Individual and prescription level factors associated with overdose in opioid naïve older people.

Background: Opioid naïve older adults may be at risk of overdose after receiving an initial opioid prescription.

Methods: This population-based cohort study from a linked dataset of patients in Oregon, linking all payer claims data to other administrative datasets, aimed to assess the prescription- and patient-level characteristics associated with increased odds of opioid overdose after an initial opioid prescription. Included patients were ≥65 years old and received an index pain-formulation opioid prescription between 2016 and 2019.

Chronic Opioid Use After Implementation of Oregon's Medicaid Back Pain Policy.

Introduction: In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify the factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy after implementation of this policy.

Methods: Using Medicaid administrative claims data, this was a retrospective cohort of patients on chronic stable opioid therapy between July and December 2016.

Opioid Overdose After Medication for Opioid Use Disorder Initiation Following Hospitalization or ED Visit.

Importance: Hospitalizations related to opioid use disorder (OUD) represent an opportunity to initiate medication for OUD (MOUD).

Objective: To assess whether starting MOUD after a hospitalization or emergency department (ED) visit is associated with the odds of fatal and nonfatal opioid overdose at 6 and 12 months.

Design, Setting, And Participants: This population-based cohort study used data from the Oregon Comprehensive Opioid Risk Registry, which links all payer claims data to other administrative health datasets, for individuals aged 18 years or older who had diagnosis codes related to OUD recorded at an index ED visit or hospitalization from January 2017 to December 2019.

Outcomes After a Statewide Policy to Improve Evidence-Based Treatment of Back Pain Among Medicaid Enrollees in Oregon.

Background: A novel Oregon Medicaid policy guiding back pain management combined opioid restrictions with emphasis on non-opioid and non-pharmacologic therapies.

Objective: To examine the effect of the policy on prescribing, health outcomes, and health service utilization.

Design: Using Medicaid enrollment, medical and prescription claims, prescription drug monitoring program, and vital statistics files, we analyzed the policy's association with selected outcomes using interrupted time series models.

The association between community social vulnerability and prescription opioid availability with individual opioid overdose.

Background: This study aims to assess the association of community social vulnerability and community prescription opioid availability with individual non-fatal or fatal opioid overdose.

Methods: We identified patients 12 years of age or older from the Oregon All Payer Claims database (APCD) linked to other public health datasets. Community-level characteristics were captured in an exposure period (EP) (1/1/2018-12/31/2018) and included: census tract-level social vulnerability domains (socio-economic status, household composition, racial and ethnic minority status, and housing type and transportation), census tract-level prescriptions and community-level opioid use disorder (OUD) diagnoses per 100 capita binned into quartiles or quintiles.

Association of Household Opioid Availability With Opioid Overdose.

Importance: Previous studies that examined the role of household opioid prescriptions in opioid overdose risk were limited to commercial claims, did not include fatal overdoses, and had limited inclusion of household prescription characteristics. Broader research is needed to expand understanding of the risk of overdose.

Objective: To assess the role of household opioid availability and other household prescription factors associated with individuals' odds of fatal or nonfatal opioid overdose.

Factors Associated With Opioid Overdose After an Initial Opioid Prescription.

Importance: The opioid epidemic continues to be a public health crisis in the US.

Objective: To assess the patient factors and early time-varying prescription-related factors associated with opioid-related fatal or nonfatal overdose.

Design, Setting, And Participants: This cohort study evaluated opioid-naive adult patients in Oregon using data from the Oregon Comprehensive Opioid Risk Registry, which links all payer claims data to other health data sets in the state of Oregon.

COVID-19-related adaptations to the implementation and evaluation of a clinic-based intervention designed to improve opioid safety.

The United States faces an opioid crisis with an unprecedented and increasing death rate from opioid overdose. Successfully reducing the rates of opioid use disorder (OUD) and overdose will require the engagement of frontline clinicians to prescribe opioids more safely and to build their capacity to treat patients with OUD using evidence-based approaches. The COVID-19 pandemic has created significant challenges for patients, clinicians and health systems and has been associated with increasing risks of overdoses and deaths.

Characteristics and health care events of patients admitted to treatment for both heroin and methamphetamine compared to patients admitted for heroin only.

Introduction: Co-occurring heroin and methamphetamine use is a growing public health problem. This study assessed the characteristics of Medicaid patients admitted to substance use disorder (SUD) treatment programs for heroin and methamphetamine use compared with patients admitted for heroin only.

Methods: The study identified patients who entered treatment for heroin and methamphetamine and those admitted for heroin only between 2014 and 2017 from the Oregon Treatment Episode Data Set linked with Medicaid enrollment, and medical and pharmacy claims.

Linkage of public health and all payer claims data for population-level opioid research.

Objective: Our objective is to describe how we combine, at an individual level, multiple administrative datasets to create a Comprehensive Opioid Risk Registry (CORR). The CORR will characterize the role that individual characteristics, household characteristics, and community characteristics have on an individual's risk of opioid use disorder or opioid overdose.

Data Sources: Study data sources include the voluntary Oregon All Payer Claims Database (APCD), American Community Survey Census Data, Oregon Death Certificate data, Oregon Hospital Discharge Data (HDD), and Oregon Prescription Drug Monitoring (PDMP) Data in 2013-2018.

Ambulance Calls for Substance-Related Issues Before and After COVID-19.

: The United States is currently facing 2 epidemics: sustained morbidity and mortality from substance use and the more recent COVID-19 pandemic. We tested the hypothesis that the pandemic has disproportionately affected individuals with substance use disorder by evaluating average daily 9-1-1 ambulance calls for substance use-related issues compared with all other calls. : This was a retrospective cross-sectional analysis of 9-1-1 ambulance calls before and after the start of COVID-19 in Massachusetts.

Prescription and Prescriber Specialty Characteristics of Initial Opioid Prescriptions Associated with Chronic Use.

Objective: This study evaluated the characteristics of opioid prescriptions, including prescriber specialty, given to opioid-naïve patients and their association with chronic use.

Design: Cross-sectional analysis of the Ohio prescription drug monitoring program from January 2010 to November 2017.

Setting: Ohio, USA.

A comparison of trends in opioid dispensing patterns between Medicaid pharmacy claims and prescription drug monitoring program data.

Purpose: Public and private payers have implemented benefit limitations to reduce high-risk opioid prescriptions. The effect of these policies on the increase of out-pocket payment is unclear. To understand this gap, we compared the discrepancies in trends between opioid prescription fills vs claims among Medicaid beneficiaries.

The effect of marriage on stage at diagnosis and survival in women with cervical cancer.

Purpose: This study assessed the effect of marital status on stage at diagnosis and survival in women with cervical cancer.

Methods: Cervical cancer cases diagnosed between 2000 and 2010 were identified from the Surveillance, Epidemiology and End Results (SEER) program. Patient demographic and clinical characteristics were compared by marital status.

No differences in cervical cancer stage at diagnosis for Blacks and Whites in the Mountain West.

This study assesses cervical cancer disparities between Blacks and Whites in terms of stage at diagnosis in a Mountain West state. A total of 1,408 women diagnosed with cervical cancer between 1995 and 2010 were identified from the Nevada Central Cancer Registry. Logistic regression modeling examined the effect of race on stage at diagnosis in both Nevada and the Surveillance, Epidemiology and End Results (SEER) population.

Comparison of 17beta-estradiol structures from x-ray diffraction and solution NMR.

The NMR-derived structure of estrogen (17beta-estradiol, E2), the drug of choice for postmenopausal women, was compared with a recent literature crystal x-ray structure of Fab-bound E2. 1H and 13C NMR spectra of E2 were acquired in DMSO-d6. Assignments were obtained from an analysis of DQF-COSY, TOCSY, HETCOR, HMQC and HMBC 2D NMR spectra.

Comparison of the phytoestrogen trans-resveratrol (3,4',5-trihydroxystilbene) structures from x-ray diffraction and solution NMR.

The NMR-derived solution structure of trans-3,4',5-trihydroxystilbene (resveratrol) was compared with two recent literature crystal x-ray structures, resveratrol in complex with human transthyretin (TTR-RES) from 1DVS.pdb and resveratrol bound to chalcone synthase (CHS-RES) from 1CGZ.pdb.