Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018

Wilson, Nana O.; Kariisa, Mbabazi; Seth, Puja; Smith, H. W.; Davis, Nicole L.

doi:10.15585/mmwr.mm6911a4

Cited by 982 publications

(845 citation statements)

References 7 publications

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“…Each phase of involvement in the criminal legal system-from the point of crisis before arrest, through detention, and after release-is an opportunity to better address SUD and mental health challenges. This means that criminal legal institutions must (1) screen and diagnose, (2) treat, (3) monitor and support, and (4) triage individuals to appropriate health care and prevention services. Other researchers have developed a model for using key inflection points to help provide necessary health care along a five-phase continuum.…”

Section: Reversing the Criminalization Of Pwudmentioning

confidence: 99%

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Park

Rouhani

Beletsky³

et al. 2020

Milbank Quarterly

110

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This article reconceptualizes our understanding of the opioid epidemic and proposes six strategies that address the epidemic's social roots. In order to successfully reduce drug‐related mortality over the long term, policymakers and public health leaders should develop partnerships with people who use drugs, incorporate harm reduction interventions, and reverse decades of drug criminalization policies. Context Drug overdose is the leading cause of injury‐related death in the United States. Synthetic opioids, predominantly illicit fentanyl and its analogs, surpassed prescription opioids and heroin in associated mortality rates in 2016. Unfortunately, interventions fail to fully address the current wave of the opioid epidemic and often omit the voices of people with lived experiences regarding drug use. Every overdose death is a culmination of a long series of policy failures and lost opportunities for harm reduction. Methods In this article, we conducted a scoping review of the opioid literature to propose a novel framework designed to foreground social determinants more directly into our understanding of this national emergency. The “continuum of overdose risk” framework is our synthesis of the global evidence base and is grounded in contemporary theories, models, and policies that have been successfully applied both domestically and internationally. Findings De‐escalating overdose risk in the long term will require scaling up innovative and comprehensive solutions that have been designed through partnerships with people who use drugs and are rooted in harm reduction. Conclusions Without recognizing the full drug‐use continuum and the role of social determinants, the current responses to drug overdose will continue to aggravate the problem they are trying to solve.

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Section: Reversing the Criminalization Of Pwudmentioning

confidence: 99%

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Park

Rouhani

Beletsky³

et al. 2020

Milbank Quarterly

110

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…In the last decade, opioid use disorder has reached epidemic proportions in the United States with a highly significant increase in overdose deaths from opioids, synthetic opioids, and heroin (Wilson et al, 2020). The Center of Disease Control and Prevention estimates nearly 68,000 drug overdose deaths in 2018 (Wilson et al, 2020). Furthermore, inner city low-income populations are more likely to misuse opioids and have opioid use disorder than the general population (Altekruse et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Chronic Developmental Lead Exposure increases μ-Opiate Receptor Levels in the Adolescent Rat Brain

Albores-García

McGlothan

Bursac

et al. 2020

Preprint

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Opioid use and abuse has reached epidemic proportion in the United States resulting in a significant numbers of deaths due to overdose. While environmental factors are implicated in opioid addiction, less is known about the role of exposure to environmental pollutants on the brain opioid system. Human and preclinical studies have suggested an association between childhood lead (Pb 2+ ) intoxication and proclivity to substance abuse and delinquent behavior. Opioid receptors are involved in the biological effects of opioids and other drugs of abuse. In this study, we examine the effect of chronic developmental Pb 2+ exposure on µ-opioid receptor (MOR) levels in the rat brain using [ 3 H]-D-Ala2-MePhe4-Gly-ol5 enkephalin ([ 3 H]-DAMGO) quantitative receptor autoradiography.Our results indicate that chronic developmental Pb 2+ exposure increases the levels of [ 3 H]-DAMGO specific binding to MOR in several limbic regions of the brain in male and female rats during the pre-adolescence (PN14) and early-adolescence (PN28) period. These changes were less pronounced in late-adolescence (PN50) and adult (PN120) animals. Our findings are important because the pre-adolescence and early adolescence period is a time in which there is higher engagement in reward and drug seeking behaviors in humans.In summary, we show that chronic exposure to Pb 2+ an ubiquitous and well-known environmental contaminant and neurotoxicant, alters MOR levels in brain regions associated with addiction circuits in the adolescent period with important implications to opioid drug use and abuse.

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“…Over the last decade, the widespread abuse of prescription painkillers, such as oxycodone and hydrocodone, has led to a dramatic increase in the incidence of opioid use disorder (OUD) in North America 1 . The extent of the crisis is such that opioids account for more than 60% of all drug overdoses in the United States, with an estimated 47 000 to 50 000 fatalities annually.…”

Section: Introductionmentioning

confidence: 99%

“…The extent of the crisis is such that opioids account for more than 60% of all drug overdoses in the United States, with an estimated 47 000 to 50 000 fatalities annually. Synthetic opioids, such as fentanyl, are the major drivers of opioid overdose 1,2 . Unfortunately, current therapeutic options for OUD are highly unsatisfactory.…”

Section: Introductionmentioning

confidence: 99%

The 5α-reductase inhibitor finasteride reduces opioid self-administration

Bossé

Cadeddu

Floris

et al. 2020

Preprint

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Opioid use disorder (OUD) has become a leading cause of death in the US, yet current therapeutic strategies remain highly inadequate. To identify novel potential treatments for OUD, we screened a targeted selection of over 100 drugs, using a recently developed opioid self-administration assay in zebrafish. This paradigm showed that finasteride, a steroidogenesis inhibitor approved for the treatment of benign prostatic hyperplasia and androgenetic alopecia, reduced self-administration of multiple opioids without affecting locomotion or feeding behavior. These findings were confirmed in rats; furthermore, finasteride did not interfere with the antinociceptive effect of opioids in rat models of neuropathic pain. Steroidomic analyses of the brains of fish treated with finasteride revealed a significant increase in dehydroepiandrosterone sulfate (DHEAS). Treatment with precursors of DHEAS reduced opioid self-administration in zebrafish, in a fashion akin to the effects of finasteride. Our results highlight the importance of steroidogenic pathways as a rich source of therapeutic targets for OUD and point to the potential of finasteride as a new option for this disorder.

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Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018

Cited by 982 publications

References 7 publications

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework

Chronic Developmental Lead Exposure increases μ-Opiate Receptor Levels in the Adolescent Rat Brain

The 5α-reductase inhibitor finasteride reduces opioid self-administration

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