scholarly journals Opioid Medication Use and Education Following Sports Medicine Procedures: An Evidence-to-Practice Review

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Caitlin S. O'Mara ◽  
Michael G. Ward ◽  
Zachary K Winkelmann
Keyword(s):  
Systematic Review ◽  
Drug Use ◽  
Prescription Drugs ◽  
Sports Medicine ◽  
Community Education ◽  
The United States ◽  
Current Data ◽  
Opioid Epidemic ◽  
Practice Review ◽  
Conducting Research

According to the Centers for Disease Control (CDC), illicit and prescription drug overdoses are responsible for 128 deaths every day in the United States. In 2018, 70% of all overdose related deaths involved opioids. Efforts to minimize the opioid epidemic focus on community education, research, partnership, and healthcare support. Under the CDC guidelines, current practices include monitoring trends of drug use and drug related deaths, conducting research to recognize areas in need of improvement and to analyze effectiveness of current treatments, partner with community organizations and healthcare systems that deal firsthand with opioid users, and educate the public on drug use, misuse, and overdoses. People are commonly uneducated on the proper use and disposal of their prescription opioids. Consistent and appropriate communication among surgeons and their patients can decrease this risk associated with prescription drugs. The purpose of this evidence-to-practice review was to summarize a systematic review on the current data and findings related to postoperative opioid prescribing and consumption behaviors after a common sports medicine operation. The guiding systematic review explored several ways to reduce the risk of patients developing opioid dependence and abuse due to physicians overprescribing opioids. First, educating each patient about pain management during pre- and postoperative phases, how to store opioids safely, and how to dispose of opioids properly need to be created to help reduce the risk of the patient abusing opioids. Secondly, having the prescribing provider create an extensive history that reveals any red flags for opioid abuse for each patient. Thirdly, the prescribing provider should prescribe the lowest dose and shortest regimen to limit the number of opioids left over. These protocols may help slow the current opioid epidemic.

scholarly journals Use of Population-Based Surveys for Estimating the Population Size of Persons Who Inject Drugs in the United States

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S218-S229
Author(s):  
Heather Bradley ◽  
Elizabeth M Rosenthal ◽  
Meredith A Barranco ◽  
Tomoko Udo ◽  
Patrick S Sullivan ◽  
...  
Keyword(s):  
United States ◽  
Drug Use ◽  
Population Size ◽  
Prescription Drugs ◽  
The United States ◽  
Population Based ◽  
Self Report ◽  
Persons Who Inject Drugs ◽  
Population Size Estimates ◽  
Prevalence Estimates

Abstract Background In the United States, injection is an increasingly common route of administration for opioids and other substances. Estimates of the number of persons who inject drugs (PWID) are needed for monitoring risk-specific infectious disease rates and health services coverage. Methods We reviewed design and instruments for 4 national household surveys, 2012–2016, for their ability to produce unbiased injection drug use (IDU) prevalence estimates. We explored potential analytic adjustments for reducing biases through use of external data on (1) arrest, (2) narcotic overdose mortality, and (3) biomarker-based sensitivity of self-reported illicit drug use. Results Estimated national past 12 months IDU prevalence ranged from 0.24% to 0.59% across surveys. All surveys excluded unstably housed and incarcerated persons, and estimates were based on <60 respondents reporting IDU behavior in 3 surveys. No surveys asked participants about nonmedical injection of prescription drugs. Analytic adjustments did not appreciably change IDU prevalence estimates due to suboptimal specificity of data points. Conclusions PWID population size estimates in the United States are based on small numbers and are likely biased by undercoverage of key populations and self-report. Novel methods as discussed in this article may improve our understanding of PWID population size and their health needs.

scholarly journals Public health strategies to combat opioid epidemic in the United States: A systematic review

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
F Balidemaj
Keyword(s):  
Public Health ◽  
United States ◽  
Systematic Review ◽  
The United States ◽  
Opioid Abuse ◽  
Opioid Epidemic ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Opioid Crisis ◽  
Public Health Strategies

Abstract Background The opioid epidemic in the United States is a national public health crisis. Driven by an increase in availability of pharmaceutical opioids and by an increase in their consumption, specifically, for pain treatment, more so in the past twenty years, it has led to an economic cost of prescription opioid abuse, overdose, and dependence in the United States estimated to be 78.5 billion USD. The purpose of this systematic review was to identify and evaluate public health strategies that contribute towards combatting the opioid crisis. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a search was conducted of the PubMed database for articles in English language that analyzed the most effective ways to regulate health markets to decrease the opioid crisis in the United States. Results The initial search yielded 2397 titles, of which 15 full-text articles were ultimately selected for inclusion in this systematic review. The review identified four categories in overcoming this epidemic nationwide, including required improvement in patient utilization of and access to safe and effective treatment options for opioid abuse and overdose, addressing the stigma correlated with opioid use, considering appropriate use of abuse deterrent formulations (ADF) along with patient education, and improving prescribing practices via utilization of drug monitoring programs, CDC opioid prescribing guidelines and provider continuing education. Conclusions Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. While the methods with promising improvement of the situation have been identified, implementing them has shown to be a challenge. Continued application is needed, while considering possible new steps that could help reinforce their utilization further. Key messages Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. The methods with promising improvement of the opioid crisis situation have been identified, however utilizing and implementing the existing public health strategies has shown to be a challenge.

scholarly journals Patterns of Marijuana Use in a 6-Month Pain Management Sample in the United States

2017 ◽  
Vol 11 ◽  
pp. 117822181772478 ◽  
Author(s):  
Hope M Smiley-McDonald ◽  
Katherine N Moore ◽  
David C Heller ◽  
Jeri D Ropero-Miller ◽  
Gregory L McIntire ◽  
...  
Keyword(s):  
Pain Management ◽  
Drug Use ◽  
Prescription Drugs ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Marijuana Use ◽  
The United States ◽  
Prescription Drug Use ◽  
Urine Drug Testing ◽  
Urine Drug

This study is a 6-month retrospective analysis of urine drug testing (UDT) data from a pain management population among specimens with clinician-ordered marijuana testing (N = 194 809). Descriptive statistics about the specimen positivity of clinician-ordered marijuana UDT are provided as well as other drug positivity. Specimens from men and adults aged 18 to 34 years had the highest prevalence rates of marijuana positivity. The prevalence of past-month marijuana use among a comparative national population was lower than the prevalence of positive marijuana tests in the UDT specimens by all characteristics. Among the specimens tested for illicit drugs and marijuana, 4.0% were positive for amphetamine, 2.8% were positive for cocaine, and 0.9% were positive for heroin. The most common prescription drugs listed were opioids (64.7%), benzodiazepines (20.5%), and antidepressants (19.9%). In sum, the findings reflect previous research showing high rates of marijuana use, illicit drug use, and prescription drug use in a pain management population.

scholarly journals The Opioid Epidemic and the Labor Market

2017 ◽  
pp. 1-6
Author(s):  
Dionissi Aliprantis ◽  
Anne Chen
Keyword(s):  
United States ◽  
Labor Market ◽  
Drug Use ◽  
Labor Force ◽  
The United States ◽  
Opioid Epidemic ◽  
Drug Overdoses ◽  
Prescription Pain Relievers ◽  
Overdose Deaths ◽  
Over Time

Drug overdoses now account for more deaths in the United States than traffic deaths or suicides, and most of the increase in overdose deaths since 2010 can be attributed to opioids--a class of drugs that includes both prescription pain relievers and illegal narcotics. We look at trends in drug use and overdose deaths to document how the opioid epidemic has evolved over time and to determine whether it could be large enough to impact the labor force.

scholarly journals An Online Survey for Pharmacoepidemiological Investigation (Survey of Non-Medical Use of Prescription Drugs Program): Validation Study

10.2196/15830 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e15830 ◽  
Author(s):  
Joshua Curtis Black ◽  
Karilynn Rockhill ◽  
Alyssa Forber ◽  
Elise Amioka ◽  
K Patrick May ◽  
...  
Keyword(s):  
Drug Use ◽  
Best Practices ◽  
Prescription Drugs ◽  
Online Survey ◽  
Methodological Approach ◽  
The United States ◽  
Relative Bias ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Online Panels

Background In rapidly changing fields such as the study of drug use, the need for accurate and timely data is paramount to properly inform policy and intervention decisions. Trends in drug use can change rapidly by month, and using study designs with flexible modules could present advantages. Timely data from online panels can inform proactive interventions against emerging trends, leading to a faster public response. However, threats to validity from using online panels must be addressed to create accurate estimates. Objective The objective of this study was to demonstrate a comprehensive methodological approach that optimizes a nonprobability, online opt-in sample to provide timely, accurate national estimates on prevalence of drug use. Methods The Survey of Non-Medical Use of Prescription Drugs Program from the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS) System is an online, cross-sectional survey on drug use in the United States, and several best practices were implemented. To optimize final estimates, two best practices were investigated in detail: exclusion of respondents showing careless or improbable responding patterns and calibration of weights. The approach in this work was to cumulatively implement each method, which improved key estimates during the third quarter 2018 survey launch. Cutoffs for five exclusion criteria were tested. Using a series of benchmarks, average relative bias and changes in bias were calculated for 33 different weighting variable combinations. Results There were 148,274 invitations sent to panelists, with 40,021 who initiated the survey (26.99%). After eligibility assessment, 20.23% (29,998/148,274) of the completed questionnaires were available for analysis. A total of 0.52% (157/29,998) of respondents were excluded based on careless or improbable responses; however, these exclusions had larger impacts on lower volume drugs. Number of exclusions applied were negatively correlated to total dispensing volume by drug (Spearman ρ=–.88, P<.001). A weighting scheme including three demographic and two health characteristics reduced average relative bias by 31.2%. After weighting, estimates of drug use decreased, reflecting a weighted sample that had healthier benchmarks than the unweighted sample. Conclusions Our study illustrates a new approach to using nonprobability online panels to achieve national prevalence estimates for drug abuse. We were able to overcome challenges with using nonprobability internet samples, including misclassification due to improbable responses. Final drug use and health estimates demonstrated concurrent validity to national probability-based drug use and health surveys. Inclusion of multiple best practices cumulatively improved the estimates generated. This method can bridge the information gap when there is a need for prompt, accurate national data.

scholarly journals Exploring Substance Use Tweets of Youth in the United States: Mixed Methods Study

10.2196/16191 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e16191 ◽  
Author(s):  
Robin C Stevens ◽  
Bridgette M Brawner ◽  
Elissa Kranzler ◽  
Salvatore Giorgi ◽  
Elizabeth Lazarus ◽  
...  
Keyword(s):  
Social Media ◽  
Substance Use ◽  
Mixed Methods ◽  
Drug Use ◽  
Prescription Drugs ◽  
The United States ◽  
Health Concern ◽  
Polysubstance Use ◽  
Keywords And Phrases ◽  
And Behaviors

Background Substance use by youth remains a significant public health concern. Social media provides the opportunity to discuss and display substance use–related beliefs and behaviors, suggesting that the act of posting drug-related content, or viewing posted content, may influence substance use in youth. This aligns with empirically supported theories, which posit that behavior is influenced by perceptions of normative behavior. Nevertheless, few studies have explored the content of posts by youth related to substance use. Objective This study aimed to identify the beliefs and behaviors of youth related to substance use by characterizing the content of youths’ drug-related tweets. Using a sequential explanatory mixed methods approach, we sampled drug-relevant tweets and qualitatively examined their content. Methods We used natural language processing to determine the frequency of drug-related words in public tweets (from 2011 to 2015) among youth Twitter users geolocated to Pennsylvania. We limited our sample by age (13-24 years), yielding approximately 23 million tweets from 20,112 users. We developed a list of drug-related keywords and phrases and selected a random sample of tweets with the most commonly used keywords to identify themes (n=249). Results We identified two broad classes of emergent themes: functional themes and relational themes. Functional themes included posts that explicated a function of drugs in one’s life, with subthemes indicative of pride, longing, coping, and reminiscing as they relate to drug use and effects. Relational themes emphasized a relational nature of substance use, capturing substance use as a part of social relationships, with subthemes indicative of drug-related identity and companionship. We also identified topical areas in tweets related to drug use, including reference to polysubstance use, pop culture, and antidrug content. Across the tweets, the themes of pride (63/249, 25.3%) and longing (39/249, 15.7%) were the most popular. Most tweets that expressed pride (46/63, 73%) were explicitly related to marijuana. Nearly half of the tweets on coping (17/36, 47%) were related to prescription drugs. Very few of the tweets contained antidrug content (9/249, 3.6%). Conclusions Data integration indicates that drugs are typically discussed in a positive manner, with content largely reflective of functional and relational patterns of use. The dissemination of this information, coupled with the relative absence of antidrug content, may influence youth such that they perceive drug use as normative and justified. Strategies to address the underlying causes of drug use (eg, coping with stressors) and engage antidrug messaging on social media may reduce normative perceptions and associated behaviors among youth. The findings of this study warrant research to further examine the effects of this content on beliefs and behaviors and to identify ways to leverage social media to decrease substance use in this population.

Current Data Resources on Nonprofit Arts Organizations

2002 ◽  
Vol 45 (10) ◽  
pp. 1592-1612 ◽  
Author(s):  
DEBORAH A. KAPLE
Keyword(s):  
United States ◽  
The United States ◽  
Current Data ◽  
Data Sources ◽  
Arts Organizations ◽  
Conducting Research ◽  
Nonprofit Arts

This article presents and examines the data sources that are currently available for conducting research on nonprofit arts organizations in the United States. It gives a detailed look at how the field has developed and why particular data problems exist. It examines the data necessary to understand sufficiently the largely uncharted territory of nonprofit arts organizations and it gives an overview of the key data sources that do exist. It summarizes recent efforts of scholars and researchers to assemble better databases on arts organizations and, finally, it makes recommendations for further research to be pursued.

scholarly journals Comprehensive cost-effectiveness of diabetes management for the underserved in the United States: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260139
Author(s):  
Rita Bosetti ◽  
Laila Tabatabai ◽  
Georges Naufal ◽  
Terri Menser ◽  
Bita Kash
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Prescription Drugs ◽  
Diabetes Management ◽  
Underserved Populations ◽  
Financial Burden ◽  
Cost Effective ◽  
The United States ◽  
Economic Evaluations ◽  
Effectiveness Studies

Background Diabetes mellitus affects almost 10% of U.S. adults, leading to human and financial burden. Underserved populations experience a higher risk of diabetes and related complications resulting from a combination of limited disposable income, inadequate diet, and lack of insurance coverage. Without the requisite resources, underserved populations lack the ability to access healthcare and afford prescription drugs to manage their condition. The aim of this systematic review is to synthesize the findings from cost-effectiveness studies of diabetes management in underserved populations. Methods Original, English, peer-reviewed cost-effectiveness studies of diabetes management in U.S. underserved populations were obtained from 8 databases, and PRISMA 2009 reporting guidelines were followed. Evidence was categorized as strong or weak based on a combination of GRADE and American Diabetes Association guidelines. Internal validity was assessed by the Cochrane methodology. Studies were classified by incremental cost-effectiveness ratio as very cost-effective (ICER≤US$25,000), cost-effective (US$25,000<ICER≤US$50,000), marginally cost-effective (US$50,000<ICER≤US$100,000) or cost-ineffective (ICER>US$100,000). Reporting and quality of economic evaluations was assessed using the CHEERS guidelines and Recommendations of Second Panel for Cost-Effectiveness in Health and Medicine, respectively. Findings Fourteen studies were included. All interventions were found to be cost-effective or very cost-effective. None of the studies reported all 24 points of the CHEERS guidelines. Given the considered cost categories vary significantly between studies, assessing cost-effectiveness across studies has many limitations. Program costs were consistently analyzed, and a third of the included studies (n = 5) only examined these costs, without considering other costs of diabetes care. Interpretation Cost-effectiveness studies are not based on a standardized methodology and present incomplete or limited analyses. More accurate assessment of all direct and indirect costs could widen the gap between intervention and usual care. This demonstrates the urgent need for a more standardized and comprehensive cost-effectiveness framework for future studies.

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