Background: Identifying solutions to the continued rise in overdose deaths is a public health priority. However, there is evidence of change in recent substance type associated with morbidity and mortality. To better understand the continued rise in overdose deaths, in particular those attributed to opioid and stimulant use disorders, increased knowledge of patterns of use is needed.
Methods: Retrospective cohort study of Veterans diagnosed with an opioid or stimulant use disorder between 2005 and 2019. The outcome of interest was diagnosis of substance use disorders, specifically examining combinations of opioid and stimulant use disorders among this population.
Results: A total of 1932,188 Veterans were diagnosed with at least one substance use disorder (SUD) during the study period, 2005 through 2019. While the annual prevalence of opioid use disorder (OUD) diagnoses increased more than 155%, OUD diagnoses absent of any other SUD diagnosis increased by an average of 6.9% (95% CI, 6.4, 7.5) per year between 2005 and 2019. Between 2011 and 2019, diagnoses of co-morbid methamphetamine use disorder (MUD) and OUD increased at a higher rate than other SUD combinations.
Conclusions: The prevalence of comorbid SUD, in particular co-occurring opioid and methamphetamine use disorder, increased at a higher rate than other combinations between 2005 and 2019. These findings underscore the urgent need to offer patients a combination of evidence-based treatments for each co-morbid SUD, such MOUD and contingency management for persons with comorbid opioid and methamphetamine use disorders.
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http://dx.doi.org/10.1016/j.drugalcdep.2022.109310 | DOI Listing |
Int J Drug Policy
January 2025
MGH Institute for Technology Assessment, Harvard Medical School, Boston, MA, 02144, USA. Electronic address:
The overdose epidemic in the United States is evolving, with a rise in stimulant (cocaine and/or methamphetamine)-only and opioid and stimulant-involved overdose deaths for reasons that remain unclear. We conducted interviews and group model building workshops in Massachusetts and South Dakota. Building on these data and extant research, we identified six dynamic hypotheses, explaining changes in stimulant-involved overdose trends, visualized using causal loop diagrams.
View Article and Find Full Text PDFJ Addict Med
January 2025
From the Division of General Internal Medicine, San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (POC); Vital Strategies, New York, NY (KB, DC); Network for Public Health Law, Edina, MN (CSD); and New York University Grossman School of Medicine, New York, NY (CSD).
Stimulant use disorder (StUD) is a rapidly growing concern in the United States, with escalating rates of death attributed to amphetamines and cocaine. No medications are currently approved for StUD treatment, leaving clinicians to navigate off-label medication options. Recent studies suggest that controlled prescription psychostimulants such as dextroamphetamine, methylphenidate, and modafinil are associated with reductions in self-reported stimulant use, craving, and depressive symptoms.
View Article and Find Full Text PDFFront Neurosci
January 2025
Kontigo Care AB, Uppsala, Sweden.
Background: It is known that illicit and prescribed drugs impact pupil size, eye movement and function. Still, comprehensive quantitative evaluations under known ambient light conditions are lacking, when smartphones are used for monitoring.
Methods: In this clinical study (NCT05731999), four medicinal products with addiction risks were administered to 48 subjects (18-70 years old, all with informed consent, 12 subjects per drug).
J Psychiatr Pract
January 2025
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA.
Insomnia, characterized by difficulty initiating or maintaining sleep, or poor sleep quality, is highly prevalent among individuals with substance use disorders (SUDs). The relationship between the 2 conditions is often bidirectional. We reviewed the impact of various substances (alcohol, stimulants, opioids, and cannabis) on sleep architecture and their potential to contribute to insomnia.
View Article and Find Full Text PDFAddiction
January 2025
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.
Aims: This study aimed to describe clinical features and outcomes of patients presenting to the emergency department with analytically confirmed methamphetamine intoxication, to determine the blood concentration of methamphetamine and to test its association with clinical findings.
Design: The Western Australian Illicit Substance Evaluation (WISE) study is a prospective observational cohort study.
Setting: Royal Perth Hospital Emergency Department, Perth, Australia, between 2016 and 2018.
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