Journal of addiction medicine
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Despite inconclusive evidence that prescription drug monitoring programs (PDMP) reduce opioid-related mortality, guidelines recommend PDMP review with opioid prescribing. Some reported barriers to use include time-consuming processes to obtain data and workflow disruptions. ⋯ Further study of PDMP-EHR integration programs on patient and clinician outcomes may illuminate the role of this technology in public health and in clinical practice.
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Multiple states have reported increases in opioid overdose deaths during the coronavirus disease 2019 (COVID-19) pandemic, however little is known about opioid-related presentations to the emergency department (ED). ⋯ Despite reductions in overall ED visit volumes and alcohol-related visits during COVID-19, the number of opioid-related visits was not significantly reduced during the early pandemic. These data reinforce the need to provide comprehensive treatment services for opioid use disorder during the co-occurring COVID-19 and opioid crises.
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North America is in the midst of an overdose crisis, with up to 130 Americans dying daily from a preventable drug overdose. Opioids account for 70% of overdose deaths. Despite government efforts to improve access to opioid use disorder (OUD) treatment and the implementation of various harm reduction initiatives, overdose mortality remains unacceptably high. ⋯ TiOAT is suitable for individuals with severe OUD who are actively injecting opioids and are refractory to conventional OUD treatment. As such, a scale-up of the TiOAT program may be a feasible alternative to address persistent opioid-related deaths in North America, while minimizing potential harms associated with unwitnessed safer supply opioid prescribing (eg, diversion and overdose). Although a comprehensive evaluation of TiOAT is of critical importance (including an assessment of the program's adverse events), completion of the evaluation should not preclude scale-up of the program in the interim as a strategy to reduce opioid-related harms.
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Emergency department (ED) initiated opioid use disorder (OUD) care is effective; however, real-world predictors of patient engagement are lacking. ⋯ Initiating treatment for OUD in the ED was associated with increased engagement in outpatient addiction care.
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To examine the longitudinal relationships between US adolescents' prescription opioid use and misuse and any subsequent heroin use in adulthood. ⋯ There is increased risk for heroin use among adolescents who initiated nonmedical misuse or adolescents prescribed opioids in more recent cohorts. These findings indicate historical variation and reinforce the critical role of vigilant monitoring and drug screening to detect high-risk individuals who would benefit from an intervention to reduce later heroin use.