Background: Fatal opioid overdose is a significant public health problem with increasing incidence in developed countries. This study aimed to describe demographic and service user characteristics of decedents of opioid overdose in Wales to identify possible targets for behaviour modification and life-saving interventions.
Methods: A retrospective cross-sectional analysis was conducted of a census sample of opioid overdose-related deaths recorded between January 01, 2012, and October 11, 2018, in Wales. UK Office for National Statistics, Welsh Demographic Service, and National Health Service datasets were linked deterministically. Decedents' circumstances of death, demographic characteristics, residency, and health service use were characterized over 3 years prior to fatal overdose using descriptive statistics.
Results: In total, 638 people died of opioid overdose in Wales between January 01, 2012, and October 11, 2018, with an incidence rate of 3.04 per 100,000 people per year. Decedents were predominantly male (73%) and middle aged (median age 50 years). Fatal overdoses predominantly occurred in the community (93%) secondary to heroin (30%) or oxycodone derivative use (34%). In the 3 years prior to death, decedents changed address frequently (53%) but rarely moved far geographically. The majority of decedents had recently visited the emergency department (83%) or were admitted to the hospital (64%) prior to death. Only a minority had visited specialist drug services (32%).
Conclusions: Deaths from opioid overdose typically occur in middle-aged men living peripatetic lifestyles. Victims infrequently visit specialist drug services but often attend emergency medical services. Emergency department-based interventions may therefore be important in prevention of opioid overdose fatalities in the community.
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http://dx.doi.org/10.1159/000521614 | DOI Listing |
HCA Healthc J Med
December 2024
HCA Florida Orange Park Hospital, Orange Park, FL.
Introduction: As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as "tranq," has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.
Case Presentation: This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine.
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.
J Addict Med
December 2024
From the Integrated Psychiatry, Pain, and Addiction Service, Vancouver General Hospital, Vancouver, British Columbia, Canada (PA, JSHW, JM, MN, VWL, MJI, NM); Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (PA, MN, VWL, MJI, NM); Addictions and Concurrent Disorders Research Group, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (JSHW, RMK); Substance Use Response and Facilitation Service, BC Children's Hospital, Provincial Health Services Authority, Vancouver, British Columbia, Canada (MJI); BC Mental Health & Substance Use Services, Provincial Health Services Authority, Vancouver, British Columbia, Canada (NM); Bridge, Public Health Institute, Oakland, CA (AAH); Department of Emergency Medicine, Highland General Hospital-Alameda Health System, Oakland, CA (AAH); Department of Emergency Medicine, University of California, San Francisco, CA (AAH); The C4 Foundation, Coronado, CA (RM); British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada (JSGM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (JSGM); and Pharmacokinetics Modeling and Simulation Laboratory, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada (ARM).
Buprenorphine has superior safety in opioid use disorder compared with alternatives due to its action as a partial opioid agonist, which limits its ability to cause respiratory depression. There is a risk of precipitated opioid withdrawal after buprenorphine exposure in someone using full opioid agonists. Buprenorphine induction strategies that avoid precipitated withdrawal remain a crucial component for starting buprenorphine in individuals actively using opioids.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA.
Background: Opioid use disorder (OUD) has been implicated as a potential risk factor for adverse outcomes and readmissions in various surgical procedures. Patients admitted with an open fracture of the lower extremity often have multifarious pain needs, require surgical procedures, and have prolonged rehabilitation; previous OUD complicates this process. Our goal was to describe at a national level how OUD is associated with readmission, complications, and healthcare expenditure for patients admitted with open lower extremity fractures.
View Article and Find Full Text PDFPsychol Addict Behav
January 2025
Department of Psychiatry and Behavioral Sciences, University of Washington.
Objective: Both opioid misuse and overdose mortality have disproportionately impacted the American Indian population. Although medications for opioid use disorder, such as buprenorphine (BUP-NX), are highly effective in reducing overdose mortality, questions have been raised about the cultural acceptability of Western medical approaches in this population. Understanding patients' desired recovery pathways can lead to more culturally appropriate, patient-centered, and effective approaches to opioid use disorder (OUD) treatment.
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