Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants — United States, 2015–2016

Seth, Puja; Scholl, Lawrence; Rudd, Rose A.; Bacon, Sarah

doi:10.15585/mmwr.mm6712a1

Cited by 720 publications

(305 citation statements)

References 9 publications

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“…There was an increase of 77% between 2011-2012 to 2015-16. This is consistent with national CDC estimates of rapidly increasing OUD-related deaths, noted to be 28,647, 33,091 and 42,249 in 2014, 2015 and 2016, respectively [1,6]. The 47% increase in OUD-related mortality from 2014 to 2016 was alarming [6].…”

Section: Discussionsupporting

confidence: 86%

“…The opioid epidemic is associated with significant mortality with calls for action to end the epidemic [4,5]. Based on national vital statistics data, the Centers for Disease Control (CDC) reported that 28,647 opioid-related deaths in 2014 that increased to 33,091 in 2015 (16% increase) [1], and to 42,249 deaths in 2016 (47% increase) [6]. The opioid overdose death rate increased from 2000 to 2014 [3] and continued the upward trend, increasing from 9.0 per 100,000 in 2014 to 10.4 in 2015 [1].…”

Section: Introductionmentioning

confidence: 99%

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National U.S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality

Singh

Cleveland

2020

PLoS ONE

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BackgroundThe opioid epidemic is a major public health crisis in the U.S. Contemporary data on opioid use disorder (OUD) related hospitalizations are needed. Our objective was to assess whether OUD hospitalizations and associated mortality are increasing over time and examine the factors associated healthcare utilization and mortality. OPEN ACCESSCitation: Singh JA, Cleveland JD (2020) National U. S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality. PLoS ONE 15(2): e0229174. https://doi.org/10.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

National U.S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality

Singh

Cleveland

2020

PLoS ONE

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“…The presence of SUD, such as alcohol or drug use disorder, may also interfere with an individual’s self-care behaviors, affect adherence to treatment regimen, or exacerbate existing medical diseases, thereby increasing disease complications, healthcare resource utilization (e.g., hospitalization), or mortality (Ducat et al, 2014; Ghitza et al, 2013; McLellan et al, 2014; Thorpe et al, 2017). In particular, drug misuse problems (e.g., illicit opioids, stimulants) and the opioid epidemic have been escalating in the United States (CDC, 2018; Seth et al, 2018). Opioid use disorder in the United States was the 11 th leading cause of disability in 1990, and it became the seventh leading cause in 2016 (U.S.…”

Section: Introductionmentioning

confidence: 99%

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Zhu

Ghitza

2018

Drug and Alcohol Dependence

111

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Background: Chronic diseases are prevalent and the leading causes of mortality. Comorbidity of substance use disorders (SUDs) and chronic diseases is understudied to inform behavioral healthcare integration. Objectives: This study leveraged electronic health record (EHR) data of 211,880 adults from a large health system to examine prevalence and correlates of comorbidity of SUDs and nine chronic disease groups and to determine their association with hospitalization. Methods: Logistic regression analyses were conducted to estimate associations between chronic diseases and SUDs. To control for severity of diagnosis, analyses of associations between SUD and hospitalization were stratified by the number of chronic conditions. Results: In the sample, 48.3% had ≥1 chronic condition (hypertension 33.7%, arthritis 16.2%, diabetes 13.7%, chronic kidney disease 9.9%, asthma 9.1%, chronic obstructive pulmonary disease 8.9%, ischemic heart disease 8.3%, cancer 4.6%, and hepatitis 1.3%). Prevalence of SUD (overall 13.3%) among patients increased with multiple chronic conditions (14.3% having SUD among patients with one condition; 21.2% having SUD among patients with two to three conditions; and 32.5% having SUD among patients with 4–9 conditions). Chronic conditions were associated with increased odds of SUDs. For all SUD groups, hospitalization was more prevalent among patients with SUD than those without it; prevalence of hospitalization increased with the number of comorbid chronic conditions. Conclusions: Findings reveal a striking pattern of multicomorbidity of SUD and chronic diseases and its positive association with hospitalization. Behavioral healthcare integration should consider efforts to assess and treat comorbid SUD and chronic diseases, especially among adults with multiple chronic conditions.

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“…There has been a marked increase in opioid prescription and related deaths in the past decade (Han et al, 2017;Seth, Scholl, Rudd, & Bacon, 2018). More than a third of American adults used a prescription opiate in 2015 alone, and prescription opioid overdose deaths were more than quadrupled between 1999 and 2015 in the USA (Han et al, 2017;Seth et al, 2018). Opioid-related deaths are mostly caused by respiratory arrest and often occur during sleep, where ventilation is primarily regulated by autonomic neurochemical control (Bailey et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

The effect of acute exposure to morphine on breathing variability and cardiopulmonary coupling in men with obstructive sleep apnea: A randomized controlled trial

Wang

Rowsell

et al. 2019

Journal of Sleep Research

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Opioid‐related deaths from respiratory depression are increasing but there is only limited information on the effect of morphine on breathing during sleep. This study aimed to detect and quantify opioid‐induced cardiorespiratory pattern changes during sleep in obstructive sleep apnea (OSA) patients using novel automated methods and correlate these with conventional polysomnography (PSG) measures. Under a randomized double‐blind placebo‐controlled crossover design, 60 male OSA patients attended two one‐night visits to the sleep laboratory, at least a week apart. Either a 40‐mg controlled‐release oral morphine dose or placebo was administered. Breathing during sleep was measured by standard in‐laboratory PSG. We analysed the inter‐breath interval (IBI) from the PSG flow channel to quantify breathing irregularity. Cardiopulmonary coupling (CPC) was analysed using the PSG electrocardiogram (ECG) channel. Following the consumption of morphine, the 60 OSA patients had fewer breaths (p = .0006), a longer inter‐breath interval (p < .0001) and more irregular breathing with increased IBI coefficient of variation (CV) (p = .0015) compared to the placebo night. A higher CPC sleep quality index was found with morphine use. The change of key IBI and CPC parameters was significantly correlated with the change of key PSG sleep‐disordered breathing parameters. In conclusion, 40 mg controlled‐release morphine resulted in a longer breathing cycle and increased breathing irregularity but generally more stable sleep in OSA patients. The significant links between the IBI and CPC techniques and a range of PSG sleep‐disordered breathing parameters may suggest a practical value as surrogate overnight cardiorespiratory measurements, because both respiratory flow and ECG can be detected by small portable devices.

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Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants — United States, 2015–2016

Cited by 720 publications

References 9 publications

National U.S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality

National U.S. time-trends in opioid use disorder hospitalizations and associated healthcare utilization and mortality

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

The effect of acute exposure to morphine on breathing variability and cardiopulmonary coupling in men with obstructive sleep apnea: A randomized controlled trial

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