The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis

Ciccarone, Daniel

doi:10.1016/j.drugpo.2019.01.010

Cited by 494 publications

(344 citation statements)

References 34 publications

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“…To compensate for lack of access to opioids, people with opioid use disorder may also seek other substances, such as alcohol and benzodiazepines, both of which potentiate overdose risk. These supply-side pressures, which result in an unpredictable and riskier product, combined with reduced tolerance, make each episode of use more likely to result in overdose 4 .…”

mentioning

confidence: 99%

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An overdose surge will compound the COVID-19 pandemic if urgent action is not taken

Wakeman

Green

Rich

2020

Nat Med

116

114

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mentioning

confidence: 99%

“…We must first act quickly to stave off a substantial increase in overdoses, an impending crisis on top of a crisis. ❐ Sarah E. Wakeman 1,2 ✉ , Traci C. Green 3,4 and Josiah Rich 4,5…”

mentioning

confidence: 99%

An overdose surge will compound the COVID-19 pandemic if urgent action is not taken

Wakeman

Green

Rich

2020

Nat Med

116

114

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“…Opioid overdose deaths are often the result of a previous history of substance abuse, which often starts between the ages of 18 to 25 years 16 . Adolescents with a family history of substance abuse are 10-fold more likely to suffer drug abuse disorders in the future than other individuals 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Our results suggest notable disparity among gender and racial groups. This could be due to the opioid overdose epidemic following a temporal trend that is comprised of three waves 14,16 . Briefly, the first wave of the opioid overdose epidemic, from 1970 to 1999, was driven by heroin overdoses, which showed a larger burden centered in the black population.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and geospatial profile of the prescription opioid crisis in Ohio, United States

Hernández

Branscum

et al. 2020

Sci Rep

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The underlying reasons behind the unprecedented increase of the mortality rates due to the opioid epidemics in the United States are still not fully uncovered. Most efforts have been focused on targeting opioids, but there is little information about vulnerable populations at high risk of opioid abuse and death. In this study, we used data from the Ohio Department of Health for deaths caused by prescription opioids from 2010-2017 to analyze the spatiotemporal dynamics of the opioid overdose epidemic. Our results showed a rapid increase in prescription opioid death rates among the white male population aged 30-39 but also a considerable increase among the black male population with an exponential growth trend. Our geospatial analysis suggests that the increasing rates of the opioid overdose epidemic in Ohio were driven by the epidemic hotspot areas. Our findings highlight the relevance of prioritizing public health measures targeting specific locations and vulnerable populations to mitigate the current opioids crisis.The United States (US) is currently experiencing an opioid overdose crisis with an unprecedented magnitude. Adjusted for age, the opioid-related death rate of 21.7 deaths per 100,000 people in 2017, and 20.7 in 2018 were the highest worldwide 1 . According to the Centers for Disease Control and Prevention (CDC), 67,367 deaths by drug overdose occurred in the US during 2018, and 351,564 deaths were related to opioids resulting in 0.36 years of life expectancy lost in 2016 1,2 . The major cause of death among people under 50 years old in the US in 2017 was drug overdose, exceeding the rates of death caused by motor vehicle and firearms 3 . Opioids have become a widespread cause of accidental fatal overdose, which historically were attributed to heroin and prescription opioid pain relievers. Recent reports show that overdoses caused by synthetic opioids (e.g., fentanyl and analogues) are emerging as a national public health emergency, as declared by the US Department of Health and Human Services in 2018 4 .National data on opioid overdose mortality rates show that the epidemic is not homogenously distributed within the US. Twenty states and the District of Columbia have reported age-adjusted drug mortality rates that are statistically higher than the national rate. Among these, West Virginia (51.5 deaths per 100,000 inhabitants), Delaware (43.8), Maryland (37.2), Pennsylvania (36.1.3), Ohio (35.9), and New Hampshire (35.8) had the highest age-adjusted drug overdose rates in 2018 1 . Moreover, Ohio is one of eight states with a doubling of the opioid mortality rate every three years from 1999 to 2016, and recently has experienced an unprecedented number of deaths caused by unintentional drug overdose, especially deaths caused by synthetic opioids 2,5 . Specifically, there was a 169% increase from 1,544 deaths in 2010 to 4,157 deaths in 2017, and approximately 13,000 overdose events reversed by the use of naloxone.Several reasons are attributed to the geographical disparity of the opioid overdose mortality...

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“…Although multiple data sources suggest that illicit high potency opioid use remains a North American problem for now [16], the implications for treatment are relevant to clinicians, researchers and policy makers globally in their efforts towards preparedness for potent synthetic opioids such as IMF. SHALINI ARUNOGIRI 1,2…”

mentioning

confidence: 99%

Opioid agonist treatment in the time of fentanyl: What can we learn from emerging evidence?

Arunogiri

Nielsen

2020

Drug and Alcohol Review

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The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis

Cited by 494 publications

References 34 publications

An overdose surge will compound the COVID-19 pandemic if urgent action is not taken

An overdose surge will compound the COVID-19 pandemic if urgent action is not taken

Epidemiological and geospatial profile of the prescription opioid crisis in Ohio, United States

Opioid agonist treatment in the time of fentanyl: What can we learn from emerging evidence?

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