Clinician Perspectives on Opioid Treatment Agreements: A Qualitative Analysis of Focus Groups

Richards, Nathan; Fried, Martin; Svirsky, Larisa; Thomas, Nicole; Zettler, Patricia J.; Howard, Dana

doi:10.1080/23294515.2023.2274606

Cited by 2 publications

(1 citation statement)

References 41 publications

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“…These materials are advantageous for use in applications that would otherwise be limited by cost and portability, while also providing increased sensitivity due to their large surface areas (i.e., that these materials can afford. As opioid overdose deaths increase nationwide with an additional burden caused by the COVID-19 pandemic increasing these rates [190], there is a great need for the development of fast screening methods with accurate results that can be generated into reports that can be easily interpreted by clinicians and healthcare staff of all levels [191].…”

Section: Fluorescence Detectionmentioning

confidence: 99%

Electrochemical Sensors, Biosensors, and Optical Sensors for the Detection of Opioids and Their Analogs: Pharmaceutical, Clinical, and Forensic Applications

Fakayode,

Brady,

Grant

et al. 2024

Chemosensors

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Pharmaceutical opioids are intravenously or orally administered analgesics. While they are effective in relieving chronic and acute pain, their narrow window of therapeutic use contributes to the high occurrence of abuse. The associated abuse of this family of drugs can be correlated to the increase in dependency, overdose, and death of users. The negative effects of opioids extend beyond the physical and psychological effects experienced by the user to their unregulated synthesis and sale, which contribute to socioeconomic challenges and are a biproduct of this global public health epidemic. From clinical to point-of-care applications, the detection and real-time monitoring of this family of drug is critical in the fight to decrease abuse and improve use in clinical settings. Chromatographic separations and chromatography–mass spectrometry are traditional methods of opioid analyses, but the high cost, long analysis time, and absence of portability highlight the need for the development of fast, in situ, point-of-care analysis, or of community drug monitoring services. This review highlights recent electrochemical and optical (FTIR, Raman, colorimetric, and fluorescent) advances and biosensors for pharmaceutical and illicit opioid analysis. Specifically, an emphasis is placed on the detection of opioids and their metabolites in biological samples and in vitro cellular assays for clinical diagnosis and forensic applications. The challenges and prospects of the role of electrochemical sensors, biosensors, and optical sensors for opioid analysis in promoting clinical diagnosis, forensic study, point-of-care, and community drug monitoring services to reduce harm are also provided.

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Section: Fluorescence Detectionmentioning

confidence: 99%

Electrochemical Sensors, Biosensors, and Optical Sensors for the Detection of Opioids and Their Analogs: Pharmaceutical, Clinical, and Forensic Applications

Fakayode,

Brady,

Grant

et al. 2024

Chemosensors

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The Legal Landscape for Opioid Treatment Agreements

SVIRSKY,

HOWARD,

FRIED

et al. 2024

Milbank Quarterly

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Policy Points Opioid treatment agreements (OTAs) are controversial because of the lack of evidence that their use reduces opioid‐related harms and the potential risks they pose of stigmatizing patients and undermining the clinician–patient relationship. Even so, their use is now required in most jurisdictions, and their use is influencing the outcomes of civil and criminal lawsuits. More research is needed to evaluate how OTAs are implemented given existing requirements. If additional research does not resolve the current level of uncertainty regarding OTA benefits, then policymakers in jurisdictions where they are required should consider eliminating OTA mandates or providing flexibility in the legal requirements to make room for clinicians and health care institutions to implement best practices. ContextOpioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in which the law permits flexibility for clinicians and health care institutions to adopt best practices.MethodsWe surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes.FindingsResults show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long‐term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability.ConclusionsOur results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks.

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Clinician Perspectives on Opioid Treatment Agreements: A Qualitative Analysis of Focus Groups

Cited by 2 publications

References 41 publications

Electrochemical Sensors, Biosensors, and Optical Sensors for the Detection of Opioids and Their Analogs: Pharmaceutical, Clinical, and Forensic Applications

Electrochemical Sensors, Biosensors, and Optical Sensors for the Detection of Opioids and Their Analogs: Pharmaceutical, Clinical, and Forensic Applications

The Legal Landscape for Opioid Treatment Agreements

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