The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City.

Background: Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated.

Methods: Our analytic cohort uses retail pharmacy claims data; three health departments' community distribution data; federal opioid overdose data; and American Community Survey data. Data were analyzed by 3-digit ZIP Code and calendar quarter-year (2016Q1-2018Q4), and weighted by population.

Gaps in naloxone ownership among people who inject drugs during the fentanyl wave of the opioid overdose epidemic in New York City, 2018.

Community distribution of naloxone, a medication that reverses opioid overdose, is an effective public health strategy to prevent overdose deaths. However, data are limited on who has naloxone during the current fentanyl wave of the opioid overdose epidemic in the United States. We aim to determine correlates of naloxone ownership among a community sample of people who inject drugs (PWID) from New York City (NYC).

Impact of a Homeless Encampment Closure on Crime Complaints in the Bronx, New York City, 2017: Implications for Municipal Policy.

Purpose: As part of COVID-19 control policy, the Centers for Disease Control and Prevention has advised local jurisdictions to permit the formation of homeless encampments to prevent community disease spread. This new federal public health guidance is in conflict with existing police policies in many jurisdictions to raze or evict homeless encampments upon discovery. However, no empirical research on homeless encampment policy actions exists.

Implementing a Methadone Delivery System in New York City in Response to COVID-19.

Opioid agonist medication, including methadone, is considered the first-line treatment for opioid use disorder. Methadone, when taken daily, reduces the risk of fatal overdose; however, overdose risk increases following medication cessation. Amid an overdose epidemic accelerated by the proliferation of fentanyl, ensuring continuity of methadone treatment during the COVID-19 pandemic is a vital public health priority.

Racial disparities in criminal legal system involvement among New York City overdose decedents: Implications for diversion programs.

Background: Past studies have identified frequent criminal legal system (CLS) involvement among overdose decedents and highlight the need for connecting individuals at risk of overdose with effective interventions during CLS encounters. While some programs divert individuals at risk of overdose to treatment during CLS encounters, eligibility is frequently restricted to those with limited prior CLS involvement. However, differences by race/ethnicity have not been examined.

Reformulation of oxycodone 80 mg to prevent misuse: A cohort study assessing the impact of a supply-side intervention.

Background: In August 2010, extended-release OxyContin® products, including oxycodone 80 mg, were reformulated and released as abuse-deterrent medications. This paper describes changes in individual prescription filling patterns that followed the reformulation of oxycodone 80 mg.

Methods: Using New York State prescription monitoring program data, we conducted a retrospective analysis of a cohort of New York City residents who had filled at least three consecutive prescriptions for oxycodone 80 mg immediately prior to the reformulation.

Underutilization of medications to treat opioid use disorder: What role does stigma play?

There is consensus in the scientific literature that the opioid agonist medications methadone and buprenorphine are the most effective treatments for opioid use disorder. Despite increasing opioid overdose deaths in the United States, these medications remain substantially underutilized. For no other medical conditions for which an effective treatment exists is that treatment used so infrequently.

Estimated impact of supervised injection facilities on overdose fatalities and healthcare costs in New York City.

Background: The opioid epidemic in the United States has resulted in over 42,000 U.S. opioid overdose fatalities in 2016 alone.

Novel use of syndromic surveillance to monitor the impact of synthetic cannabinoid control measures on morbidity.

Background: Using data from syndromic surveillance, the New York City Department of Health and Mental Hygiene (DOHMH) identified an increase in the number of emergency department (ED) visits related to synthetic cannabinoids. Syndromic surveillance data were used to target community-level interventions and assess the real-time impact of control measures in reducing synthetic cannabinoid ("K2")-related morbidity.

Methods: From April 2015 through September 2015, DOHMH implemented 3 separate interventions to reduce K2-related morbidity by limiting the availability of K2 products.

Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City.

Purpose: To evaluate New York State's mandate that prescribers query the prescription drug monitoring program (PDMP) prior to prescribing Schedule II-IV medications.

Methods: We conducted an interrupted time series analysis of opioid analgesic prescriptions dispensed to adult New York City (NYC) residents using data from New York State's PDMP. Our main outcomes were the rate of (a) greater than or equal to five prescriber episodes, (b) greater than or equal to five prescriber and greater than or equal to five pharmacy episodes, and (c) paying for prescriptions with both cash and insurance, per quarter, per 100 000 NYC residents.

Racial Differences in Opioid Overdose Deaths in New York City, 2017.

This study evaluates racial differences in opioid overdose deaths in New York City for 2017.

Overdose Deaths Involving Fentanyl and Fentanyl Analogs - New York City, 2000-2017.

Unintentional drug overdose deaths have climbed to record high levels, claiming approximately 70,000 lives in the United States in 2017 alone (1). The emergence of illicitly manufactured fentanyl* (a synthetic, short-acting opioid with 50-100 times the potency of morphine) mixed into heroin, cocaine, and counterfeit pills, with or without the users' knowledge, has increased the risk for fatal overdose (2,3). The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) conducts routine overdose mortality surveillance by linking death certificates with toxicology findings from the NYC Office of the Chief Medical Examiner (OCME).

Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention.

After remaining stable from 2010 to 2014, the  rate of cocaine-involved overdose death increased sharply from 2015 to 2016. This study aims to determine the contribution of opioids, and fentanyl in particular, to the increase in cocaine-involved overdose death from 2015 to 2016. Using New York City death certificate data linked to medical examiner toxicology data, we identified all overdose deaths where post-mortem toxicology results were positive for cocaine from 2010 to 2016.

Estimating the Risk of Exposure to Fentanyl in New York City: Testing Drug Residue in Used Syringes.

Objectives: To estimate the risk of exposure to fentanyl among syringe exchange program (SEP) participants in New York City.

Methods: We recruited a convenience sample from 11 SEPs in New York City between March and June 2017. Consenting participants (n = 434) received a labeled syringe for their next injection.

Witnessed overdoses and naloxone use among visitors to Rikers Island jails trained in overdose rescue.

With the opioid overdose mortality rates rising nationally, The New York City Department of Health and Mental Hygiene (NYC DOHMH) has worked to expand overdose rescue training (ORT) and naloxone distribution. This study sought to determine rates of overdose witnessing and naloxone use among overdose rescue-trained visitors to the NYC jails on Rikers Island. We conducted a six-month prospective study of visitors to NYC jails on Rikers Island who received ORT.

Developing Syndromic Surveillance to Monitor and Respond to Adverse Health Events Related to Psychoactive Substance Use: Methods and Applications.

Introduction: Recent increases in drug overdose deaths, both in New York City and nationally, highlight the need for timely data on psychoactive drug-related morbidity. We developed drug syndrome definitions for syndromic surveillance to monitor drug-related emergency department (ED) visits in real time.

Materials And Methods: We used 2012 archived syndromic surveillance data from New York City hospitals to develop definitions for psychoactive drug-related syndromes.

Decrease in rate of opioid analgesic overdose deaths - Staten Island, New York City, 2011-2013.

From 2000 to 2011, the rate of unintentional drug poisoning (overdose) deaths involving opioid analgesics increased 435% in Staten Island, from 2.0 to 10.7 per 100,000 residents.

Illnesses and deaths among persons attending an electronic dance-music festival - New York City, 2013.

Outdoor electronic dance-music festivals (EDMFs) are typically summer events where attendees can dance for hours in hot temperatures. EDMFs have received increased media attention because of their growing popularity and reports of illness among attendees associated with recreational drug use. MDMA (3,4-methylenedioxymethamphetamine) is one of the drugs often used at EDMFs.