Mortality Associated With Opioid Overdose: A Review of Clinical Characteristics and Health Services Received in the Year Prior to Death

Rose, Christian; Shahanaghi, Abtin; Romero-Gonzalez, Mauricio; Yarzebski, Jorge; Andre, Michael; DiGirolamo, Gregory J.; Brown, Alan; González, Gerardo

doi:10.1176/appi.ps.201800122

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…This report is the first comprehensive examination of the court process during CC hearings for opioid use. Although other researchers have reported gender differences in opioid use 3,17–20 and experiences in the criminal legal system, 22–24 our data suggest that experiences in the CC hearing process for opioid use do not differ substantively by gender. Women in this study reported fewer previous arrests, but prior CC hearings and prior CC rates were comparable with those reported by men.…”

Section: Discussioncontrasting

confidence: 77%

“…Men have higher rates of opioid use, heroin initiation, 17 acute opioid overdose and naloxone receipt, and overdose death compared with women. 3,[18][19][20] Although women may report less severe substance use outcomes compared with men, the widespread availability of prescription and nonprescription opioids has provided an entry point for women to join the at-risk population. Indeed, newer initiates of these opioid types include more women than in the past.…”

mentioning

confidence: 99%

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Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

et al. 2023

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Objectives Civil commitment has increasingly served as a court-based legal intervention for severe opioid use, but little research has examined the civil commitment (CC) hearing process from the perspective of the person who is committed. Despite documented gender differences in opioid use and experiences within the legal system, past research has also not investigated gender differences in perceptions of the CC process for persons who use opioids. Methods Participants were 121 persons (43% female) with opioid use who were interviewed upon arrival at the CC facility about their experience of the CC hearing process in Massachusetts. Results Two thirds of participants were taken to the commitment hearing by police, and 59.5% shared a cell with others while waiting. Overall, the commitment intake process at the courthouse took over 5 hours. Participants spent, on average, less than 15 minutes with their lawyer before the hearing, and a majority of CC hearings lasted less than 15 minutes. Once transferred to a CC facility, opioid withdrawal management began within 4 hours. Compared with women, men reported longer wait times between the hearing and transfer, as well as longer wait times for withdrawal management at the facility (P < 0.05). Women perceived worse interactions with the judge and greater dissatisfaction with the commitment process compared with men (P < 0.05). Conclusions There were few gender differences in the experience of CC. However, overall, participants reported a lengthy court process and low levels of perceived procedural justice.

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Section: Discussioncontrasting

confidence: 77%

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confidence: 99%

Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

et al. 2023

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“…The finding that non-fatal overdose was significantly associated with higher average pain interference is concerning, given that non-fatal overdose is a significant predictor of subsequent fatal overdose in PWUD [ 44 ]. In a study that examined characteristics of fatal opioid overdose decedents, the prevalence of mental illness and chronic pain were significantly higher in decedents with non-problematic opioid use—that is, in individuals without a diagnosis of opioid use disorder or evidence of aberrant drug-related behaviours within the year prior to death—compared to decedents with diagnosed problematic opioid use [ 5 ]. Greater attention to this less recognizable undiagnosed group, which constituted 53% of the deaths in the aforementioned study, is warranted given that their risk for overdose may not be as apparent as in individuals demonstrating problematic opioid use.…”

Section: Discussionmentioning

confidence: 99%

“…In light of the ongoing opioid crisis, there is an urgent need for research that identifies risk factors in populations that may be susceptible to high-risk opioid use and overdose, such as individuals with persistent pain. To this end, mental illness has been identified as a determinant of problematic opioid use and opioid overdose [ 5 ], and therefore remains an important area requiring further investigation.…”

Section: Introductionmentioning

confidence: 99%

The effect of depressive symptoms on pain in a substance-using population with persistent pain: a cross-sectional cohort study

et al. 2021

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Background In light of the ongoing opioid overdose crisis, there is an urgent need for research on the impacts of mental health among people presenting with concurrent pain and substance use. This study examined the effect of depressive symptoms on pain severity and functional interference among people who use drugs (PWUD) during a community-wide overdose crisis. Methods From December 1st 2016 to December 31st 2018, 288 participants in two cohort studies of PWUD in Vancouver, Canada completed interviewer-administered questionnaires that included the Brief Pain Inventory and PROMIS Emotional Distress–Depression instruments. Generalized linear regression modelling (GLM) was used to examine the cross-sectional effect of depressive symptoms and other confounding factors on pain severity and interference. Results Moderate to severe depressive symptoms were significantly associated with greater pain-related functional interference (adjusted β = 1.24, 95% confidence interval [CI] = 0.33–2.15), but not significantly associated with greater average pain severity (adjusted β = 0.22, 95% CI = − 0.3 – 0.82), when controlling for confounding variables. Reported daily heroin use (adjusted β = 1.26, 95% CI = 0.47–2.05) and non-fatal overdose (adjusted β = 1.02, 95% CI = 0.08–1.96) were also significantly associated with greater pain-related functional interference. Conclusions In a substance-using population, greater pain-related functional interference was positively associated with depressive symptoms as well as overdose and daily heroin use. These findings emphasize the need to address the functional impact of pain, mental health comorbidity, and high-risk substance use that may contribute to overdose and other harms.

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“…Opioid use disorder (OUD) has emerged as a major health threat in the United States [1][2][3][4][5][6] . Nearly 1% of the population (> 2.5 million persons) suffer from OUD with over 67,367 opioid related deaths reported in 2018 [7][8][9] .…”

mentioning

confidence: 99%

Social vulnerability in persons with chronic hepatitis C virus infection is associated with a higher risk of prescription opioid use

Butt

Yan

Kapadia

et al. 2021

Sci Rep

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Prescription opioid use (POU) is often a precursor to opioid use disorder (OUD) and subsequent consequences. Persons with chronic hepatitis C virus infection (CHC) may be at a higher risk of POU due to a higher comorbidity burden and social vulnerability factors. We sought to determine the burden of POU and associated risk factors among persons with CHC in the context of social vulnerability. We identified CHC persons and propensity-score matched HCV− controls in the electronically retrieved Cohort of HCV-Infected Veterans and determined the frequency of acute, episodic long-term and chronic long-term POU and the prevalence of social vulnerability factors among persons with POU. We used logistic regression analysis to determine factors associated with POU. Among 160,856 CHC and 160,856 propensity-score matched HCV-controls, acute POU was recorded in 38.4% and 38.0% (P = 0.01) respectively. Episodic long-term POU was recorded in 3.9% in each group (P = 0.5), while chronic long-term POU was recorded in 28.4% and 19.2% (P < 0.0001). CHC was associated with a higher risk of chronic long-term POU (OR 1.66, 95%CI 1.63, 1.69), but not with acute or episodic long-term POU. Black race, female sex and homelessness were associated with a higher risk of chronic long-term POU. Presence of ≥ 1 factor was associated with a higher risk of all POU patterns. Persons with CHC have more social vulnerability factors and a higher risk of chronic long-term POU. Presence of ≥ 1 social vulnerability factor is associated with a higher risk of POU. Downstream consequences of POU need further study.

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Mortality Associated With Opioid Overdose: A Review of Clinical Characteristics and Health Services Received in the Year Prior to Death

Cited by 3 publications

References 10 publications

Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

The effect of depressive symptoms on pain in a substance-using population with persistent pain: a cross-sectional cohort study

Social vulnerability in persons with chronic hepatitis C virus infection is associated with a higher risk of prescription opioid use

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