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Ajumobi O, Friedman S, Westhoff J, Granner M, Lucero J, Koch B, Wagner KD. Age and racial and ethnic disparities in filled buprenorphine prescriptions post-emergency department visit in Nevada. J Am Coll Emerg Physicians Open 2024; 5:e13272. [PMID: 39247155 PMCID: PMC11377888 DOI: 10.1002/emp2.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 07/16/2024] [Accepted: 08/02/2024] [Indexed: 09/10/2024] Open
Abstract
Objectives We described age, gender, race, and ethnicity associations with filling buprenorphine prescriptions post-emergency department (post-ED) visits. Methods We analyzed 1.5 years (July 1, 2020-December 31, 2021) of encounter-level Medicaid ED and retail pharmacy claims data obtained from the Nevada Department of Health and Human Services. We studied ED patients with an opioid use disorder (OUD) diagnosis who did not fill a prescription for OUD medications within 6 months before the ED encounter. Using logistic regression, we modeled the associations between the patient's demographic characteristics and the outcome, filling a buprenorphine prescription at a community pharmacy within 14 or 30 days of the ED encounter. Results Among 2781 ED visits, representing 2094 patients, the median age was 39 years, 54% were male, 18.5% were Black, 11.7% were Hispanic, and 62.3% were White. Only 4% of the ED visits were followed by a filled buprenorphine prescription. Increasing age (14-day window: adjusted odds ratio (aOR) = 0.965, 95% confidence interval [CI]: 0.948-0.983) and being a Black patient (14-day window: aOR: 0.114, 95% CI 0.036-0.361) were both associated with lower odds of filled buprenorphine prescriptions. These results were similar within 30 days of an ED visit. Conclusions Initiation of buprenorphine following an ED visit remains low among Nevadan Medicaid patients and is less likely with increasing age and among Black patients, despite strong evidence supporting its use. Overburdened EDs, lack of attention from managers, and substance use stigma are among possible explanations. When ED clinicians do write buprenorphine prescriptions, peer recovery support could increase the fill rates.
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Affiliation(s)
- Olufemi Ajumobi
- School of Public Health University of Nevada Reno Nevada USA
- North Carolina Department of Health and Human Services Raleigh North Carolina USA
- Present address: Oak Ridge Institute for Science and Education United States Department of Energy Oak Ridge Tennessee USA
| | - Sarah Friedman
- School of Public Health University of Nevada Reno Nevada USA
| | - John Westhoff
- Department of Internal Medicine University of Nevada Reno School of Medicine Reno Nevada USA
| | | | - Julie Lucero
- College of Health University of Utah Salt Lake City Utah USA
| | - Brandon Koch
- College of Public Health The Ohio State University Columbus Ohio USA
| | - Karla D Wagner
- School of Public Health University of Nevada Reno Nevada USA
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2
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Kuang W, Yang EJ, Truong R, Woo BK. Bringing Virtual Reality to Mainstream Pediatric Care. J Patient Cent Res Rev 2024; 11:107-111. [PMID: 39044851 PMCID: PMC11262837 DOI: 10.17294/2330-0698.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
Virtual reality (VR) stands as an innovative technology transforming our interactions with the digital world. Its integration into health care has proven advantageous for both patients and health care providers across multiple levels and modalities. Given that VR is becoming increasingly accessible and prevalent, health care providers should explore incorporating the technology into their practices, particularly within the pediatric population, which is becoming progressively more accustomed to the technology. This topic synopsis provides a broad discussion of the current literature, exploring current and probable future applications of VR in pediatric patient care, particularly in improving the hospital experience, facilitating education during hospitalizations, providing an alternative to pharmacological therapy for pain management, and enhancing mental health care practices.
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Affiliation(s)
- Wayne Kuang
- Department of Pediatrics, Los Angeles General Medical Center, Los Angeles, CA
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Eric J. Yang
- Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Roland Truong
- KPC Health Graduate Medical Education, Hemet Valley Medical Center, Hemet, CA
- Department of Anesthesiology, Indiana University School of Medicine, Indianapolis, IN
| | - Benjamin K.P. Woo
- Department of Psychiatry, Olive View – UCLA Medical Center, Sylmar, CA
- Chinese American Health Promotion Laboratory, University of California, Los Angeles, Los Angeles, CA
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Garcia S, Teater J, Trimble C, Entrup P, Hall OE, Hall OT. Years of life lost due to unintentional drug overdose relative to the leading underlying causes of death in the United States: a comparative analysis of excess mortality 2017-2019. J Addict Dis 2024; 42:205-209. [PMID: 36876385 DOI: 10.1080/10550887.2023.2173929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The present study aims to compare Years of Life Lost for unintentional drug overdose and the leading underlying causes of death in the United States annually from 2017 to 2019. Years of Life Lost provide valuable context to incident deaths when comparing the relative mortality burden of underlying causes of death. Prior research has shown unintentional drug overdose was the third leading cause of Years of Life Lost in the state of Ohio in 2017. However, this finding has yet to be replicated at the national level in the US. Death statistics for 2017-2019 were accessed via CDC WONDER. Years of Life Lost were calculated for unintentional drug overdose and each of the top five causes of incident deaths in the US during the study period. Unintentional drug overdose caused nearly seven million Years of Life Lost in the US during the three-year period of study and was the fourth leading cause of Years of Life Lost after cancer, heart disease and other accidents. Incidence alone provides an incomplete picture of the effect of unintentional drug overdose on overall mortality burden in the US. Years of Life Lost give critical context to the overdose crisis, underscoring unintentional drug overdose as a leading cause of premature mortality.
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Affiliation(s)
| | - Julie Teater
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Candice Trimble
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Parker Entrup
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Orman E Hall
- College of Health Sciences and Professions, Ohio University, Athens, OH, USA
- National Emerging Threat Initiative, National HIDTA Assistance Center Miami, Miami, FL, USA
| | - O Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
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Riggs P. Epilogue. Psychiatr Clin North Am 2023; 46:801-804. [PMID: 37879840 DOI: 10.1016/j.psc.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Affiliation(s)
- Paula Riggs
- Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, University of Colorado School of Medicine, 3434 Jennings Street, San Diego, CA 92106, USA.
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5
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Garcia S, Entrup P, Hall OT, Deaner M, Thomas A, Lim R. Years of Life Lost to Firearm Suicide Among Young People in the US. JAMA Pediatr 2023; 177:1230-1232. [PMID: 37669072 PMCID: PMC10481317 DOI: 10.1001/jamapediatrics.2023.3366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 09/06/2023]
Abstract
This cross-sectional study examines years of life lost among the top 3 causes of death and compares firearm suicide with other methods of suicide among individuals aged 10 to 24 years in the US.
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Affiliation(s)
- Stephanie Garcia
- Department of General Surgery, University of Oklahoma School of Medicine at Tulsa
| | - Parker Entrup
- College of Medicine, The Ohio State University, Columbus
| | - O. Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, Columbus
| | - Megan Deaner
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, Columbus
| | - Arielle Thomas
- Committee on Trauma, American College of Surgeons, Chicago, Illinois
| | - Robert Lim
- Department of General Surgery, University of Oklahoma School of Medicine at Tulsa
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Azarbakhsh H, Jafari F, Dehghani SP, Karami H, Hassanzadeh J, Mirahmadizadeh A. Trend Analysis of Deaths With Unintentional Poisoning and Years of Life Lost in the South of Iran: 2004-2019. J Res Health Sci 2023; 23:e00588. [PMID: 38315903 PMCID: PMC10660503 DOI: 10.34172/jrhs.2023.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/29/2023] [Accepted: 09/02/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND This study was conducted to determine the mortality rate and the years of life lost (YLL) due to unintentional poisoning in Fars province in the south of Iran. Study Design: A cross-sectional study. METHODS In this study, data from all of the deaths due to unintentional poisoning in the south of Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of the crude mortality rate, the age-standardized mortality rate (ASMR), and the YLL rate. RESULTS During the 16-year study period (2004-2019), 1466 deaths due to poisoning occurred in Fars province. Of this number, 75.2% (1103 cases) were in men, and 37.5% (550 cases) were in the age group of 15-29 years. The total YLL due to poisoning during the 16-year study period were 25149 and 8392 in men and women, respectively. According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was stable. Moreover, the annual percent change (APC) was -0.7% (95% CI: -4.0 to 2.7, P=0.677) for males and - 0.3% (95% CI: -3.8 to 3.3, P=0.862) for females. CONCLUSION The trend of crude mortality rate, ASMR and YLL due to unintentional poisonings was stable. Considering the high rate of mortality and YLL due to unintentional poisoning in the age group of 15-29 years, it is essential to take necessary actions in this age group.
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Affiliation(s)
| | - Fatemeh Jafari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Parsa Dehghani
- Department of Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Karami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jafar Hassanzadeh
- Department of Epidemiology, Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Entrup P, Brodsky L, Trimble C, Garcia S, Mohamed N, Deaner M, Martell JP, Teater J, Jordan A, Tetrault JM, Hall OT. Years of life lost due to deaths of despair and COVID-19 in the United States in 2020: patterns of excess mortality by gender, race and ethnicity. Int J Equity Health 2023; 22:161. [PMID: 37612748 PMCID: PMC10464324 DOI: 10.1186/s12939-023-01949-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/02/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND In 2020 COVID-19 was the third leading cause of death in the United States. Increases in suicides, overdoses, and alcohol related deaths were seen-which make up deaths of despair. How deaths of despair compare to COVID-19 across racial, ethnic, and gender subpopulations is relatively unknown. Preliminary studies showed inequalities in COVID-19 mortality for Black and Hispanic Americans in the pandemic's onset. This study analyzes the racial, ethnic and gender disparities in years of life lost due to COVID-19 and deaths of despair (suicide, overdose, and alcohol deaths) in 2020. METHODS This cross-sectional study calculated and compared years of life lost (YLL) due to Deaths of Despair and COVID-19 by gender, race, and ethnicity. YLL was calculated using the CDC WONDER database to pull death records based on ICD-10 codes and the Social Security Administration Period Life Table was used to get estimated life expectancy for each subpopulation. RESULTS In 2020, COVID-19 caused 350,831 deaths and 4,405,699 YLL. By contrast, deaths of despair contributed to 178,598 deaths and 6,045,819 YLL. Men had more deaths and YLL than women due to COVID-19 and deaths of despair. Among White Americans and more than one race identification both had greater burden of deaths of despair YLL than COVID-19 YLL. However, for all other racial categories (Native American/Alaskan Native, Asian, Black/African American, Native Hawaiian/Pacific Islander) COVID-19 caused more YLL than deaths of despair. Also, Hispanic or Latino persons had disproportionately higher mortality across all causes: COVID-19 and all deaths of despair causes. CONCLUSIONS This study found greater deaths of despair mortality burden and differences in burden across gender, race, and ethnicity in 2020. The results indicate the need to bolster behavioral health research, support mental health workforce development and education, increase access to evidence-based substance use treatment, and address systemic inequities and social determinants of deaths of despair and COVID-19.
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Affiliation(s)
- Parker Entrup
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA.
| | - Leon Brodsky
- College of Medicine, the Ohio State University, Columbus, OH, USA
| | - Candice Trimble
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | | | - Nasra Mohamed
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - Megan Deaner
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - J P Martell
- Department of Psychiatry and Behavioral Sciences, University of Kansas Health System, Kansas City, KS, USA
| | - Julie Teater
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - Ayana Jordan
- Department of Population Health NYU Grossman School of Medicine, New York City, NY, USA
| | - Jeanette M Tetrault
- Department of Internal Medicine, Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | - O Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
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Shelton RC, Goodwin K, McNeil M, Bernitz M, Alexander SP, Parish C, Brotzman L, Lee M, Li WB, Makam S, Ganek N, Foskett D, Warren C, Metsch LR. Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses. Implement Sci Commun 2023; 4:56. [PMID: 37221618 PMCID: PMC10204023 DOI: 10.1186/s43058-023-00438-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/09/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The opioid epidemic in the US continues to worsen. Opioid-only and polysubstance-involved opioid overdose deaths are increasing among adolescents and young adults, who have limited knowledge of opioid overdose prevention, including recognition and response. College campuses have infrastructure to support national-level implementation of evidence-based public health strategies for providing opioid overdose prevention and naloxone training programs among this priority population. However, college campuses are an underutilized, understudied setting for this programming. To address this gap, we conducted research assessing barriers and facilitators to planning and implementing this programming on college campuses. METHODS We held 9 focus groups among purposively selected campus stakeholders whose perceptions were important to understand in planning for the dissemination and implementation of opioid overdose prevention and naloxone training. Focus group scripts were informed by The Consolidated Framework for Implementation Research (CFIR) to query about perceptions of opioid and other substance use, opioid and other substance use-related resources, and naloxone administration training. We used a deductive-inductive, iterative approach to thematic analysis. RESULTS Themes about implementation barriers included (1) the perception that problematic use of other (non-opioid) substances was more prevalent than opioid use on campus and focus on those substances would be a greater priority on college campuses; (2) student schedules were overwhelmed with academic commitments and extracurricular activities, making delivery of additional training challenging; (3) barriers related to the perceived complexity and decentralization of communication on campus, preventing students from knowing how to access substance use-related resources. Themes about implementation facilitators included (1) framing naloxone training as important in becoming a responsible leader on campus and in the broader community and (2) leveraging existing infrastructure, champions within existing campus groups, and tailored messaging to facilitate participation in naloxone training. CONCLUSIONS This is the first study to provide in-depth insights into potential barriers and facilitators to widespread, routine implementation of naloxone/opioid education on undergraduate college campuses. The study captured diverse stakeholder perspectives and was theoretically grounded in CFIR, contributing to the growing literature on the application and refinement of CFIR across diverse community and school contexts.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA.
| | - Kathleen Goodwin
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael McNeil
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- Columbia Health, Columbia University, New York, NY, USA
| | - Melanie Bernitz
- Columbia Health, Columbia University, New York, NY, USA
- Center for Family and Community Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Savannah P Alexander
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Carrigan Parish
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Laura Brotzman
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Matthew Lee
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | | | | | | | | | - Chloe Warren
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- School of General Studies, Columbia University, New York, NY, USA
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Bhadra-Heintz NM, Garcia S, Entrup P, Trimble C, Teater J, Rood K, Trent Hall O. Years of Life Lost due to Unintentional Drug Overdose among Perinatal Individuals in the United States. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100842. [PMID: 37028239 DOI: 10.1016/j.srhc.2023.100842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 02/20/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND The United States has one of the highest maternal mortality rates of developing countries, but the contribution of perinatal drug overdose is not known. Communities of color also have higher rates of maternal morbidity and mortality when compared to White communities, however the contribution due to overdose has not yet been examined in this population. OBJECTIVES To quantify the years of life lost due to unintentional overdose in perinatal individuals from 2010 to 2019 and assess for disparity by race. STUDY DESIGN This was a cross-sectional retrospective study with summary-level mortality statistics for the years 2010-2019 obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) mortality file. A total of 1,586 individuals of childbearing age (15-44 years) who died during pregnancy or six weeks postpartum (perinatal) from unintentional overdose in the United States from January 1, 2010 to December 31, 2019 were included. Total years of life lost (YLL) was calculated and summated for White, Black, Hispanic, Asian/Pacific Islander, and American Indian/Native Alaska women. Additionally, the top three overall causes of death were also identified for women in this age group for comparison. RESULTS Unintentional drug overdose accounted for 1,586 deaths and 83,969.78 YLL in perinatal individuals from 2010 to 2019 in the United States. Perinatal American Indian/Native American individuals had a disproportionate amount of YLL when compared to other ethnic groups, with 2.39% of YLL due to overdose, while only making up 0.80% of the population. During the last two years of the study, only American Indian/Native American and Black individuals had increased rates of mortality when compared to other races. During the ten-year study period, when including the top three causes of mortality, unintentional drug overdoses made up 11.98% of the YLL overall and 46.39% of accidents. For the years 2016-2019, YLL due to unintentional overdose was the third leading cause of YLL overall for this population. CONCLUSIONS Unintentional drug overdose is a leading cause of death for perinatal individuals in the United States, claiming nearly 84,000 years of life over a ten-year period. When examining by race, American Indian/Native American women are most disproportionately affected.
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Hermans SP, Samiec J, Golec A, Trimble C, Teater J, Hall OT. Years of Life Lost to Unintentional Drug Overdose Rapidly Rising in the Adolescent Population, 2016-2020. J Adolesc Health 2023; 72:397-403. [PMID: 36096899 DOI: 10.1016/j.jadohealth.2022.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/12/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Years of life lost (YLL) is an epidemiological estimate of premature death which provides increased weight to mortality at younger ages. This study aims to quantify the impact of overdose mortality in adolescents from 2016 to 2020 using YLL and document the role of illicitly manufactured fentanyl in rising overdose rates. METHODS Data were obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research mortality file for years 2016-2020 to investigate unintentional overdose in adolescents aged 10-19. Unintentional overdose rates were investigated by year, gender, age, and substances involved. YLL was calculated using the Social Security Period of Life Table by age and year. YLL to unintentional overdoses was then compared to other leading causes of adolescent death. RESULTS The number of adolescent YLL to unintentional drug overdose in the United States more than doubled from 2019 to 2020 after remaining relatively stable between 2016 and 2019. In 2020, YLL to unintentional overdose accumulated to 84,179 YLL, surpassing that of cancer. Synthetic opioids including primarily illicitly manufactured fentanyl contributed to 81% of overdose deaths and 68,356 YLL, compared to 67% (26,628 YLL) in 2019. YLL to unintentional overdose during 2020 was higher for males (59,274) compared to females (24,905). DISCUSSION Mortality due to unintentional overdose in adolescents reached an all-time high in 2020. The majority of deaths (81%) involved fentanyl and other synthetic opioids. The trends depicted in this study signify the need for increased harm reduction approaches and treatment of opioid use disorder in adolescents.
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Affiliation(s)
- Sarah Perou Hermans
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jennifer Samiec
- College of Medicine, The Ohio State University, Columbus, Ohio
| | - Alexander Golec
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, Columbus, Ohio
| | | | - Julie Teater
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, Columbus, Ohio
| | - Orman Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, Columbus, Ohio.
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11
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Epilogue. Child Adolesc Psychiatr Clin N Am 2023; 32:169-172. [PMID: 36410903 DOI: 10.1016/j.chc.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Korona-Bailey J, Mukhopadhyay S. Characteristics of fatal drug overdoses among college age decedents in Tennessee, 2019-2020. DIALOGUES IN HEALTH 2022; 1:100050. [PMID: 38515907 PMCID: PMC10953990 DOI: 10.1016/j.dialog.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/02/2022] [Accepted: 09/25/2022] [Indexed: 03/23/2024]
Abstract
Purpose College age persons experienced unique disruptions to their regular lives during the COVID-19 pandemic, sometimes resulting in negative coping mechanisms. We examined changes in the number of and characteristics of college age fatal drug overdoses before and during the early COVID-19 pandemic. Methods We conducted a statewide cross-sectional study to determine the changes in the number and characteristics of college age fatal drug overdose decedents before and during the COVID-19 pandemic using 2019-2020 data from the Tennessee State Unintentional Drug Overdose Reporting System. We defined college age as 18-24 years. Frequencies and rates were generated to compare demographics, circumstances, and toxicology between 2019 and 2020. Results From 2019 to 2020, 336 college age persons experienced an unintentional or undetermined fatal drug overdose in Tennessee. Characteristics of college age decedents: mean age 21.7 years, 68.5% males, and 71.4% White. Rates of fatal overdoses among college age persons increased 50.0% overall, 150.1% for female decedents, and 141.7% for Black decedents. Fewer people were treated for substance use disorder or mental health conditions (p = 0.0243) in 2020. Conclusion This analysis can inform local and regional public health workers to implement focused prevention and intervention efforts to curtail the overdose epidemic among college age persons in Tennessee.
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Affiliation(s)
- Jessica Korona-Bailey
- Tennessee Department of Health, Office of Informatics and Analytics, Andrew Johnson Tower 7 Floor, 710 James Robertson Parkway, Nashville, TN 37243, United States
| | - Sutapa Mukhopadhyay
- Tennessee Department of Health, Office of Informatics and Analytics, Andrew Johnson Tower 7 Floor, 710 James Robertson Parkway, Nashville, TN 37243, United States
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Haile CN, Baker MD, Sanchez SA, Lopez Arteaga CA, Duddupudi AL, Cuny GD, Norton EB, Kosten TR, Kosten TA. An Immunconjugate Vaccine Alters Distribution and Reduces the Antinociceptive, Behavioral and Physiological Effects of Fentanyl in Male and Female Rats. Pharmaceutics 2022; 14:2290. [PMID: 36365109 PMCID: PMC9694531 DOI: 10.3390/pharmaceutics14112290] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 09/15/2023] Open
Abstract
Fentanyl (FEN) is a potent synthetic opioid associated with increasing incidence of opioid use disorder (OUD) and fatal opioid overdose. Vaccine immunotherapy for FEN-associated disorders may be a viable therapeutic strategy. Here, we expand and confirm our previous study in mice showing immunological and antinociception efficacy of our FEN vaccine administered with the adjuvant dmLT. In this study, immunized male and female rats produced significant levels of anti-FEN antibodies that were highly effective at neutralizing FEN-induced antinociception in the tail flick assay and hot plate assays. The vaccine also decreased FEN brain levels following drug administration. Immunization blocked FEN-induced, but not morphine-induced, rate-disrupting effects on schedule-controlled responding. Vaccination prevented decreases on physiological measures (oxygen saturation, heart rate) and reduction in overall activity following FEN administration in male rats. The impact of FEN on these measures was greater in unvaccinated male rats compared to unvaccinated female rats. Cross-reactivity assays showed anti-FEN antibodies bound to FEN and sufentanil but not to morphine, methadone, buprenorphine, or oxycodone. These data support further clinical development of this vaccine to address OUD in humans.
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Affiliation(s)
- Colin N. Haile
- Department of Psychology & TIMES, University of Houston, Houston, TX 77204, USA
| | - Miah D. Baker
- Department of Psychology & TIMES, University of Houston, Houston, TX 77204, USA
| | - Sergio A. Sanchez
- Department of Psychology & TIMES, University of Houston, Houston, TX 77204, USA
| | | | - Anantha L. Duddupudi
- Department of Pharmacological & Pharmaceutical Sciences, University of Houston, Houston, TX 77204, USA
| | - Gregory D. Cuny
- Department of Pharmacological & Pharmaceutical Sciences, University of Houston, Houston, TX 77204, USA
| | - Elizabeth B. Norton
- Department of Microbiology & Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Thomas R. Kosten
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA
- The Michael E DeBakey Veteran’s Affairs Medical Center, Houston, TX 77030, USA
| | - Therese A. Kosten
- Department of Psychology & TIMES, University of Houston, Houston, TX 77204, USA
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14
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Oliva EM, Bagley SM, Bottner R, Northup R, MacLane-Baeder D. Association of multidisciplinary education and research in substance use and addiction's (AMERSA) 2021 transforming care through evidence and policy conference: Tackling stigma and giving voice to lived experience. Subst Abus 2022; 43:1341-1345. [PMID: 36044546 DOI: 10.1080/08897077.2022.2074607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This commentary provides an overview of the Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) 2021 annual conference: Transforming Care Through Evidence and Policy. The topics covered during the conference were especially critical given the unprecedented rise in drug overdose deaths and continued impact of the COVID-19 pandemic on substance use and addiction. The importance of tackling stigma and ensuring that we partner with those with lived experience to have maximal impact was highlighted.
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Affiliation(s)
- Elizabeth M Oliva
- VA Program Evaluation and Resource Center, VA Office of Mental Health and Suicide Prevention; VA Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA
| | - Sarah M Bagley
- Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA.,Division of General Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Richard Bottner
- Quality Improvement and Patient Safety, Colorado Hospital Association, Denver, Colorado, USA
| | - Rebecca Northup
- Association for Multidisciplinary Education and Research in Substance use and Addiction, Cranston, Rhode Island, USA
| | - Doreen MacLane-Baeder
- Association for Multidisciplinary Education and Research in Substance use and Addiction, Cranston, Rhode Island, USA
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15
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Wilson JD, Bagley SM. An Urgent Need to Focus on Youth With Opioid Use Disorder. J Adolesc Health 2022; 71:143-144. [PMID: 35870825 PMCID: PMC9483656 DOI: 10.1016/j.jadohealth.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | - Sarah M Bagley
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts; Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts
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16
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Affiliation(s)
- O Trent Hall
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
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17
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18
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Braverman ER, Dennen CA, Gold MS, Bowirrat A, Gupta A, Baron D, Roy AK, Smith DE, Cadet JL, Blum K. Proposing a "Brain Health Checkup (BHC)" as a Global Potential "Standard of Care" to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of "Dopamine Homeostasis". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5480. [PMID: 35564876 PMCID: PMC9099927 DOI: 10.3390/ijerph19095480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/27/2022]
Abstract
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of "dopamine homeostasis" to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
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Affiliation(s)
- Eric R. Braverman
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Catherine A. Dennen
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
| | - A. Kenison Roy
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - David E. Smith
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, CA 94158, USA;
| | - Jean Lud Cadet
- The Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, Baltimore, MD 21224, USA;
| | - Kenneth Blum
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
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