Rural communities face more than an opioid crisis: Reimagining funding assistance to address polysubstance use, associated health problems, and limited rural service capacity

Mun, Carolyn Carpenedo; Schuler, Heather; Baker, Robin; Byrne, Fraser Rothenberg; Bresani, Elena; Meyers, Kathleen N.

doi:10.1111/jrh.12743

Cited by 7 publications

(2 citation statements)

References 38 publications

(87 reference statements)

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“…However, their effectiveness does not come without a price, as it is well-documented that with prolonged use of this class of analgesics, individuals are at a higher risk for developing opioid abuse, addiction, and dependence. The resulting opioid crisis has plagued the United States since the 1990s and continues to worsen each year, with opioid-involved overdose deaths reaching a new high of 80,411 across all ages [ 12 ]. Unfortunately, the opioid crisis cannot simply be fixed by removing these analgesics [ 7 ].…”

Section: Therapeutic Potential Of Chronic Pain Biomarkersmentioning

confidence: 99%

Kynurenine Pathway Metabolites as Potential Biomarkers in Chronic Pain

et al. 2023

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Chronic pain is a pressing medical and socioeconomic issue worldwide. It is debilitating for individual patients and places a major burden on society in the forms of direct medical costs and lost work productivity. Various biochemical pathways have been explored to explain the pathophysiology of chronic pain in order to identify biomarkers that can potentially serve as both evaluators of and guides for therapeutic effectiveness. The kynurenine pathway has recently been a source of interest due to its suspected role in the development and sustainment of chronic pain conditions. The kynurenine pathway is the primary pathway responsible for the metabolization of tryptophan and generates nicotinamide adenine dinucleotide (NAD+), in addition to the metabolites kynurenine (KYN), kynurenic acid (KA), and quinolinic acid (QA). Dysregulation of this pathway and changes in the ratios of these metabolites have been associated with numerous neurotoxic and inflammatory states, many of which present simultaneously with chronic pain symptoms. While further studies utilizing biomarkers to elucidate the kynurenine pathway’s role in chronic pain are needed, the metabolites and receptors involved in its processes nevertheless present researchers with promising sources of novel and personalized disease-modifying treatments.

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Section: Therapeutic Potential Of Chronic Pain Biomarkersmentioning

confidence: 99%

Kynurenine Pathway Metabolites as Potential Biomarkers in Chronic Pain

et al. 2023

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“…Rural communities have been the epicenter of the opioid epidemic for decades, through the various waves of the opioid epidemic that have affected the United States across various demographics [ 26 ]. The strain of treating OUD puts rural hospitals in a precarious position due to the lack of experienced professionals who can effectively treat the condition as well as the expensive nature of the materials required for treatment.…”

Section: Reviewmentioning

confidence: 99%

The Opioid Epidemic: A Review of the Contributing Factors, Negative Consequences, and Best Practices

Judd¹,

King²,

Galke³

2023

Cureus

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The opioid epidemic is a significant public health crisis that has caused extensive harm and devastation in the United States. This literature review aimed to identify the contributing factors and negative consequences of the epidemic, as well as best practices for healthcare providers in managing the epidemic. Overprescribing opiates and opioids, lack of education and opportunity, and being unmarried or divorced were some of the identified contributing factors to dependence on opioids. The epidemic's negative consequences are substantial, leading to increased access to opioids for vulnerable populations, which consequently cause accidental death among men and the degradation of rural community health services. As part of the literature review, we also analyzed the best practices for healthcare providers, including implementing prescription drug monitoring programs (PDMPs). However, we found that while PDMPs resulted in a decrease in opioid overprescription and an increase in provider confidence when prescribing medication, the evidence for their effectiveness in improving rural community health services or reducing opioid overdoses and opioid-related deaths was inconclusive. Our review highlights that the greatest challenge to overcome is a lack of legal mandates and proper education for healthcare providers on best practices for addressing the epidemic. To regulate and control opioids effectively, tracking and standardizing prescription models by federal agencies and medical institutions is necessary but not enough. Legal action is vital for the successful containment of the opioid crisis.

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