterns. It is important to note that additional research into the effectiveness of PDMPs in preventing opioid-­related morbidity and mortality is needed.

scholarly journals Laxatives and Erectile Dysfunction Medications to Treat Side Effects of Opioid Agonist and Methadone Maintenance Therapy

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Sara D. Khangura ◽  
Andrea Ryce
Keyword(s):  
Erectile Dysfunction ◽  
Side Effects ◽  
Treatment Adherence ◽  
Methadone Maintenance ◽  
Clinical Effectiveness ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Medical Interventions

Opioid agonist and methadone maintenance therapies are essential medical interventions for effectively managing opioid use disorder. However, side effects, including constipation and erectile dysfunction can compromise treatment adherence and increase the risk of relapse. No studies or guidelines describing the clinical effectiveness or recommendations for the use of laxatives or erectile dysfunction medications in the treatment of constipation or erectile dysfunction in patients undergoing OAT or MMT were identified. Research is needed to understand the clinical effectiveness and inform guidance concerning the treatment of constipation with laxatives and the use of medications indicated for erectile dysfunction.

scholarly journals Development of a Novel Behavioral Intervention for Opioid Use Disorders

2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Mercy Mumba ◽  
George Mugoya ◽  
Natalia Smith ◽  
Andrea Glenn ◽  
Courtney Potts ◽  
...  
Keyword(s):  
Behavioral Intervention ◽  
Behavioral Therapy ◽  
Treatment Protocol ◽  
Opioid Use Disorder ◽  
Health Concern ◽  
Treatment Modalities ◽  
Opioid Use ◽  
Theoretical Frameworks ◽  
Effective Interventions ◽  
National Priority

The opioid crisis is a serious public health concern and finding appropriate treatment modalities for opioid use disorder (OUD) has become a national priority. Evidence-based treatment recommendations from national organizations have indicated mixed results. In this article, we discuss the background knowledge and significance of the problem, and selected theoretical frameworks and review of the literature about several effective interventions, such as mindfulness, motivational interviewing, and cognitive behavioral therapy. However, there is a lack of a standardized behavioral intervention for OUD. In response to this gap, our team developed a manual-based treatment protocol for use in group settings of individuals with OUD who are also on medications. We describe the methods used to develop the manual, including detailed information about the 12 intervention sessions. The article concludes with discussion about implications and future directions for use of the manual.

scholarly journals Changes in pharmacy are associated with gaps in medication possession in individuals treated with buprenorphine

2020 ◽  
Author(s):  
Tyler J Varisco ◽  
Susan Abughosh ◽  
Hua Chen ◽  
Marc Fleming ◽  
Douglas Ziedonis ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Monitoring Program ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Random Intercept ◽  
National Quality ◽  
Reliable Source ◽  
Clinically Significant ◽  
Definition Of

AbstractAims: The objective of this study was to identify the prevalence of changes in pharmacy among incident buprenorphine users and to estimate the association between a change in pharmacy and a clinically significant gap in therapy of seven-days or longer. Design: A retrospective, repeated measures, longitudinal cohort design was used. Setting and Participants: Patients initiating treatment with a buprenorphine product indicated for opioid use disorder were identified from the 2016-2018 Texas Prescription Monitoring Program Prescription Dispensation Dataset. Patients were excluded if they filled fewer than three prescriptions or remained in therapy for less than seven-days. Intervention and Measurement: The predictor of interest, a change in pharmacy, was defined by comparing the dispensary used between subsequent prescriptions. The outcome of interest was defined as a gap in medication possession of seven-days or longer based on the National Quality Forum’s definition of continuity of pharmacotherapy for opioid use disorder. A random intercept, fixed slope mixed model with a logistic link was then used to measure the association between a change in pharmacy and a gap in therapy. Findings: Of 13,375 eligible patients, 29.6% had at least one change in pharmacy and 51.6% of those did so more than once. The median time to initial change in pharmacy was 30 (IQR:13-66) days. Patients who changed pharmacies were significantly more likely to have a gap in therapy between 7 and 29 days (aOR:1.96, 95% CI=1.81-2.13).Conclusion: Patients receiving buprenorphine based MOUD change pharmacies frequently and early in treatment which leads to clinically significant gaps in therapy. While qualitative explanatory work is needed to understand the reasons for such frequent changes in pharmacy, pharmacists and prescribers must ensure that patients have reliable access to a convenient and reliable source of buprenorphine to prevent changes in pharmacy.

scholarly journals Reducing the stigma surrounding opioid use disorder: evaluating an opioid overdose prevention training program applied to a diverse population

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicholas Alexander Bascou ◽  
Benjamin Haslund-Gourley ◽  
Katrina Amber-Monta ◽  
Kyle Samson ◽  
Nathaniel Goss ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Opioid Use Disorder ◽  
Health Concern ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Faculty Advisors ◽  
The Usa ◽  
Attitudes And Knowledge ◽  
Overdose Deaths

Abstract Background The opioid epidemic is a rapidly growing public health concern in the USA, as the number of overdose deaths continues to increase each year. One strategy for combating the rising number of overdoses is through opioid overdose prevention programs (OOPPs). Objective To evaluate the effectiveness of an innovative OOPP, with changes in knowledge and attitudes serving as the primary outcome measures. Methods The OOPP was developed by a group of medical students under guidance from faculty advisors. Training sessions focused on understanding stigmatizing factors of opioid use disorder (OUD), as well as protocols for opioid overdose reversal through naloxone administration. Pre- and post-surveys were partially adapted from the opioid overdose attitudes and knowledge scales and administered to all participants. Paired t-tests were conducted to assess differences between pre- and post-surveys. Results A total of 440 individuals participated in the training; 381 completed all or the majority of the survey. Participants came from a diverse set of backgrounds, ages, and experiences. All three knowledge questions showed significant improvements. For attitude questions, significant improvements were found in all three questions evaluating confidence, two of three questions assessing attitudes towards overdose reversal, and four of five questions evaluating stigma and attitudes towards individuals with OUD. Conclusions Our innovative OOPP was effective not only in increasing knowledge but also in improving attitudes towards overdose reversal and reducing stigma towards individuals with OUD. Given the strong improvements in attitudes towards those with OUD, efforts should be made to incorporate the unique focus on biopsychosocial and sociohistorical components into future OOPPs.

Opioid use in pregnancy: An emerging health crisis

2020 ◽  
pp. 1753495X2097116
Author(s):  
Jonathan Zipursky ◽  
David N Juurlink
Keyword(s):  
Healthcare Providers ◽  
Opioid Use Disorder ◽  
Health Concern ◽  
Opioid Use ◽  
Health Crisis ◽  
Appropriate Care ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Maternal And Neonatal Health ◽  
In Pregnancy

Opioid use in pregnancy has increased in parallel to the opioid crisis observed in the general population. Rising rates of peripartum opioid use pose a significant public health concern for both mothers and their children. Pregnancy also represents a unique opportunity for healthcare providers to screen women for opioid use disorder and engage them in appropriate care. In the present review, we describe patterns of opioid use in pregnancy and how this relates to maternal and neonatal health outcomes. We also examine screening for and treatment of opioid use disorder in pregnancy, neonatal outcomes following maternal opioid use, and breastfeeding recommendations for women taking opioids postpartum.

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