Reducing the Oversupply of Prescription Opioids

McEwen, Sara; Prakken, Steven D

doi:10.18043/ncm.79.3.175

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…While reducing the supply of prescription pills may prevent people from becoming addicted, those who become addicted may gravitate toward non-legal drugs like heroin and fentanyl, which can be more lethal [18]. A correlation between prescription opioid pills and mortality rates has been noted in numerous other studies, including studies focused on North Carolina [4,5,16]. Our results did not show a statistically significant relationship between the per capita pill rates and death rates at the county level.…”

Section: Discussioncontrasting

confidence: 59%

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Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

Jones

Luo

Mansfield

et al. 2020

North Carolina Medical Journal

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background Deaths from unintentional opioid overdose have increased markedly over the last decade in North Carolina. In 2017 the state created a North Carolina Opioid Action Plan, which laid out a multisectoral response to the crisis that included the medical community, law enforcement, emergency medical services, and treatment professionals. It also created a website providing county-level data associated with the crisis. Using this publicly available data, we examine trends and associations between opioid-related mortality and strategies to reduce opioid prescriptions, reduce fatality of overdose, and improve treatment and recovery. method We examine yearly trends from 2010-2017 for statewide unintentional opioid-related death rates, prescription of opioid pills, buprenorphine prescription rates, naloxone administrations, and number of Certified Peer Support Specialists. We compare recent opioidrelated death rates for 2015-2017 with an earlier period (2010-2012) at the county level, and examine the association between death rates and rates of the supply, treatment, and recovery metrics. results Trends for all metrics increased from 2010-2017, although the number of opioid pills per capita has declined since 2015. Between 2010 and 2017, 84 of the state's 100 counties experienced an increase in opioid-related mortality. County-level mortality was positively associated with opioid prescription rate (r = +0.12, P = 0.24) and with naloxone administrations (r = +0.20, P = 0.05). Prescription of buprenorphine was associated with a reduction in opioid mortality (r =-0.27, P = 0.01). The effect of Certified Peer Support Specialists was not discernable. limitations Data are available for only eight years and aggregated at the county level. Mortality data are based on death certificates using ICD-10 codes from the North Carolina State Center for Health Statistics, Vital Statistics, which may not capture all opioid-related fatalities. Drug-related deaths may involve multiple non-opioid substances; in addition, determining the intent of the deceased individual may be difficult (suicide versus unintentional). Naloxone administration data only includes data from emergency medical services, not communityadministered naloxone, because that data was only available for 2013 and later and is based only on self-reports. conclusions The potential efficacy of buprenorphine is promising and should be further explored. All interventions should be monitored.

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Section: Discussioncontrasting

confidence: 59%

“…A key part of North Carolina's strategy for addressing the epidemic has been to limit the supply of prescription opioid pills [3,16]. Opioid-related deaths include deaths due to both prescription and non-prescription opioids.…”

Section: Discussionmentioning

confidence: 99%

Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

Jones

Luo

Mansfield

et al. 2020

North Carolina Medical Journal

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“…First, the Action Plan includes efforts to reduce the oversupply of prescription opioids. As discussed by McEwen and Prakken in this issue, last year the North Carolina Medical Board adopted Centers for Disease Control (CDC) guidelines on management of pain [6]. The Board, along with other organizations like the Governor's Institute for Substance Abuse and Area Health Education Centers, implemented a concerted training effort for physicians on these guidelines.…”

Section: Strategy 1: Reducing the Oversupply Of Prescription Opioidsmentioning

confidence: 99%

“…We have more to do in the areas of research, funding, and delivery of these approaches to managing chronic pain. This is critically important, as McEwen and Prakken point out, so that we do not further exacerbate opioid addiction by squeezing people with chronic pain toward illicit drugs [6].…”

Section: Strategy 1: Reducing the Oversupply Of Prescription Opioidsmentioning

confidence: 99%

The Opioid Epidemic in NC

Kansagra

Cohen

2018

North Carolina Medical Journal

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Like many states, North Carolina faces an opioid crisis that has rapidly intensified in recent years. Addressing this epidemic requires interventions such as judicious prescribing of opioids, community based prevention efforts, broader naloxone distribution, law enforcement efforts to curb drug trafficking, and harm reduction efforts like safe syringe programs. Expanding access to treatment and recovery services, as well as affordable health insurance for individuals with substance use disorder or at risk for developing a disorder, is also critical. North Carolina has made significant progress, but we have much more work to do.

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“…Warum wurde dieser Teil der Publikation nicht zitiert? Ärzten kam also eine zentrale Rolle zu [4,7,30,48]. Und auch noch später, von 2013 bis 2015, wurden von den Opioidherstellern 46 Mio.…”

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Wie lange dauert eine Langzeitanwendung?

Zenz

2020

Schmerz

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Reducing the Oversupply of Prescription Opioids

Cited by 9 publications

References 13 publications

Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

Tracking Trends in the Opioid Epidemic in North Carolina : Early Results from the Opioid Action Plan Metrics

The Opioid Epidemic in NC

Wie lange dauert eine Langzeitanwendung?

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