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Opioid overdose

Macarena C García, Anton B Dodek, Tom Kowalski, John Fallon, Scott H Lee, Michael F Iademarco, John Auerbach, Michele K Bohm
Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1). In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids (2). In Massachusetts, unintentional opioid-related overdose deaths, including deaths involving heroin, increased 45% from 2012 to 2013.* In 2014, the rate of these deaths reached 20.0 per 100,000, nearly 2.5 times higher than the U.S. rate overall (3,4)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Michelle M Van Handel, Charles E Rose, Elaine J Hallisey, Jessica L Kolling, Jon E Zibbell, Brian Lewis, Michele K Bohm, Christopher M Jones, Barry E Flanagan, Azfar-E-Alam Siddiqi, Kashif Iqbal, Andrew L Dent, Jonathan H Mermin, Eugene McCray, John W Ward, John T Brooks
OBJECTIVE: A recent HIV outbreak in a rural network of persons who inject drugs (PWID) underscored the intersection of the expanding epidemics of opioid abuse, unsterile injection drug use (IDU), and associated increases in hepatitis C virus (HCV) infections. We sought to identify US communities potentially vulnerable to rapid spread of HIV, if introduced, and new or continuing high rates of HCV infections among PWID. DESIGN: We conducted a multistep analysis to identify indicator variables highly associated with IDU...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Pamela Leece, Margaret Gassanov, Shaun Hopkins, Chantel Marshall, Peggy Millson, Rita Shahin
SETTING: A harm reduction program at a public health unit in Toronto, Ontario, between August 31, 2011 and August 31, 2013. INTERVENTION: We conducted a process evaluation of the first two years of an opioid overdose prevention and response program, Prevent Overdose in Toronto (POINT), including analysis of data from program documentation forms, as well as qualitative interviews with program staff, representatives from partner agencies, and program clients. OUTCOMES: In the first two years of the program, 662 individuals (52...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mari-Lynn Drainoni, Elisa A Koppelman, James A Feldman, Alexander Y Walley, Patricia M Mitchell, Jacqueline Ellison, Edward Bernstein
BACKGROUND: The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose...
October 18, 2016: BMC Research Notes
Victoria J Ganem, Alejandra G Mora, Nina Nnamani, Vikhyat S Bebarta
BACKGROUND: Drug overdose has become a leading cause of death in the United States and is a growing issue in civilian and military populations. Increasing prescription drug misuse and poisonings translate into greater utilization of medical resources. Our objective was to describe the incidences of overdoses and their associated events and outcomes following emergency department consult. METHODS: We performed a retrospective cohort study on cases evaluated in 2 military hospital emergency departments over 3 years...
October 2016: Military Medicine
Julie Latimer, Stephen Ling, Ian Flaherty, Marianne Jauncey, Allison M Salmon
BACKGROUND: Fentanyl is a powerful analgesic, the prescription of which has increased markedly in recent years. The emergence of the drug at the Sydney Medically Supervised Injecting Centre (MSIC) warranted a retrospective clinical audit to assess the risk of fentanyl overdose in comparison with other opioids, in the context of a drug consumption room. METHOD: Heroin, fentanyl or other prescription opioids (PO) injections resulting in overdose were audited (September 1, 2012 and August 31, 2015)...
October 14, 2016: International Journal on Drug Policy
Andrew Kestler, Jane Buxton, Gray Meckling, Amanda Giesler, Michelle Lee, Kirsten Fuller, Hong Quian, Dalya Marks, Frank Scheuermeyer
STUDY OBJECTIVE: Although the World Health Organization recommends take-home naloxone to address the increasing global burden of opioid-related deaths, few emergency departments (EDs) offer a take-home naloxone program. We seek to determine the take-home naloxone acceptance rate among ED patients at high risk of opioid overdose and to examine factors associated with acceptance. METHODS: At a single urban ED, consecutive eligible patients at risk of opioid overdose were invited to complete a survey about opioid use, overdose experience, and take-home naloxone awareness, and then offered take-home naloxone...
October 10, 2016: Annals of Emergency Medicine
Erin A Ferries, Aaron M Gilson, Rajendar R Aparasu, Hua Chen, Michael L Johnson, Marc L Fleming
OBJECTIVE:  Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. METHODS:  This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data...
October 15, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Janie Simmons, Sonali Rajan, Lloyd Goldsamt, Luther Elliott
BACKGROUND: This article reports on the first web-based implementation of an opioid-overdose prevention, recognition and response training for professional first responders. The training was disseminated nationally over one listserv in November 2014. The same year, following Act 139, which mandated the provision of an online training for police officers in Pennsylvania, the Pennsylvania Department of Health approved the training. It was subsequently adopted as the primary training tool for police and other first responders in Pennsylvania and has been used as a training tool by first responders nationally...
October 11, 2016: Drug and Alcohol Dependence
Sohita Dhillon
Hydrocodone bitartrate extended-release (Hysingla(®) ER; referred to hereafter as hydrocodone ER) was the first single-entity hydrocodone formulation recognized by the US FDA as having abuse-deterrent properties. It is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Once-daily oral hydrocodone ER provides consistent plasma hydrocodone concentrations and sustained analgesia over the 24-h dosing interval...
October 7, 2016: Clinical Drug Investigation
Donna Purviance, Bradley Ray, Abigail Tracy, Erik Southard
BACKGROUND: Opioid intoxication and overdoses are life-threatening emergencies requiring rapid treatment. One response to this has been to train law enforcement to detect the signs of an opioid overdose and train them to administer naloxone to reverse the effects. While not a new concept, few studies have attempted to examine this policy. METHODS: At four different locations in Indiana law enforcement were trained to detect the signs of an opioid related overdose and how to administer naloxone to reverse the effects of the overdose...
August 11, 2016: Substance Abuse
Deborah Dowell, Kun Zhang, Rita K Noonan, Jason M Hockenberry
To address the opioid overdose epidemic in the United States, states have implemented policies to reduce inappropriate opioid prescribing. These policies could affect the coincident heroin overdose epidemic by either driving the substitution of heroin for opioids or reducing simultaneous use of both substances. We used IMS Health's National Prescription Audit and government mortality data to examine the effect of these policies on opioid prescribing and on prescription opioid and heroin overdose death rates in the United States during 2006-13...
October 1, 2016: Health Affairs
Joseph A Boscarino, H Lester Kirchner, James M Pitcavage, Vijay R Nadipelli, Naoko A Ronquest, Michael H Fitzpatrick, John J Han
OBJECTIVE: Opioid overdoses (ODs) have been increasing, and harm reduction efforts are a priority. The success of these efforts will be dependent on the identification of at-risk patients and improved access to the antidote naloxone. Therefore, to identify access to naloxone and factors associated with negative health outcomes, we conducted a retrospective study of patients with OD to identify those at highest risk of adverse outcomes and to assess the use of naloxone. METHODS: We conducted a study of electronic health records for patients admitted to the largest multihospital system in the region - the Geisinger Health System (GHS) for ODs - from April 2005 through March 2015...
2016: Substance Abuse and Rehabilitation
Philippe Poulain, Marie-Pierre Berleur, Shimsi Lefki, Danièle Lefebvre, Gisèle Chvetzoff, Eric Serra, Fibra Tremellat, Alain Derniaux, Marilène Filbet
CONTEXT: In the European Association for Palliative Care recommendations for cancer pain management, there was no consensus regarding the indications, titration or monitoring of methadone. OBJECTIVES: This national, randomized, multicentre trial aimed to compare two methadone titration methods (stop-and-go vs progressive) in patients with cancer-related pain who were inadequately relieved by or intolerant to level 3 opioids. METHODS: The primary endpoint was the rate of success/failure at Day 4, defined as pain relief (reduction of at least two points on the visual scale and a pain score <5 for 2 consecutive days) and no overdose (Rudkin scale ≥3 and respiratory rate <8/min)...
September 29, 2016: Journal of Pain and Symptom Management
(no author information available yet)
No abstract text is available yet for this article.
October 2016: American Journal of Nursing
James Dodington, Pina Violano, Carl R Baum, Kirsten Bechtel
Significant breakthroughs in the field of injury prevention and childhood safety have occurred during the past half-century. For example, the Poison Prevention Packaging Act of 1970 and the institution of child passenger safety laws are responsible for a significant reduction in injuries among children and adolescents. This review will focus on the following three topics because of their significant contribution to pediatric injury morbidity, especially among adolescents, and their promise for further effective prevention research...
September 27, 2016: Pediatric Research
Gabriel Rudd-Barnard, Sanjog Pangarkar, Norwan Moaleji, Peter Glassman
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Kelly E Dunn, Frederick S Barrett, Claudia Yepez-Laubach, Andrew C Meyer, Bryce J Hruska, Kathy Petrush, Suzan Berman, Stacey C Sigmon, Michael Fingerhood, George E Bigelow
BACKGROUND: Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined. METHODS: Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors...
December 2016: Journal of Substance Abuse Treatment
Bill H McCarberg, Ernest A Kopecky, Melinda O'Connor, Ann Marseilles, Ravi K Varanasi, Christy Thompson, Alison B Fleming
BACKGROUND: Patients with chronic pain may experience difficulty swallowing, in part due to worsening disease, comorbid conditions, iatrogenic etiology, or age. Patients or caregivers may manipulate extended-release (ER) opioid formulations to facilitate oral dosing due to a lack of therapeutic options that allow for sprinkle or enteral feeding tube administration. If crushed or broken, current oral ER opioids can be associated with adverse sequelae, including risk of potentially fatal overdose...
September 26, 2016: Current Medical Research and Opinion
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