The opioid crisis and the 2020 US election: crossroads for a national epidemic

Wen, Leana S.; Sadeghi, Nakisa B.

doi:10.1016/s0140-6736(20)32113-9

Cited by 20 publications

(18 citation statements)

References 7 publications

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“…With respect to psychosocial interventions, a Cochrane review found that patients receiving psychosocial interventions in addition to OAT did not show improved outcomes compared to individuals receiving OAT alone; whereas another systematic review did support their efficacy to improve clinical outcomes [34]. There is emerging evidence that some of these inconsistent findings may be indicative of other variables impacting patient responses to psychiatric treatment, including ongoing substance use and complex psychosocial such as housing and employment [9,33,35].…”

Section: Discussionmentioning

confidence: 99%

“…In Canada, overdose deaths and hospitalizations related to opioid use disorder (OUD) have remained high despite increasing awareness and intervention [5,6]. In the United States, opioids are involved in the majority of deaths related to drug overdose, which rose to an all-time high in 2019 with 49,860 overdose deaths involving opioids [7][8][9]. The impacts of the COVID-19 pandemic have additionally exacerbated preexisting issues relating to access to appropriate treatment and interventions, ensuring that the opioid crisis will remain an ongoing concern for patients and families, healthcare workers, and policymakers alike [9].…”

Section: Introductionmentioning

confidence: 99%

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Sensitivity and specificity of self-reported psychiatric diagnoses amongst patients treated for opioid use disorder

Leung

Rosic

et al. 2021

BMC Psychiatry

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Background Patients with opioid use disorder (OUD) frequently present with comorbid psychiatric illnesses which have significant implications for their treatment outcomes. Notably, these are often identified by self-report. Our study examined the sensitivity and specificity of self-reported psychiatric diagnoses against a structured diagnostic interview in a cohort of patients receiving outpatient pharmacological treatment for OUD. Methods Using cross-sectional data from adults receiving outpatient opioid agonist treatment for OUD in clinics across Ontario, Canada, we compared participants’ self-reported psychiatric diagnoses with those identified by the Mini Neuropsychiatric Interview (MINI) Version 6.0 administered at the time of study entry. Sensitivity and specificity were calculated for self-report of psychiatric diagnoses. Results Amongst a sample of 683 participants, 24% (n = 162) reported having a comorbid psychiatric disorder. Only 104 of these 162 individuals (64%) reporting a comorbidity met criteria for a psychiatric disorder as per the MINI; meanwhile, 304 (75%) participants who self-reported no psychiatric comorbidity were in fact identified to meet MINI criteria for a psychiatric disorder. The sensitivity and specificity for any self-reported psychiatric diagnoses were 25.5% (95% CI 21.3, 30.0) and 78.9% (95% CI 73.6, 83.6), respectively. Conclusions Our findings raise questions about the utility of self-reported psychiatric comorbidity in patients with OUD, particularly in the context of low sensitivity of self-reported diagnoses. Several factors may contribute to this including remittance and relapse of some psychiatric illnesses, underdiagnosis, and the challenge of differentiating psychiatric and substance-induced disorders. These findings highlight that other methods should be considered in order to identify comorbid psychiatric disorders in patients with OUD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sensitivity and specificity of self-reported psychiatric diagnoses amongst patients treated for opioid use disorder

Leung

Rosic

et al. 2021

BMC Psychiatry

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“…4,5 Since 2019, opioid overdoses have increased 30%. 6 While overdose is a common cause of death in those with opioid dependence, opioid dependence is also associated with increased risk of suicide, cancer, and cardiovascular disease. 5,7,8 Opioid agonist treatment, also known as medication-assisted therapy, is a promising management strategy for those with opioid dependence, with the World Health Organization recommending methadone and buprenorphine as essential medications for opioid agonist treatment as these medications may reduce the risk of overdose and thus mortality.…”

Section: Commentarymentioning

confidence: 99%

Is Opioid Agonist Treatment Associated With Reduced Risk of Overall and Cause-Specific Mortality in Opioid-Dependent People?

Long¹,

Gottlieb²

2021

Annals of Emergency Medicine

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“…Since the onset of the opioid epidemic two decades ago, half a million Americans have perished from opioid overdose ( Wen & Sadeghi, 2020 ; Wilson et al, 2020 ). In the first 12 months of the COVID-19 pandemic (March 2020 through February 2021), the Centers for Disease Control and Prevention ( CDC, COVID Data Tracker, 2021 ) reported a similar number succumbed to the coronavirus in a fraction of the time.…”

Section: Introductionmentioning

confidence: 99%

The COVID-19 pandemic and opioid use disorder: Expanding treatment with buprenorphine, and combining safety precautions with telehealth

Cales¹,

Cales²,

Shreffler

et al. 2022

Journal of Substance Abuse Treatment

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Background This study investigated the efficacy and safety of providing medication for opioid use disorder (MOUD) and individualized telehealth in Kentucky, a state severely impacted simultaneously by the opioid epidemic and the COVID-19 pandemic. Methods The investigation analyzed pre- and post-COVID-19 characteristics in 191 opioid use disorder (OUD) buprenorphine outpatients who completed an 18-question survey in late 2020 related to COVID testing, OUD relapses, obstacles to maintaining abstinence, and treatment resources. Results The study revealed no statistically significant changes in drug use before and after the onset of the COVID-19 pandemic despite monthly volume increases. Results further demonstrated statistically significant barriers to treatment, including loss of housing and transportation, food insecurity, and onset of depression. No patients required hospitalization or succumbed to OUD or COVID-19. Potentially effective resource utilization findings included clinic transportation and 24/7 crisis intervention. Respondents rated telehealth as helpful when used in an individualized hybrid model matching patient's need to available resources based on COVID-19 safety guidelines. Conclusion This report yields key clinical insights into providing outpatient MOUD care during the COVID-19 pandemic, validating in-person care as both safe and effective. Patients' experiences proved helpful in identifying and quantifying obstacles to abstinence in conjunction with facilitating continued patient access to essential clinical resources. Notably, telehealth can supplement rather than replace in-person treatment.

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The opioid crisis and the 2020 US election: crossroads for a national epidemic

Cited by 20 publications

References 7 publications

Sensitivity and specificity of self-reported psychiatric diagnoses amongst patients treated for opioid use disorder

Sensitivity and specificity of self-reported psychiatric diagnoses amongst patients treated for opioid use disorder

Is Opioid Agonist Treatment Associated With Reduced Risk of Overall and Cause-Specific Mortality in Opioid-Dependent People?

The COVID-19 pandemic and opioid use disorder: Expanding treatment with buprenorphine, and combining safety precautions with telehealth

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