Prescription opioid poisoning across urban and rural areas: identifying vulnerable groups and geographic areas

Cerdá, Magdalena; Gaidus, Andrew; Keyes, Katherine M.; Ponicki, William R.; Martins, Sílvia S.; Galea, Sandro; Gruenewald, Paul J.

doi:10.1111/add.13543

Cited by 93 publications

(63 citation statements)

References 48 publications

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“…The current epidemic of opioid use disorder has severely impacted rural areas; the rural population has not only experienced a surge in opioid use, but limited access to proper treatment will only continue to perpetuate the suffering . Telemedicine—particularly telemental health—has strong evidence of effectiveness with diverse populations and clinical contexts, including rural populations .…”

Section: Discussionmentioning

confidence: 99%

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

et al. 2018

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Background and Objectives The opioid epidemic in the United States has resulted in a public health emergency. Medication‐assisted treatment (MAT) with methadone and buprenorphine are evidence‐based treatments for opioid use disorder. However, numerous barriers hinder access to treatment in rural areas. The use of telemedicine to deliver psychiatric services is demonstrated to be safe and effective; however, limited data exist on the novel application of telemedicine in the delivery of MAT. This report describes the results of a retrospective chart review of 177 patients in a rural drug treatment center that were treated with buprenorphine through telemedicine. Methods This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. Results Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid‐negative urine toxicology. Discussion and Conclusions Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program. Scientific Significance This use of telemedicine is a potential tool to expand medication‐assisted treatment to underserved rural populations. (Am J Addict 2018;XX:1–6)

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Section: Discussionmentioning

confidence: 99%

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

et al. 2018

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“…First, they assess the distribution of alcohol‐ and drug‐related problems across geographic and social space enabling the identification of those human communities which most suffer from these problems. Studies of the distributions of incidence and prevalence of AOD problems over space and time (e.g., intimate partner violence, Cunradi et al., ; child abuse and neglect, Freisthler et al., ; motor vehicle crashes, Ponicki et al., ; violent assaults, Mair et al., ; methamphetamine abuse, Gruenewald et al., ; prescription opioid abuse, Cerda et al., ) demonstrate the need for rational allocation of scarce prevention and treatment resources. Second, they focus research efforts on elucidating the micro‐ecological human social mechanisms that accelerate risks for AOD problems.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneous Costs of Alcohol and Drug Problems Across Cities and Counties in California

Miller

Nygaard

Gaidus

et al. 2017

Alcoholism Clin & Exp Res

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Background Estimates of economic and social costs related to alcohol and other drug (AOD) use and abuse are usually made at state and national levels. Ecological analyses demonstrate, however, that substantial variations exist in the incidence and prevalence of AOD use and problems including impaired driving, violence, and chronic disease between smaller geopolitical units like counties and cities. This study examines the ranges of these costs across counties and cities in California. Methods We used estimates of the incidence and prevalence of AOD use, abuse and related problems to calculate costs in 2010 dollars for all 58 counties and an ecological sample of 50 cities with populations between 50,000 and 500,000 persons in California. The estimates were built from archival and public-use survey data collected at state, county and city-levels over the years from 2009 to 2010. Results Costs related to alcohol use and related problems exceeded those related to illegal drugs across all counties and most cities in the study. Substantial heterogeneities in costs were observed between cities within counties. Conclusions AOD costs are heterogeneously distributed across counties and cities, reflecting the degree to which different populations are engaged in use and abuse across the state. These findings provide a strong argument for the distribution of treatment and prevention resources proportional to need.

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“…In each year during 1999-2015, all-cause injury death rates were higher in nonmetropolitan areas of the United States than they were in metropolitan areas (3), and previous studies indicate that rates of drug overdose death and drug use varied markedly by metropolitan/nonmetropolitan status (4)(5)(6). Drug overdoses are now the leading cause of injury death in the United States, and although prescription drugs were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem (7).…”

Section: Introductionmentioning

confidence: 99%

Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas—United States

Mack

Jones

Ballesteros

2017

American Journal of Transplantation

101

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Prescription opioid poisoning across urban and rural areas: identifying vulnerable groups and geographic areas

Cited by 93 publications

References 48 publications

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

Heterogeneous Costs of Alcohol and Drug Problems Across Cities and Counties in California

Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas—United States

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