The prescription opioid epidemic in developed versus underdeveloped countries: Is there a happy medium?

2016 ◽  
Vol 12 (2) ◽  
pp. 93 ◽  
Author(s):  
Roland N. Kaddoum, MD ◽  
Doralina L. Anghelescu, MD ◽  
Cynthia Karam ◽  
Marie T. Aouad, MD ◽  
Eveline Hitti, MD, MBA

No abstract

2019 ◽  
Vol 94 (12) ◽  
pp. 2437-2443 ◽  
Author(s):  
Thomas J. Hwang ◽  
Michael S. Sinha ◽  
Chintan V. Dave ◽  
Aaron S. Kesselheim

2019 ◽  
Vol 15 (12) ◽  
pp. e997-e1009 ◽  
Author(s):  
Virginia T. LeBaron ◽  
Fabian Camacho ◽  
Rajesh Balkrishnan ◽  
Nengliang (Aaron) Yao ◽  
Aaron M. Gilson

PURPOSE: A key challenge regarding the current opioid epidemic is understanding how concerns regarding opioid-related harms affect access to pain management, an essential element of cancer care. In certain regions of the United States where disproportionately high cancer mortality and opioid fatality rates coexist (such as southwest Virginia in central Appalachia), this dilemma is particularly pronounced. METHODS: This longitudinal, exploratory, secondary analysis used the Commonwealth of Virginia All Payer Claims Database to describe prescription opioid medication (POM) prescribing patterns and potential harms for adult patients with cancer living in rural southwest Virginia between 2011 and 2015. Descriptive and inferential statistical analyses were conducted at the patient, prescriber, and prescription levels to identify patterns and predictors of POM prescribing and potential harms. To explore geographic patterns, choropleth and heat maps were created. RESULTS: Of the total sample of patients with cancer (n = 4,324), less than 25% were prescribed a Controlled Substance Schedule II POM at least three times in any study year. More than 60% of patients never received a Controlled Substance Schedule II POM prescription. Six hundred fifty-two patients (15.1%) experienced 1,599 hospitalizations for any reason; 10 or fewer patients were admitted for 11 opioid use disorder–related hospitalizations. The main findings suggest potential undertreatment of cancer-related pain; no difference in risk for opioid-related hospitalization on the basis of frequency of POM prescriptions; and geographic disparities where opioid overdoses are occurring versus where POM prescription use is highest. CONCLUSION: These findings have significant opioid policy and practice implications related to the need for cancer-specific prescribing guidelines, how to optimally allocate health delivery services, and the urgent need to improve data interoperability and access related to POMs.


2018 ◽  
Vol 67 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Sheila A. Higgins ◽  
Jill Simons

The opioid epidemic is a national public health crisis. It began with the misuse of commonly used prescription opioid pain relievers and has led to the increased use of heroin and illicit fentanyl. Large-scale initiatives have begun on the federal and state level and place an emphasis on improved opioid prescribing, which have important implications for the workplace. Treatment of work injury may initiate the use of prescription opioids and result in misuse and possible overdose. Prescription drug abuse affects all aspects of society so potentially any workplace could be affected. A multifaceted approach is needed to reduce opioid morbidity and mortality and the occupational health nurse should be actively involved. The intent of this article is to provide an overview of the epidemic and its impact on health, the challenges for the workplace, and recommended strategies for the occupational health nurse to impact the problem.


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