A history of opioid abuse: Why buprenorphine is superior for the management of opioid use disorder and pain

2021 ◽  
Vol 17 (7) ◽  
pp. 43-50
Author(s):  
Michael D. Komrowski, MS ◽  
Nitin K. Sekhri, MD
Keyword(s):  
Public Health ◽  
Opioid Use Disorder ◽  
Opioid Abuse ◽  
Common Side Effect ◽  
Opioid Use ◽  
Health Crisis ◽  
Public Health Crisis ◽  
History Of ◽  
Opioid Medications ◽  
Regulatory Economic

Opioid abuse represents a public health crisis that has significant associated morbidity and mortality. Since beginning in the early 1990’s, the opioid abuse epidemic has been difficult to control due to regulatory, economic, and psychosocial factors that have perpetuated its existence. This era of opioid abuse has been punctuated by three distinct rises in mortality, precipitated by unique public health problems that needed to be addressed. Patients affected by opioid abuse have been historically treated with either methadone or naltrexone. While these agents have clinical utility supported by robust literature, we the authors posit that buprenorphine is a superior therapy for both opioid use disorder (OUD) as well as pain. This primacy is due to the pharmacological properties of buprenorphine which render it unique among other opioid medications. One such property is buprenorphine’s ceiling effect of respiratory depression, a common side effect and complicating factor in the administration of many classical opioid medications. This profile renders buprenorphine safer, while simultaneously retaining therapeutic utility in the medical practitioner’s pharmacopeia for the treatment of opioid use disorder and pain.

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

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.

scholarly journals Opioids and Infectious Diseases: A Converging Public Health Crisis

2019 ◽  
Vol 220 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Tara A Schwetz ◽  
Thomas Calder ◽  
Elana Rosenthal ◽  
Sarah Kattakuzhy ◽  
Anthony S Fauci
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Opioid Use Disorder ◽  
Soft Tissue Infections ◽  
Opioid Use ◽  
Therapeutic Approaches ◽  
Predisposing Factor ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Immunodeficiency Virus

Abstract A converging public health crisis is emerging because the opioid epidemic is fueling a surge in infectious diseases, such as human immunodeficiency virus infection with or without AIDS, the viral hepatitides, infective endocarditis, and skin and soft-tissue infections. An integrated strategy is needed to tailor preventive and therapeutic approaches toward infectious diseases in people who misuse and/or are addicted to opioids and to concurrently address the underlying predisposing factor for the infections—opioid use disorder. This commentary highlights the unique and complementary roles that the infectious diseases and substance use disorder communities can play in addressing this crisis of dual public health concerns.

scholarly journals Opioid abuse in children: an emerging public health crisis in the United States!

2017 ◽  
Vol 82 (4) ◽  
pp. 562-563 ◽  
Author(s):  
Veerajalandhar Allareddy ◽  
Sankeerth Rampa ◽  
Veerasathpurush Allareddy
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Opioid Abuse ◽  
Health Crisis ◽  
Public Health Crisis

scholarly journals The Intertwined History of Malingering and Brain Injury: An Argument for Structural Competency in Traumatic Brain Injury

2021 ◽  
Vol 49 (3) ◽  
pp. 365-371
Author(s):  
Stephen T. Casper
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Health Crisis ◽  
Sources Of Uncertainty ◽  
Public Health Crisis ◽  
Structural Competency ◽  
History Of ◽  
The Cost

AbstractEvery year millions of people suffer minor brain injuries, many of which occur in collision sports. While there has been substantial commentary and debate about the nature of this public health crisis, it is clear that the scientific and clinical arguments reflect values preferences and judgments that are often invisible in documents which combine artful language with undue focus paid to sources of uncertainty at the cost of clarity and transparency. This essay gives a brief history of these patterns and proposes a remedy.

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 Association between Participation in Counseling and Retention in a Buprenorphine-Assisted Treatment Program for People Experiencing Homelessness with Opioid Use Disorder

2021 ◽  
Vol 18 (21) ◽  
pp. 11072
Author(s):  
Amanda R. W. Berry ◽  
Tracy L. Finlayson ◽  
Luke M. Mellis ◽  
Lianne A. Urada
Keyword(s):  
Public Health ◽  
Cohort Analysis ◽  
Retention In Care ◽  
Opioid Use Disorder ◽  
San Diego County ◽  
Opioid Use ◽  
Health Crisis ◽  
Medication Assisted Treatment ◽  
Retrospective Cohort Analysis ◽  
Human Habitation

The opioid epidemic is a public health crisis that disproportionately affects our unsheltered neighbors. Because medication-assisted treatment (MAT) is effective for preventing deaths from drug overdose and retention is associated with better health outcomes, there is a clear need for more research on factors impacting retention in care. This retrospective cohort analysis examines the relationship between attendance in counseling and retention on buprenorphine for three or more months for individuals experiencing homelessness being treated at a Federally Qualified Health Center (FQHC) and Public Health Service Act §330(h) Health Care for the Homeless Program grantee in San Diego County, California. The cohort included 306 adults experiencing homelessness who had at least one prescription for buprenorphine and participated in a MAT program between 2017 and 2019. The sample included 64.4% men, almost exclusively white, and 35% lived in a place not meant for human habitation. Of the sample, 97 patients were retained at 3 months and 209 were not. Results from a logistic regression model showed that counseling appointments were positively associated with retention at three months (OR = 1.57, p < 0.001). Findings from this study inform future MAT program design components for people experiencing homelessness.

scholarly journals The state of naloxone: Access amid a public health crisis

2019 ◽  
Vol 3 ◽  
pp. 239920261984763
Author(s):  
Jeffrey Fudin ◽  
Amelia L Persico ◽  
Jeffrey J Bettinger ◽  
Erica L Wegrzyn
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Mitigation Strategies ◽  
Patient Specific ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Risk Patients

Over the past decade, opioid use has been at the forefront of a public health crisis throughout the United States. In response to the tremendous negative societal, personal, and economic impacts that the growing opioid crisis has caused, several governmental agencies began to respond. These efforts include declaration of a nationwide public health emergency, increased public health surveillance of the epidemic, research support for pain and addiction, and increased access to overdose-reversing drugs such as naloxone. Naloxone access, in particular, has become a priority. In the United States, pharmacists have had the opportunity to play a crucial role in promoting access to naloxone. Since initial approval by the Food and Drug Administration (FDA) in 1971 as an antidote to opioid agonist overdose, naloxone access has evolved significantly. Today many states have authorized standing orders for naloxone, allowing it to be dispensed by pharmacists without a patient-specific prescription, and all 50 states and the District of Columbia allow medical providers to prescribe take-home naloxone to at-risk patients. While the opioid epidemic itself remains a contentious topic of political, ethical, and medical debate, it is widely acknowledged that mitigation strategies that could lessen morbidity and mortality are essential. Improved access to naloxone is one such strategy which remains at the forefront during this public health crisis.

CAEP Position Statement: Emergency department management of people with opioid use disorder

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 768-771
Author(s):  
Justin J. Koh ◽  
Michelle Klaiman ◽  
Isabelle Miles ◽  
Jolene Cook ◽  
Thara Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Position Statement ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Health Crisis ◽  
Canadian Youth ◽  
National Public Health ◽  
Problematic Substance ◽  
Emergency Department Management

Deaths due to opioid overdose have reached unprecedented levels in Canada; over 12,800 opioid-related deaths occurred between January 2016 and March 2019, and overdose death rates increased by approximately 50% from 2016 to 2018.1 In 2016, Health Canada declared the opioid epidemic a national public health crisis,2 and life expectancy increases have halted in Canada for the first time in decades.3 Children are not exempt from this crisis, and the Chief Public Health Officer of Canada has recently prioritized the prevention of problematic substance use among Canadian youth.4

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