Drug and alcohol dependence
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Drug Alcohol Depend · Jan 2019
Stakeholder perspectives on implementing fentanyl drug checking: Results from a multi-site study.
The opioid epidemic is one of the greatest public health crises of our times, driven increasingly by synthetic opioids such as fentanyl in the heroin supply. The implementation of drug checking in community settings has the potential to reduce the burden of fatal overdose, provide harm reduction education around safer drug consumption, and increase health access among people who use drugs (PWUD). To inform program development, we explored stakeholder opinions on drug checking technologies and implementation considerations. ⋯ Stakeholders overwhelmingly supported the concept of drug checking with the goals of providing needed risk reduction information and resources to PWUD and serving as a point for greater engagement in services. Programs need to be tailored to local circumstances. Law enforcement buy-in and policy change will be critical aspects of providing drug checking services.
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Drug Alcohol Depend · Jan 2019
Recreational marijuana legalization and prescription opioids received by Medicaid enrollees.
Medical marijuana use may substitute prescription opioid use, whereas nonmedical marijuana use may be a risk factor of prescription opioid misuse. This study examined the associations between recreational marijuana legalization and prescription opioids received by Medicaid enrollees. ⋯ No evidence suggested that recreational marijuana legalization increased prescription opioids received by Medicaid enrollees. There was some evidence in some states for reduced Schedule III opioids following the legalization.
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Drug Alcohol Depend · Jan 2019
Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: A national systematic legal review.
Opioid overdose is a continuing public health crisis. In response to an increasing recognition of the negative outcomes sometimes associated with the use of opioid analgesics, states have taken a number of steps attempting to reduce inappropriate prescribing of these medications. These include the imposition of strict legal limitations on the amount or duration that opioid analgesics may be prescribed or dispensed to patients with acute pain. ⋯ Just over half of all states have enacted laws that restrict the prescribing or dispensing of opioids for acute pain. To date, there is no data on whether and to what extent these laws mediate opioid-related morbidity and mortality, as well as whether they are associated with negative unintended outcomes. Research into these questions is urgently needed.
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Drug Alcohol Depend · Jan 2019
Mental health functioning and severity of cannabis withdrawal among medical cannabis users with chronic pain.
To describe patterns of cannabis withdrawal among a large sample of those who use medical cannabis and test the association between withdrawal symptomology and functioning. ⋯ Cannabis withdrawal symptomology is highly prevalent among patients who use medical cannabis at least three times a week. Helping patients recognize the association between poorer functioning and withdrawal may be an effective way to highlight potentially negative consequences of regular and moderate heavy use.
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Drug Alcohol Depend · Jan 2019
Patterns and history of prescription drug use among opioid-related drug overdose cases in British Columbia, Canada, 2015-2016.
British Columbia is the epicenter of the current fentanyl-related overdose crisis in Canada. Our study characterizes prescribing histories of people who had an opioid-related overdose compared to matched controls. ⋯ Low prevalence of active prescriptions for opioids for pain at the time of overdose suggests that opioid prescribing plays a limited short-term impact in the current fentanyl-related crisis of overdoses. While liberal opioid prescribing practices may have contributed to the development of the current overdose crisis, regulation and enforcement of clinicians' prescribing practices will likely have limited impact in reducing overdoses.