Bull Math Biol
Department of Mathematics and Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, TN, USA.
Published: August 2021
Opioid addiction represents a major national health issue spanning decades. In recent years, prescription opioid use disorder has increasingly led to heroin and fentanyl use, with subsequent increases in mortality rates due to overdose. In this paper, we present a mechanistic, epidemic model for prescription opioid addiction and illicit heroin or fentanyl addiction which aims to better understand and predict the dynamics between these two stages of opioid use disorder. Our model aims to be both parsimonious and robust: as a system of five differential equations it is appropriate for use in theory advancement and yet it remains powerful enough to capture state-level data from Tennessee for the period 2013-2018. A key finding from our data-driven analysis is that, in the face of changing policy around prescription opioids, heroin and fentanyl are now the driving force behind the Tennessee opioid epidemic. Model projections suggest that both addictions and overdoses related to heroin and fentanyl will continue to increase in the next few years (2020-2022), even as addiction to prescription drugs continues to fall. Finally, management strategy analysis suggests that in the changing face of the epidemic, the most successful approach will target availability of treatment with subsequent monitoring of stably recovered individuals to see that they do not relapse, coincident with direct efforts to decrease opioid overdose fatalities (e.g., further availability of Naloxone).
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http://dx.doi.org/10.1007/s11538-021-00925-0 | DOI Listing |
Dis Mon
January 2025
Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
The subject of substance use disorders in the pediatric population remains a disturbing conundrum for clinicians, researchers and society in general. Many of our youth are at risk of being damaged and even killed by drug addictions that result from the collision of rapidly developing as well as vulnerable central nervous systems encountering the current global drug addiction crisis. A major motif of this chemical calamity is opioid use disorder in adolescents and young adults that was stimulated by the 19th century identification of such highly addictive drugs as morphine, heroin and a non-opiate, cocaine.
View Article and Find Full Text PDFInj Prev
January 2025
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Background: In 2020, Maryland had the fourth-highest opioid overdose mortality rate in the USA. We describe substances identified in postmortem toxicology screening and designated as cause of death (COD) for overdose decedents in Maryland, including specific combinations of substances designated as COD.
Methods: We performed a retrospective analysis of N=5442 adult overdose decedents (ie, manner of death unintentional or undetermined) in Maryland between January 2020 and December 2021.
Drug Alcohol Depend
January 2025
Neuropsychoimaging of Addictions and Related Conditions (NARC), Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Question: The opioid epidemic causes massive morbidity, and males have substantially greater overdose mortality rates than females. It is unclear whether there are sex-related disparities at different stages in the trajectory of opioid use disorders (OUD), from large samples in the community.
Goal: To determine sex disparities in non-medical opioid use (NMOU) at the end of treatment with medications for opioid use disorder (MOUD), using national data.
PLoS One
December 2024
Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
In Canada, the ongoing fatal overdose crisis remains driven by the unpredictable potency and content of the illicit drug supply. From August 2022 until October 2023, the Drug User Liberation Front [DULF] operated a drug compassion club [CC], which sells drugs of known composition and purity without medical oversight. The present study is a qualitative evaluation of this project.
View Article and Find Full Text PDFJ Bone Joint Surg Am
December 2024
Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons and a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe and complex xylazine-associated necrotic (XAN) wounds, the aim of this consecutive case series was to characterize the variability of presentations (ranging from mild to severe) at a single institution at the epicenter of the xylazine epidemic.
Methods: Patients presenting to a tertiary referral center for XAN upper-extremity wounds were retrospectively identified from emergency department visits and hospital admissions between January 2021 and December 2023.
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