The opioid crisis: Origins, trends, policies, and the roles of pharmacists

Chisholm-Burns, Marie A.; Spivey, Christina A.; Sherwin, Erin; Wheeler, James; Hohmeier, Kenneth C.

doi:10.1093/ajhp/zxy089

Cited by 101 publications

(84 citation statements)

References 62 publications

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“…The initiative “Pain as the Fifth Vital Sign” lowered the threshold for medical treatment of pain to any pain score >0. This change has been suggested to be one of the important drivers of the current opioid epidemic which has claimed hundreds of thousands of lives . However, it is important to recognize that the Pain as the Fifth Vital Sign initiative was motivated by compassion for patients and it was events happening in parallel where opioid medicines were misleadingly marketed to doctors, patients and patient advocacy groups that enabled overdefinition to cause so much harm.…”

Section: Overdefinitionmentioning

confidence: 99%

Musculoskeletal healthcare: Have we over‐egged the pudding?

et al. 2019

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The phrase "to over-egg the pudding" is a terrific analogy for what is now increasingly common in health care: medical overuse. Cooks would know that if you skimp with the eggs a pudding won't hold together and if you use too many eggs the pudding will go rubbery.And in musculoskeletal health care we also need to get the balance right. People's health can suffer when they receive too little health care and also if they receive too much health care.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Overdefinitionmentioning

confidence: 99%

Musculoskeletal healthcare: Have we over‐egged the pudding?

et al. 2019

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“…Research on the opioid crisis identifies economic deprivation, overprescribing, and inadequate treatment access as root causes. [51][52][53] This study has shown that lack of relative visibility of critical EMS agency interventions, beyond naloxone administration, could also be a contributing factor. There are also signification gaps in presentation of the outcomes of these programs which could limit replication across other communities.…”

Section: Discussionmentioning

confidence: 88%

Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions

et al. 2020

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“…Among other recommendations, the CDC guideline also suggests prescribing the lowest effective dose of opioids, conducting periodic evaluation of the benefits and harms of opioid therapy in a given patient, and periodically reviewing state prescription drugmonitoring systems to review patients' history of controlled substance prescriptions to assist in decision-making regarding opioid prescription/management [47,48]. Additional recommended strategies include educating and counseling patients concerning appropriate pain management, screening patients for risk of opioid abuse using instruments such as the Opioid Risk Tool, and referring patients to addiction treatment specialists as needed, among other strategies [49]. RTRs, particularly those who use high levels of opioids chronically, would likely also benefit from education about the use of opioid overdose reversal agents such as naloxone [49].…”

Section: Discussionmentioning

confidence: 99%

“…Additional recommended strategies include educating and counseling patients concerning appropriate pain management, screening patients for risk of opioid abuse using instruments such as the Opioid Risk Tool, and referring patients to addiction treatment specialists as needed, among other strategies [49]. RTRs, particularly those who use high levels of opioids chronically, would likely also benefit from education about the use of opioid overdose reversal agents such as naloxone [49].…”

Section: Discussionmentioning

confidence: 99%

Association between Posttransplant Opioid Use and Immunosuppressant Therapy Adherence among Renal Transplant Recipients

Chisholm-Burns

Spivey²,

Potukuchi³

et al. 2020

Nephron

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Introduction: Little is known about the effect of posttransplant opioid use on adherence to immunosuppressant therapy (IST) among adult renal transplant recipients (RTRs). Objective: The aim of this study was to examine the relationship between opioid use and IST adherence among adult RTRs during the first year posttransplant. Methods: Longitudinal data were analyzed from a retrospective cohort study examining US veterans undergoing renal transplant from October 1, 2007, through March 31, 2015. Data were collected from the US Renal Data System, Centers for Medicare and Medicaid Services Data (Medicare Part D), and Veterans Affairs pharmacy records. Dose of opioid prescriptions was collected and divided based on annual morphine milligram equivalent within a year of transplant. Proportion of days covered of greater than or equal to 80% indicated adherence to tacrolimus. Unadjusted and multivariable-adjusted logistic regression analyses were performed. Results: A study population of 1,229 RTRs included 258 with no opioid use, while 971 opioid users were identified within the first year after transplantation. Compared to RTRs without opioid usage, RTRs with opioid usage had a lower probability of being adherent to tacrolimus in unadjusted logistic regression (odds ratio [OR] (95% confidence interval [CI]): 0.22 [0.07–0.72]) and adjusted logistic regression (OR [95% CI]: 0.11 [0.03–0.44]). These patterns generally remained consistent in unadjusted and adjusted main and sensitivity analyses. Conclusions: Findings indicate RTRs who use prescription opioids during the first year posttransplant, regardless of the dosage/amount, are less likely to be adherent to tacrolimus. Future studies are needed to better understand underlying causes of the association between opioid use and tacrolimus nonadherence.

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The opioid crisis: Origins, trends, policies, and the roles of pharmacists

Cited by 101 publications

References 62 publications

Musculoskeletal healthcare: Have we over‐egged the pudding?

Musculoskeletal healthcare: Have we over‐egged the pudding?

Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions

Association between Posttransplant Opioid Use and Immunosuppressant Therapy Adherence among Renal Transplant Recipients

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