drug overdoses
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2021 ◽  
Vol 3 (4) ◽  
pp. 523-539
Author(s):  
Jason Huh ◽  
Julian Reif

We investigate the effect of teenage driving on mortality and risky behaviors in the United States using a regression discontinuity design. We estimate that total mortality rises by 5.84 deaths per 100,000 (15 percent) at the minimum legal driving age cutoff, driven by an increase in motor vehicle fatalities of 4.92 deaths per 100,000 (44 percent). We also find that poisoning deaths, which are caused primarily by drug overdoses, rise by 0.31 deaths per 100,000 (29 percent) at the cutoff and that this effect is concentrated among females. Our findings show that teenage driving contributes to sex differences in risky drug use behaviors. (JEL I12, J13, J16, R41)


2021 ◽  
Vol 7 (5) ◽  
pp. 44-51
Author(s):  
Aswini Abraham ◽  
Andrew C. Gray ◽  
Jascha Wagner ◽  
Tammy L. Anderson

2021 ◽  
Author(s):  
Katherine L Potaka ◽  
Rebecca Freeman ◽  
Danny Soo ◽  
Nam-Anh Nguyen ◽  
Tin Fei Sim ◽  
...  

Abstract BackgroundOpioid-related overdoses cause substantial numbers of preventable deaths. Naloxone is an opioid antagonist available in take-home naloxone (THN) kits as a lifesaving measure for opioid overdose. As the emergency department (ED) is a primary point of contact for patients with high-risk opioid use, evidence-based recommendations from the Society of Hospital Pharmacists of Australia THN practice guidelines include the provision of THN, accompanied by psychosocial interventions. However, implementation of these guidelines in practice is unknown. This study investigated ED opioid-related overdose presentations, concordance of post-overdose interventions with the THN practice guidelines, and the impact, if any, of the SARS-CoV-2 (COVID-19) pandemic on case presentations.MethodsA single-centre retrospective audit was conducted at a major tertiary hospital of patients presenting with overdoses involving opioids and non-opioids between March to August 2019 and March to August 2020. Patient presentations and interventions delivered by the paramedics, ED and upon discharge from the ED were collated from medical records and analysed using descriptive statistics, chi square and independent T-tests.ResultsThe majority (66.2%) of patients presented to hospital with mixed drug overdoses involving opioids and non-opioids. Pharmaceutical opioids were implicated in a greater proportion (72.1%) of overdoses than illicit opioids. Fewer patients presented in March to August 2020 as compared with 2019 (26 vs. 42), and mixed drug overdoses were more frequent in 2020 than 2019 (80.8% vs. 57.1%). Referral to outpatient psychology (22.0%) and drug and alcohol services (20.3%) were amongst the most common post-discharge interventions. Naloxone was provided to 28 patients (41.2%) by the paramedics and/or ED. No patients received THN upon discharge.ConclusionsThis study highlights opportunities to improve ED provision of THN and other interventions post-opioid overdose. Large-scale multi-centre studies are required to ascertain the capacity of EDs to provide THN and the impact of COVID-19 on opioid overdose presentations.


2021 ◽  
Vol 15 (11) ◽  
pp. 3395-3397
Author(s):  
Taimur Khan ◽  
Imran Khan ◽  
Muhammad Kamran Khan ◽  
Shakil Asif ◽  
Syed Azhar Ali Kazmi ◽  
...  

Background and Aim: Drug or substance abuse is still a major public health concern all over the world. Globally, the rate of fatal substances or drug overdoses has increased in recent decades, owing primarily to prescription drug overdoses, particularly opioids. The aim of the present study was to determine the frequency of socio-demographic factors and variety of substances used by drug induced psychotic patients in tertiary care hospital. Methodology: This retrospective study was conducted on 86 drug-induced psychotic patients attending the Department of Psychiatry at Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from January 2020 to June 2020. Patient’s demographic details and diagnosis of psychosis were collected and recorded in semi-structured proforma and ICD-10 DCR criteria respectively. Inclusion and exclusion criteria was followed for all the patients enrolled in this study. Socio-demographic details such as age, gender, identification number, educational status, marital status, occupation, socioeconomic status, and family types were all recorded. Results: Out of 86 patients, male and females were 67 (77.9%) and 19 (22.1%) respectively. The majority of the patients were between the ages of 16 and 26. Single patients outnumbered married patients by 37 (43.0%) and 49 (57%) respectively. According to education, the proportion of patients attending university, higher secondary school, secondary school, primary school, and illiterate was 14 (16.3%), 24 (27.9%), 26 (30.2%), 13 (15.1%), and 9 (10.5%) respectively. Patients were mostly unemployed 41 (47.8%). Regarding social status, the prevalence of higher, middle, and lower class was 12 (14%), 47 (54.7%), and 27 (31.4%) respectively. Among 86 patients, Schizophrenia, ATPD, and Mental and Behavioral Disorders were diagnosed in 40 (46.5%), 28 (32.6%), and 18 (20.9%) respectively. Conclusion: Our study revealed that substance abuse is common among drug-induced psychiatric patients. It was also discovered that unemployment could be one of the causes of substance abuse. Our study found a higher prevalence of schizophrenia. Keywords: Socio-demographic; Substance use; drug induced patients


2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 80S-86S
Author(s):  
Heather A. Clinton ◽  
Shobha Thangada ◽  
James R. Gill ◽  
Amy Mirizzi ◽  
Susan B. Logan

Objectives Drug overdose deaths in Connecticut increasingly involve a growing number of fentanyl analogs and other novel nonfentanyl synthetic opioids (ie, novel synthetics). Current postmortem toxicology testing methods often lack the sophistication needed to detect these compounds. We examined how improved toxicology testing of fatal drug overdoses can determine the prevalence and rapidly evolving trends of novel synthetics. Methods From 2016 to June 2019, the Connecticut Office of the Chief Medical Examiner increased its scope of toxicology testing of suspected drug overdose deaths in Connecticut from basic to enhanced toxicology testing to detect novel synthetics. The toxicology laboratory also expanded its testing panels during this time. We analyzed toxicology results to identify and quantify the involvement of novel synthetics over time. Results From 2016 to June 2019, 3204 drug overdose deaths received enhanced toxicology testing; novel synthetics were detected in 174 (5.4%) instances. Ten different novel synthetics were detected with 205 total occurrences. Of 174 overdose deaths with a novel synthetic detected, most had 1 (n = 146, 83.9%) or 2 (n = 26, 14.9%) novel synthetics detected, with a maximum of 4 novel synthetics detected. Para-fluorobutyrylfentanyl/FIBF, furanylfentanyl, and U-47700 were most identified overall, but specific novel synthetics came in and out of prominence during the study period, and the variety of novel synthetics detected changed from year to year. Conclusions Enhanced toxicology testing for drug overdose deaths is effective in detecting novel synthetics that are not identified through basic toxicology testing. Identifying emerging novel synthetics allows for a timely and focused response to potential drug outbreaks and illustrates the changing drug market.


2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 87S-95S
Author(s):  
Terra Wiens ◽  
Elisabeth Bilden ◽  
Stefan Saravia ◽  
Jason Peterson ◽  
Matthew Wogen ◽  
...  

Objectives Increasing knowledge about the toxicology of drug overdose and substance misuse (DOSM) is important in improving our understanding of the epidemic. We describe the Minnesota Drug Overdose and Substance Use Pilot Surveillance Activity, which started collecting data on emergency department (ED) visits attributable to DOSM in 2017, with a focus on the toxicology results of a subset of clinical encounters. Methods From November 1, 2017, through January 30, 2020, we collected near–real-time data on DOSM-related ED encounters. The Minnesota Department of Health Public Health Laboratory tested leftover clinical specimens (blood and/or urine) for the presence of various substances for patients who died, were hospitalized, had an atypical clinical presentation, or were part of a local drug overdose cluster. Testing looked for >250 drugs or their metabolites, including those commonly misused (eg, methamphetamine, cocaine), prescription medications, synthetic cannabinoids and cathinones, and opioids. We describe characteristics of the overall group and a subgroup of clinical encounters with toxicology results. Results Specimens submitted from 6 EDs during the study period represented 239 clinical encounters. Methamphetamine was the most frequently detected substance (67.4%) but was suspected in only 45.6% of encounters. At least 1 opioid was detected in 42.5% of encounters but suspected in only 29.7%. Testing also detected potential adulterants and additives (eg, fentanyl, fentanyl analogues, levamisole) and showed frequent patient exposure to substances not reported by patients or suspected by clinicians. Nearly half (44.4%) of clinical encounters had >1 substance detected. Conclusions ED surveillance for DOSM encounters, enhanced by toxicology testing, can provide local situational awareness on overdoses, prevent potential mischaracterization of the true drug overdose epidemic, and inform harm reduction and drug overdose prevention efforts.


2021 ◽  
Author(s):  
Jennifer Nguyen ◽  
Lauren R. Gilbert ◽  
George Shaw

Abstract Background: The opioid crisis has fuelled dramatic increases in fatal drug overdoses, with illicitly manufactured fentanyl and fentanyl analogues driving the opioid-related overdose death rates among all groups. One way to address these overdose deaths is through increasing public awareness about opioid overdoses and encouraging people who use drugs to make safe choices about opioids. The ease, convenience, and privacy of social media sites provide an inside look into the world of opioid users. This study seeks to understand the nature and significance of Reddit discussions regarding opioid overdoses and safe choices. Methods: We systematically searched Reddit during the month of August (2019). We collected 4,844 posts, across 25 distinct r/opiates subreddit forums using the search terms “opioids,” “drugs,” and “fentanyl”. We then used qualitative thematic analysis methods to code 49 unique original posts. Results: The posts from these Reddit discussions provide insight into this online opioid community and how they are sharing and normalizing risk-mitigating strategies to avoid opioid-related overdoses through (1) recognizing the dangers and avoiding fentanyl; (2) knowing the signs and symptoms of opioid overdoses; and (3) having and using naloxone to treat opioid overdoses. Conclusions: These informal and social interactions provide insight into the complexity the opioid epidemic crisis and can inform future strategies and interventions to address the opioid crisis.


2021 ◽  
Vol 12 ◽  
Author(s):  
Radhouene Doggui ◽  
Keyrellous Adib ◽  
Alex Baldacchino

Background: Drug overdoses (fatal and non-fatal) are among the leading causes of death in population with substance use disorders. The aim of the current study was to identify risk factors for fatal and non-fatal drug overdose for predominantly opioid-dependent treatment–seeking population.Methods: Data were collected from 640 adult patients using a self-reported 25-item Overdose Risk (OdRi) questionnaire pertaining to drug use and identified related domains. The exploratory factor analysis (EFA) was primarily used to improve the interpretability of this questionnaire. Two sets of EFA were conducted; in the first set of analysis, all items were included, while in the second set, items related to the experience of overdose were removed. Logistic regression was used for the assessment of latent factors’ association with both fatal and non-fatal overdoses.Results: EFA suggested a three-factor solution accounting for 75 and 97% of the variance for items treated in the first and second sets of analysis, respectively. Factor 1 was common for both sets of EFA analysis, containing six items (Cronbach’s α = 0.70) focusing around “illicit drug use and lack of treatment.” In the first set of analysis, Factors 2 (Cronbach’s α = 0.60) and 3 (Cronbach’s α = 0.34) were focusing around “mental health and emotional trauma” and “chronic drug use and frequent overdose” domains, respectively. The increase of Factor 2 was found to be a risk factor for fatal drug overdose (adjusted coefficient = 1.94, p = 0.038). In the second set of analysis, Factors 2 (Cronbach’s α = 0.65) and 3 (Cronbach’s α = 0.59) as well as Factor 1 were found to be risk factors for non-fatal drug overdose ever occurring. Only Factors 1 and 3 were positively associated with non-fatal overdose (one in a past year).Conclusion: The OdRi tool developed here could be helpful for clinical studies for the overdose risk assessment. However, integrating validated tools for mental health can probably help refining the accuracy of latent variables and the questionnaire’s consistency. Mental health and life stress appear as important predictors of both fatal and non-fatal overdoses.


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