Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998–2012

McGinty, Emma E.; Kennedy-Hendricks, Alene; Baller, Julia; Niederdeppe, Jeff; Gollust, Sarah E.; Barry, Colleen L.

doi:10.1176/appi.ps.201500065

Cited by 88 publications

(77 citation statements)

References 43 publications

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“…In a sense, overdose deaths represent the public face of the prescription opioid crisis. Previous research has documented greater media coverage over time as rates of opioid-related mortality have increased (Dasgupta et al, 2009; McGinty et al, 2016). In such an environment, physicians may perceive that there will be sufficient patients to warrant obtaining a buprenorphine waiver.…”

Section: Discussionmentioning

confidence: 99%

“…As noted by Rogers (2003) in his classic work, Diffusion of Innovations , innovations are more likely to spread when there is a perceived need for change. Media attention and public awareness regarding the prescription opioid crisis has increased over time (Barry et al, 2016; McGinty et al, 2016), which may increase the perceived need for solutions among physicians in states with greater rates of overdose mortality. These implementation frameworks offer one rationale for why the rates of growth in buprenorphine physicians may be greater in states with high rates of prescription opioid overdose mortality.…”

Section: Introductionmentioning

confidence: 99%

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Buprenorphine physician supply: Relationship with state-level prescription opioid mortality

Knudsen

Havens

Lofwall

et al. 2017

Drug and Alcohol Dependence

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Background Buprenorphine is an effective treatment for opioid use disorder but the supply of buprenorphine physicians is currently inadequate to address the nation’s prescription opioid crisis. Perception of need due to rising opioid overdose rates is one possible reason for physicians to adopt buprenorphine. This study examined associations between rates of growth in buprenorphine physicians and prescription opioid overdose mortality rates in US states. Methods The total buprenorphine physician supply and number of physicians approved to treat 100 patients (per 100,000 population) were measured from June, 2013 to January, 2016. States were divided into two groups: those with rates of prescription opioid overdose mortality in 2013 at or above the median (>5.5 deaths per 100,000 population) and those with rates below the median. State-level growth curves were estimated using mixed-effects regression to compare rates of growth between high and low overdose states. Results The total supply and the supply of 100-patient buprenorphine physicians grew significantly (total supply from 7.7 to 9.9 per 100,000 population, p<.001; 100-patient supply from 2.2 to 3.4 per 100,000 population, p<.001). Rates of growth were significantly greater in high overdose states when compared to low overdose states (total supply b=.033, p<.01; 100-patient b=.022, p<.01). Conclusions The magnitude of the US prescription opioid crisis, as measured by the rate of prescription opioid overdose mortality, is associated with growth in the number of buprenorphine physicians. Because this observational design cannot establish causality, further research is needed to elucidate the factors influencing physicians’ decisions to begin prescribing buprenorphine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Buprenorphine physician supply: Relationship with state-level prescription opioid mortality

Knudsen

Havens

Lofwall

et al. 2017

Drug and Alcohol Dependence

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“…America’s public perception of OUD has been framed more often as a criminal justice issue than a treatable health condition. (72) However, the opioid-led drug overdose epidemic (73) and more recent evidence of individuals transitioning from prescription opioid use to heroin use (74–77) have led to calls to improve access to treatment, including a recent Presidential Memorandum. (16, 78–81) Far more individuals are in need of OUD treatment than can access it; (82) the primary reasons include lack of accessibility or availability as well as treatment costs, (37, 82) and as our findings have shown, individuals with OUD spend most of their time out of treatment.…”

Section: Discussionmentioning

confidence: 99%

The costs of crime during and after publicly funded treatment for opioid use disorders: a population‐level study for the state of California

et al. 2017

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Background and aims Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly-funded treatment for OUD to compare total costs of crime over a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification. Design Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Setting Publicly-funded drug treatment facilities in California, USA (2006–2010). Participants 31,659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women, and 37.1% primarily used prescription opioids. Measurements Daily costs of crime (2014$US) were calculated from a societal perspective and were composed of the costs of policing, court, corrections, and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Findings Daily costs of crime during treatment compared with after treatment were $126 lower for OAT (95% CI: $116, $136) and $144 lower for detoxification ($135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17,550 ($16,840, $18,383). Conclusions In publicly-funded drug treatment facilities in California USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the six months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment.

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“…Throughout the survey, we used the term "prescription pain medication" to refer to OPRs as a means of facilitating comprehension among respondents by reproducing the conventional language used in media coverage. 25 OPRs were described to differentiate them from nonprescription pain medications (eg, Tylenol); respondents could view a list of generic and trademarked OPRs (Supplemental Information A). A $5 cash equivalent was earned for completing the survey, which was fielded between February 24 and March 16, 2015.…”

Section: Methodsmentioning

confidence: 99%

Safe Storage of Opioid Pain Relievers Among Adults Living in Households With Children

McDonald¹,

Kennedy-Hendricks²,

McGinty

et al. 2017

Pediatrics

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OBJECTIVES: To describe safe storage practices and beliefs among adults who have used a prescription opioid pain reliever (OPR) in the past year; to compare practices and beliefs among those living with younger (<7 years) versus older children (7-17 years). METHODS:A survey was administered to a nationally representative sample of adults reporting OPR use in the previous 12 months and who had children <18 years old living with them. We used Health Belief Model-derived items to measure beliefs. Safe storage was defined as locked or latched for younger children and as locked for older children. Regression models examined the association between beliefs and safe storage practices. RESULTS:Among 681 adults who completed our survey and reported having children in their home, safe storage was reported by 32.6% (95% confidence interval [CI], 21.4-43.8) of those with only young children, 11.7% (95% CI, 7.2-16.2) among those with only older children, and 29.0% (95% CI, 18.3-39.8) among those with children in both age groups. Among those asked to answer survey questions thinking about only their oldest child, the odds of reporting safe storage decreased by half as perceived barriers increased (0.505; 95% CI, 0.369-0.692), increased twofold as efficacy increased (2.112; 95% CI, 1.390-3.210), and increased (1.728; 95% CI, 1.374-2.174) as worry increased. CONCLUSIONS:OPRs are stored unsafely in many households with children. Educational messages should address perceived barriers related to safe storage while emphasizing how it may reduce OPR access among children.

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Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998–2012

Abstract: Findings underscore the need for a concerted effort to reframe opioid analgesic abuse as a treatable condition addressable via well-established public and behavioral health approaches.

Cited by 88 publications

References 43 publications

Buprenorphine physician supply: Relationship with state-level prescription opioid mortality

Buprenorphine physician supply: Relationship with state-level prescription opioid mortality

The costs of crime during and after publicly funded treatment for opioid use disorders: a population‐level study for the state of California

Safe Storage of Opioid Pain Relievers Among Adults Living in Households With Children

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