Trends in Methadone Distribution for Pain Treatment, Methadone Diversion, and Overdose Deaths — United States, 2002–2014

Jones, Christopher M.; Baldwin, Grant T.; Manocchio, Teresa; White, Jessica O; Mack, Karin A.

doi:10.15585/mmwr.mm6526a2

Cited by 72 publications

(71 citation statements)

References 2 publications

(2 reference statements)

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“…US The decline in methadone death rates, a trend observed since 2008, followed efforts to reduce methadone use for pain, including Food and Drug Administration warnings, limits on high dose formulations, and clinical guidelines (6). The small increase in natural/semisynthetic opioid death rates illustrates an ongoing problem with prescription opioids; however, the increase has slowed from 2013-2014, potentially because of policy and health system changes, required prescription drug monitoring program review, legislative changes in naloxone distribution, and prescribing guidelines (7,8).…”

Section: What Are the Implications For Public Health Practice?mentioning

confidence: 99%

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Rudd¹,

Seth²,

David³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

2,014

1,423

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Section: What Are the Implications For Public Health Practice?mentioning

confidence: 99%

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Rudd¹,

Seth²,

David³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

2,014

1,423

View full text Add to dashboard Cite

“…Use of methadone became a popular pain‐treatment option in the early 2000s because of its long half‐life and the fact that it was less expensive than nongeneric extended‐release opioids (such as OxyContin®). But its long half‐life, slow onset of action, and complicated pharmacokinetics and pharmacodynamics make it difficult to manage medically, as well as make it particularly prone to overdose . At its peak in the mid‐to‐late 2000s, methadone was involved in approximately 30% of overdose deaths, although it accounted for less than 2% of opioid prescriptions .…”

Section: Agent Factorsmentioning

confidence: 99%

Epidemiology of the U.S. opioid crisis: the importance of the vector

Compton

Jones

2019

Annals of the New York Academy of Sciences

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The roots of the remarkably lethal U.S. opioid crisis are complex and inextricably entangled with healthcare, especially in its treatment of another serious health problem: pain. Failures of the healthcare system—including lack of both training in pain management and caution in using an addictive class of medications—precipitated the rise in opioid misuse and addiction over the past two decades, but a wider range of social and economic forces has helped perpetuate the crisis and altered its character. The classic epidemiologic host–agent–environment triad can be augmented for the purpose of elucidating the current opioid crisis by addition of the “vector” to emphasize the importance of purveyors of opioids (licit and illicit), leading to our proposing an expanded host–agent–vector–environment model. Interventions addressing multiple components are needed, including solutions that account for behaviors of all vectors associated with the crisis. For prescription opioids, the vectors include clinicians and pharmaceutical‐related companies involved in marketing, prescribing, distributing, and dispensing opioid medications; for illicit opioids, they include drug manufacturing and distribution networks. Attending to the vectors of opioids, while simultaneously implementing a full range of public health, clinical, law enforcement, and other approaches to ending the opioid crisis, may help to improve public health outcomes.

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“…Nevertheless, methadone fatalities have also increased more than 5‐fold with expanded use, and methadone was involved in about one‐third of fatal opioid‐related overdoses from 1999 to 2009. In 2009, specifically, methadone accounted for only 2% of prescriptions, but 30% of prescription painkiller deaths . Although in the limited number of studies with buprenorphine and protease inhibitors, there were no significant drug interactions, additional research is needed to determine drug interactions between buprenorphine and several new antiretroviral and antiviral medications.…”

Section: Medications For the Treatment Of Hiv/aidsmentioning

confidence: 99%

Drug–Drug Interactions and Diagnostics for Drug Users With HIV and HIV/HCV Coinfections: Introduction

Khalsa

Talal

Morse

2017

Clinical Pharm in Drug Dev

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Substance use and pharmacologic treatment of co-occurring infections such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are associated with many adverse consequences including pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs). The National Institute on Drug Abuse sponsored a 2-day conference on DDIs at which clinicians/scientists from government, academia, and the pharmaceutical industry presented the most current research findings to formulate a comprehensive overview of DDIs. Specific topics discussed included drug metabolism; drug interactions between medications used in the treatment of HIV, HCV, and substance use disorders; intrahepatic concentrations and methods of assessment of drugs in liver disease of varying etiologies and degrees of impairment; and minimally invasive sampling techniques for the assessment of intrahepatic drug concentrations, viral replication, and changes in gene expression in response to treatment. Finally, the speakers identified research targets and priorities on DDIs. Areas of emphasis included development of diagnostic assays for drug concentration assessment in different organs, an enhanced understanding of factors responsible for alterations in drug metabolism and excretion, and establishment of clinical trials and work groups to study DDIs. Our long-term objective is to broaden investigation in the field of DDIs in substance users.

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Trends in Methadone Distribution for Pain Treatment, Methadone Diversion, and Overdose Deaths — United States, 2002–2014

Cited by 72 publications

References 2 publications

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Epidemiology of the U.S. opioid crisis: the importance of the vector

Drug–Drug Interactions and Diagnostics for Drug Users With HIV and HIV/HCV Coinfections: Introduction

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