EVALUATION OF MEDICATIONS FOR OPIOID USE DISORDER ON OVERDOSE AND HEALTHCARE UTILIZATION IN THE US

AbstractObjectiveMethadone is an evidence based treatment for opioid use disorder and is also employed for acute pain. The primary objective of this study was to explore methadone distribution patterns between the years 2017 and 2019 across the United States (US). This study builds upon previous literature that has analyzed prior years of US distribution patterns, and further outlines regional and state specific methadone trends.MethodsThe Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS) was used to acquire the number of narcotic treatment programs (NTPs) per state and methadone distribution weight in grams. Methadone distribution by weight, corrected for state populations, and number of NTPs were compared from 2017 to 2019 between states, within regions, and nationally.ResultsBetween 2017 and 2019, the national distribution of methadone increased 12.30% for NTPs but decreased 34.57% for pain, for a total increase of 2.66%. While all states saw a decrease in distribution for pain, when compared regionally, the Northeast showed a significantly smaller decrease than all other regions. Additionally, the majority of states experienced an increase in distribution for NTPs and most states demonstrated a relatively stable or increasing number of NTPs, with an 11.49% increase in NTPs nationally. The number of NTPs per 100K in 2019 ranged from 2.08 in Rhode Island to 0.00 in Wyoming.ConclusionAlthough methadone distribution for OUD was increasing in the US, there were pronounced regional disparities.

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Use of Buprenorphine for the Treatment of Opioid Use Disorder

Substance Use Disorders ◽

10.1093/med/9780190920197.003.0009 ◽

2020 ◽

pp. 155-168

Author(s):

Paul J. Fudala ◽

Anne Cramer Andorn

Keyword(s):

Opioid Dependence ◽

Addiction Treatment ◽

Partial Agonist ◽

The United States ◽

Opioid Use Disorder ◽

Sublingual Administration ◽

Opioid Use ◽

The Us ◽

Monthly Administration ◽

Drug Addiction Treatment

Buprenorphine is a mu-opioid partial agonist that was first developed as a parenteral analgesic and subsequently as a treatment for opioid dependence. In the United States, the first two products approved by the US Food and Drug Administration (in 2002) for the latter indication were buprenorphine (Subutex) and buprenorphine/naloxone (Suboxone) tablet formulations for sublingual administration. Since that time, additional products for both sublingual and buccal administration have also been approved, as well as a subcutaneous injection for once-monthly administration for the treatment of moderate or severe opioid use disorder (OUD) and a subdermal implant for the maintenance treatment of opioid dependence that delivers buprenorphine over a 6-month period. Under the Drug Addiction Treatment Act of 2000 (DATA 2000), qualified practitioners may apply for waivers to treat opioid dependence/OUD with approved buprenorphine products in any setting in which they are qualified to practice. Like other opioids, buprenorphine has the potential for being misused and abused.

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Factors Associated with Prescription Opioid Analgesic Use in the US Population, 2011–2014

Pain Medicine ◽

10.1093/pm/pny158 ◽

2018 ◽

Vol 20 (7) ◽

pp. 1338-1346 ◽

Cited By ~ 3

Author(s):

Steven M Frenk ◽

Susan L Lukacs ◽

Qiuping Gu

Keyword(s):

Opioid Analgesic ◽

Opioid Analgesics ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Opioid Use ◽

Factors Associated ◽

The Past ◽

The Us ◽

Opioid Users ◽

Analgesic Use

Abstract Objective This study examined factors associated with prescription opioid analgesic use in the US population using data from a nationally representative sample. It focused on factors previously shown to be associated with opioid use disorder or overdose. Variations in the use of different strength opioid analgesics by demographic subgroup were also examined. Methods Data came from respondents aged 16 years and older who participated in the National Health and Nutrition Examination Survey (2011–2014). Respondents were classified as opioid users if they reported using one or more prescription opioid analgesics in the past 30 days. Results Opioid users reported poorer self-perceived health than those not currently using opioids. Compared with those not using opioids, opioid users were more likely to rate their health as being “fair” or “poor” (40.4% [95% confidence interval {CI} = 34.9%–46.2%] compared with 15.6% [95% CI = 14.3%–17.1%]), experienced more days of pain during the past 30 days (mean = 14.3 [95% CI = 12.9–15.8] days compared with 2.3 [95% CI = 2.0–2.7] days), and had depression (22.5% [95% CI = 17.3%–28.7%] compared with 7.1% [95% CI = 6.2%–8.0%]). Among those who reported using opioids during the past 30 days, 18.8% (95% CI = 14.4%–24.1%) reported using benzodiazepine medication during the same period and 5.2% (95% CI = 3.5%–7.7%) reported using an illicit drug during the past six months. When opioid strength was examined, a smaller percentage of adults aged 60 years and older used stronger-than-morphine opioids compared with adults aged 20–39 and 40–59 years. Conclusions Higher percentages of current opioid users than nonusers reported having many of the factors associated with opioid use disorder and overdose.

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Accessibility to Medication for Opioid Use Disorder After Interventions to Improve Prescribing Among Nonaddiction Clinics in the US Veterans Health Care System

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.37238 ◽

2021 ◽

Vol 4 (12) ◽

pp. e2137238

Author(s):

Eric J. Hawkins ◽

Carol A. Malte ◽

Adam J. Gordon ◽

Emily C. Williams ◽

Hildi J. Hagedorn ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Opioid Use Disorder ◽

Veterans Health ◽

Opioid Use ◽

The Us ◽

Us Veterans ◽

Care System

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National U.S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality

PLoS ONE ◽

10.1371/journal.pone.0229174 ◽

2020 ◽

Vol 15 (2) ◽

pp. e0229174 ◽

Cited By ~ 1

Author(s):

Jasvinder A. Singh ◽

John D. Cleveland

Keyword(s):

Healthcare Utilization ◽

Time Trends ◽

Opioid Use Disorder ◽

Opioid Use

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Psycho-Social Correlates of Opioid Use Disorder among the US Adult Population: Evidence from the National Survey on Drug Use and Health, 2015–2018

Substance Use & Misuse ◽

10.1080/10826084.2020.1788086 ◽

2020 ◽

Vol 55 (12) ◽

pp. 2002-2010

Author(s):

Mohammad Rifat Haider ◽

Monique J. Brown ◽

Rajat Das Gupta ◽

Sabrina Karim ◽

Bankole Olatosi ◽

...

Keyword(s):

Drug Use ◽

National Survey ◽

Adult Population ◽

Opioid Use Disorder ◽

Opioid Use ◽

Social Correlates ◽

The Us

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Current and Future Potential Impact of COVID-19 on Kratom (Mitragyna speciosa Korth.) Supply and Use

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.574483 ◽

2020 ◽

Vol 11 ◽

Author(s):

Darshan Singh ◽

Paula N. Brown ◽

Eduardo Cinosi ◽

Ornella Corazza ◽

Jack E. Henningfield ◽

...

Keyword(s):

Southeast Asia ◽

Opioid Use Disorder ◽

Adverse Outcomes ◽

Opioid Use ◽

Traditional Use ◽

Mitragyna Speciosa ◽

The Us ◽

Psychoactive Effects ◽

Future Potential ◽

Unites States

Kratom (Mitragyna speciosa Korth., Rubiaceae) is native to and has traditional use in Southeast Asia. The number of kratom users outside of Southeast Asia has increased significantly in recent decades with use spreading to the Unites States (US) and Europe. Because of its reputed opioid-like psychoactive effects at higher doses, kratom has been regulated in several countries and is subject to an import ban by the US Food and Drug Administration. Nonetheless, in the US it is estimated that 10–15 million people consume kratom primarily for the self-treatment of pain, psychiatric disorders, to mitigate withdrawal from or dependence on opioids, and to self-treat opioid use disorder or other substance use disorders (SUDs). Due to the global COVID-19 pandemic, a shortage in the supply of kratom products may place unexpected burdens on kratom users, potentially influencing some who use kratom for SUD self-treatment to regress to harmful drug use, hence increasing the likelihood of adverse outcomes, including overdose. Inadequate treatment, treatment barriers, and increases in the sales of adulterated kratom products on the internet or in convenience stores could exacerbate circumstances further. Although there are currently no verified indications of kratom scarcity, researchers and clinicians should be aware of and remain vigilant to this unanticipated possibility.

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Alternatives to Arrest for Illicit Opioid Use: A Joint Criminal Justice and Healthcare Treatment Collaboration

Substance Abuse Research and Treatment ◽

10.1177/1178221820953390 ◽

2020 ◽

Vol 14 ◽

pp. 117822182095339

Author(s):

Andrea J Yatsco ◽

Rachel D Garza ◽

Tiffany Champagne-Langabeer ◽

James R Langabeer

Keyword(s):

Public Health ◽

Criminal Justice ◽

Law Enforcement ◽

Opioid Use Disorder ◽

Opioid Use ◽

Health Crisis ◽

Public Health Crisis ◽

The Us ◽

History Of ◽

Illicit Opioid Use

Opioid overdoses continue to be a leading cause of death in the US. This public health crisis warrants innovative responses to help prevent fatal overdose. There is continued advocacy for collaborations between public health partners to create joint responses. The high correlation between persons with opioid use disorder who have a history of involvement in the criminal justice system is widely recognized, and allows for treatment intervention opportunities. Law enforcement-led treatment initiatives are still relatively new, with a few sparse early programs emerging almost a decade ago and only gaining popularity in the past few years. A lack of published methodologies creates a gap in the knowledge of applied programs that are effective and can be duplicated. This article seeks to outline an interagency relationship between police and healthcare that illustrates arrest is not the only option that law enforcement may utilize when encountering persons who use illicit substances. Program methods of a joint initiative between law enforcement and healthcare in a large, metropolitan area will be reviewed, supplemented with law enforcement overdose data and statistics on law enforcement treatment referrals.

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Epidemiology of Substance Use Disorders

Substance Use Disorders ◽

10.1093/med/9780190920197.003.0001 ◽

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.

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