Publications by authors named "M Buonora"

Among people with substance use disorders (SUDs), chronic pain is among the most common comorbid chronic health conditions. Chronic pain increases risk for poor SUD treatment outcomes, including risk for overdose. Given rising overdose rates across North America, a renewed research focus has emerged to better understand the contribution and treatment of chronic pain in the context of an SUD.

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Background: Patients face well documented problems accessing methadone from opioid treatment programs (OTPs) in the U.S., yet addressing these barriers has proven difficult due in part to the sheer number of actors governing treatment, including state authorities.

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Amidst the US overdose epidemic, policymakers, law enforcement agencies, and healthcare institutions have contributed to a decrease in opioid prescribing, assuming reduced mortality would result-an assumption we now understand was oversimplified. At this intersection between public health and public safety domains as they relate to opioid prescribing, unregulated and proprietary clinical decision support tools have emerged without rigorous external validation or public data sharing. In the following piece, we discuss challenges facing clinicians practicing medicine amidst unregulated clinical decision support tools, using the case of Bamboo Health's NarxCare-a prescription drug monitoring program-based analytics platform marketed as a clinical decision support tool-that is already positioned to impact over 1 billion patient encounters annually.

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Article Synopsis
  • - The study examines how U.S. state policies on opioid prescribing influence overdose mortality rates from both prescription and non-prescription opioids, particularly after policies were implemented in 2014.
  • - Researchers analyzed data from 1999 to 2016 and focused on six strong policy provisions, finding that those emphasizing prescriber training and dose limits generally reduced overdose mortality, while some policies had negative effects.
  • - Notably, strong provisions for responding to misuse led to increased non-prescription overdose mortality, indicating that not all regulations were beneficial or effective in decreasing overall opioid-related deaths.
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