26 naloxone papers:

1) Naloxone prescriptions from the emergency department: An initiative in evolution.

Verdier M, Routsolias JC, Aks SE.

Am J Emerg Med. 2018 May 22. pii: S0735-6757(18)30422-4. doi: 10.1016/j.ajem.2018.05.044. [Epub ahead of print] No abstract available.

Comments: 18% got filled. More likely to get filled if sent with other Rx’s.

2) “Once I’d done it once it was like writing your name”: Lived experience of take-home naloxone administration by people who inject drugs.

McAuley A, Munro A, Taylor A.

Int J Drug Policy. 2018 May 23;58:46-54. doi: 10.1016/j.drugpo.2018.05.002. [Epub ahead of print]

Comments: Qualitative study with 8 PWID who have administered naloxone.

3) Characterizing peer roles in an overdose crisis: Preferences for peer workers in overdose response programs in emergency shelters.

Bardwell G, Kerr T, Boyd J, McNeil R.

Drug Alcohol Depend. 2018 Jun 26;190:6-8. doi: 10.1016/j.drugalcdep.2018.05.023. [Epub ahead of print]

Comments: Peers are hugely important in service provision.

4) Successful bystander-administered intranasal naloxone reversal of opioid overdose between two veterans: A case report.

Ouyang S, Moore T.

Ment Health Clin. 2018 Mar 23;7(6):287-289. doi: 10.9740/mhc.2017.11.287. eCollection 2017 Nov.

Comments: There are hundreds to thousands of successful lay reversals in the US daily.

5) At-a-glance – Lessons learned from launching the Manitoba Take-Home Naloxone Program.

Bozat-Emre S, Marshall SG, Zhong C, Reimer J.

Health Promot Chronic Dis Prev Can. 2018 Jun;38(6):252-255. doi: 10.24095/hpcdp.38.6.06. English, French.

Comments: Standard programmatic data, noting that the program gives valuable information about street opioids.

6) Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review.

Behar E, Bagnulo R, Coffin PO.

Prev Med. 2018 Jun 15;114:79-87. doi: 10.1016/j.ypmed.2018.06.005. [Epub ahead of print] Review.

Comments: Systematic review of literature on naloxone prescribing from primary care.

7) Yes, not now, or never: an analysis of reasons for refusing or accepting emergency department-based take-home naloxone.

Kestler A, Giesler A, Buxton J, Meckling G, Lee M, Hunte G, Wilkins J, Marks D, Scheuermeyer F.

CJEM. 2018 May 23:1-9. doi: 10.1017/cem.2018.368. [Epub ahead of print]

Comments: Those refusing naloxone felt they weren’t at risk of overdose or that the ED wasn’t the place to get the prescription. Those accepting felt they could help others.

8) Naloxone Use Among Emergency Department Patients with Opioid Overdose.

Marco CA, Trautman W, Cook A, Mann D, Rasp J, Perkins O, Ballester M.

J Emerg Med. 2018 May 16. pii: S0736-4679(18)30360-3. doi: 10.1016/j.jemermed.2018.04.022. [Epub ahead of print]

Comments: Ohio study of overdoses in the ED. Lots of repeated visits. Only 31% had home access to naloxone. Among those who had naloxone, 33% reported less opioid usage, 4% reported more, and 63% reported no change.

9) An overview of take-home naloxone programs in Australia.

Dwyer R, Olsen A, Fowlie C, Gough C, van Beek I, Jauncey M, Lintzeris N, Oh G, Dicka J, Fry CL, Hayllar J, Lenton S.

Drug Alcohol Rev. 2018 May;37(4):440-449. doi: 10.1111/dar.12812.

Comments: Peer programs!

10) Knowledge of naloxone and take-home naloxone programs among a sample of people who inject drugs in Australia: Variations across capital cities.

Dietze PM, Stare M, Cogger S, Nambiar D, Olsen A, Burns L, Lenton S.

Drug Alcohol Rev. 2018 May;37(4):457-463. doi: 10.1111/dar.12644. Epub 2017 Dec 21.

Comments: Half of PWID were aware of take-home naloxone. Good start, ways to go.

11) Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Enrolled in Medication Assisted Therapy Clinics in North Carolina.

Khatiwoda P, Proeschold-Bell RJ, Meade CS, Park LP, Proescholdbell S.

N C Med J. 2018 May-Jun;79(3):149-155. doi: 10.18043/ncm.79.3.149.

Comments: Smaller kits more likely to be carried.

12)Feasibility of Bystander Administration of Public-Access Naloxone for Opioid Overdose.

Goldberg SA, Dworkis DA, Liao VT, Eyre AJ, Albert J, Fawcett MM, Narovec CM, DiClemente J, Weiner SG.

Prehosp Emerg Care. 2018 May 3:1-7. doi: 10.1080/10903127.2018.1461284. [Epub ahead of print]

Comments: Public access naloxone stations is an idea that’s been batted about for decades without much in terms of implementation.

13)Pharmacokinetic properties of intranasal and injectable formulations of naloxone for community use: a systematic review.

Ryan SA, Dunne RB.

Pain Manag. 2018 Apr 23. doi: 10.2217/pmt-2017-0060. [Epub ahead of print]

Comments: Intranasal works well.

14) [Temporary approval for intranasal naloxone: Setting up in a French addiction center].

Barré T, Vorspan F, Fortias M, Veyrier M, Cavagna P, Azuar J, Nicolas L, Naccache F, Barreteau H, Bellivier F, Bloch V.

Therapie. 2018 Mar 29. pii: S0040-5957(18)30060-X. doi: 10.1016/j.therap.2018.03.003. [Epub ahead of print] French.

Comments: Pilot naloxone prescribing in France.

15) Cost-Effectiveness of Take-Home Naloxone for the Prevention of Overdose Fatalities among HeroinUsers in the United Kingdom.

Langham S, Wright A, Kenworthy J, Grieve R, Dunlop WCN.

Value Health. 2018 Apr;21(4):407-415. doi: 10.1016/j.jval.2017.07.014. Epub 2018 Feb 4.

Comments: Remarkably similar outcomes as the 2012 naloxone model in the United States.

16) Distribution of take-home opioid antagonist kits during a synthetic opioid epidemic in British Columbia, Canada: a modelling study.

Irvine MA, Buxton JA, Otterstatter M, Balshaw R, Gustafson R, Tyndall M, Kendall P, Kerr T, Gilbert M, Coombs D.

Lancet Public Health. 2018 Apr 17. pii: S2468-2667(18)30044-6. doi: 10.1016/S2468-2667(18)30044-6. [Epub ahead of print]

Comments: Authors conclude that rapid expansion of naloxone access helped to reverse the increasing trend of opioid overdose deaths during the fentanyl crisis.

17) Prescribing naloxone for opioid overdose intervention.

Dunne RB.

Pain Manag. 2018 Apr 18. doi: 10.2217/pmt-2017-0065. [Epub ahead of print]

Comments: A review, although it is incorrect that screening for patients at risk of opioid overdose is required. The majority of US states allow for third party prescribing to those who might witness an opioid overdose. Moreover, the use of “overdose” when speaking to patients prescribed opioids can sabotage efforts to get naloxone to where the opioids are.

18) The feasibility of employing a home healthcare model for education and treatment of opioid overdoseusing a naloxone auto-injector in a private practice pain medicine clinic.

Dragovich A, Brason F, Beltran T, McCoart A, Plunkett AR.

Curr Med Res Opin. 2018 Apr 18:1-11. doi: 10.1080/03007995.2018.1466698. [Epub ahead of print]

Comments: Home health approach to training on overdose response.

19) Emergency physician resistance to a take-home naloxone program led by community harm reductionists.

Barbour K, McQuade M, Somasundaram S, Chakravarthy B.

Am J Emerg Med. 2018 Mar 17. pii: S0735-6757(18)30228-6. doi: 10.1016/j.ajem.2018.03.036. [Epub ahead of print] No abstract available.

Comments: A study of providing naloxone in an emergency department, in which the attending physician refused to prescribe naloxone to 37% of the patients who wanted it. Really unclear why someone would refuse to provide a naloxone prescription to a patient who wanted one. And few of the patients filled the prescription – again consistent with what we know about naloxone and any other preventive intervention like flu shots: it has to be free and convenient.

20) Pharmacokinetics and -dynamics of intramuscular and intranasal naloxone: an explorative study in healthy volunteers.

Skulberg AK, Tylleskar I, Nilsen T, Skarra S, Salvesen Ø, Sand T, Loftsson T, Dale O.

Eur J Clin Pharmacol. 2018 Mar 22. doi: 10.1007/s00228-018-2443-3. [Epub ahead of print]

Comments: Intranasal naloxone was 0.75 as bioavailable as intramuscular.

21) Implementation and evaluation of an opioid overdose education and naloxone distribution (OEND) program at a Veterans Affairs Medical Center.

Pauly JB, Vartan CM, Brooks AT.

Subst Abus. 2018 Mar 22:1-17. doi: 10.1080/08897077.2018.1449174. [Epub ahead of print]

Comments: 30% of veterans referred for naloxone completed education and most were at low risk for opioid overdose.

22) Naloxone reversal of clonidine toxicity: dose, dose, dose.

Seger DL, Loden JK.

Clin Toxicol (Phila). 2018 Mar 16:1-7. doi: 10.1080/15563650.2018.1450986. [Epub ahead of print]

Comments: 10mg of naloxone in pediatric patients worked very well. Fascinating.

23) Effects of naloxone distribution to likely bystanders: Results of an agent-based model.

Keane C, Egan JE, Hawk M.

Int J Drug Policy. 2018 Mar 7;55:61-69. doi: 10.1016/j.drugpo.2018.02.008. [Epub ahead of print]

Comments: I have a fair amount of experience with models (created several Markov and decision tree-based models) and, while I’ve never constructed an agent-based model, the absence of a table of parameters for this paper is highly concerning to me. I cannot evaluate if this paper has value.

24) Naloxone access for Emergency Medical Technicians: An evaluation of a training program in rural communities.

Zhang X, Marchand C, Sullivan B, Klass EM, Wagner KD.

Addict Behav. 2018 Mar 5. pii: S0306-4603(18)30109-6. doi: 10.1016/j.addbeh.2018.03.004. [Epub ahead of print]

Comments: EMTs can be trained to administer naloxone.

25) Naloxone formulation for overdose reversal preference among patients receiving opioids for pain management.

Dunn KE, Barrett FS, Bigelow GE.

Addict Behav. 2018 Mar 28. pii: S0306-4603(18)30131-X. doi: 10.1016/j.addbeh.2018.03.011. [Epub ahead of print]

Comments: They prefer non-injectable. No surprise there.

26) Utilizing risk index for overdose or serious opioid-induced respiratory depression (RIOSORD) scores to prioritize offer of rescue naloxone in an outpatient veteran population: A telephone-based project.

Yates D, Frey T, Montgomery JC.

Subst Abus. 2018 Mar 26:1-12. doi: 10.1080/08897077.2018.1449171. [Epub ahead of print]

Comments: 63.4% of those contacted accepted the naloxone prescription.

Plus 6 papers on naloxone and Good Samaritan laws:

27) Naloxone laws facilitate the establishment of overdose education and naloxone distribution programs in the United States.

Lambdin BH, Davis CS, Wheeler E, Tueller S, Kral AH.

Drug Alcohol Depend. 2018 May 12. pii: S0376-8716(18)30238-2. doi: 10.1016/j.drugalcdep.2018.04.004. [Epub ahead of print]

Comments: As title says.

28) Do naloxone access laws increase outpatient naloxone prescriptions? Evidence from Medicaid.

Gertner AK, Domino ME, Davis CS.

Drug Alcohol Depend. 2018 Jun 22;190:37-41. doi: 10.1016/j.drugalcdep.2018.05.014. [Epub ahead of print]

Comments: Naloxone access laws are associated with increased outpatient prescriptions.

29) Opioid-overdose laws association with opioid use and overdose mortality.

McClellan C, Lambdin BH, Ali MM, Mutter R, Davis CS, Wheeler E, Pemberton M, Kral AH.

Addict Behav. 2018 Mar 19. pii: S0306-4603(18)30138-2. doi: 10.1016/j.addbeh.2018.03.014. [Epub ahead of print]

Comments: Laws supporting naloxone programming were associated with less opioid overdose mortality and no increase in non-medical opioid use.

30) Assessing the effectiveness of New York’s 911 Good Samaritan Law-Evidence from a natural experiment.

Nguyen H, Parker BR.

Int J Drug Policy. 2018 Jun 29;58:149-156. doi: 10.1016/j.drugpo.2018.05.013. [Epub ahead of print]

Comments: Interesting comparison between New York and New Jersey, although this could have been influenced by market forces as well.

31) Lay responder naloxone access and Good Samaritan law compliance: postcard survey results from 20 Indiana counties.

Watson DP, Ray B, Robison L, Huynh P, Sightes E, Walker S, Brucker K, Duwve J.

Harm Reduct J. 2018 Apr 6;15(1):18. doi: 10.1186/s12954-018-0226-x.

Comments: Knowing someone who overdosed predicts getting naloxone. If people know about Good Sam protections they are more likely to call emergency medical services after the overdose.

32) State naloxone access laws are associated with an increase in the number of naloxone prescriptions dispensed in retail pharmacies.

Xu J, Davis CS, Cruz M, Lurie P.

Drug Alcohol Depend. 2018 Aug 1;189:37-41. doi: 10.1016/j.drugalcdep.2018.04.020. Epub 2018 May 29.

Comments: See title.

And 6 papers on pharmacies and naloxone/opioids:

33) Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016.

Meyerson BE, Agley JD, Davis A, Jayawardene W, Hoss A, Shannon DJ, Ryder PT, Ritchie K, Gassman R.

Drug Alcohol Depend. 2018 Apr 26;188:187-192. doi: 10.1016/j.drugalcdep.2018.03.032. [Epub ahead of print]

Comments:  Bigger pharmacies and chains stocked naloxone more.

34) Reviewing state-mandated training requirements for naloxone-dispensing pharmacists.

Roberts AW, Carpenter DM, Smith A, Look KA.

Res Social Adm Pharm. 2018 Apr 5. pii: S1551-7411(17)30915-4. doi: 10.1016/j.sapharm.2018.04.002. [Epub ahead of print]

Comments: The state requirements are silly. Why do we always create barriers to providers taking care of people with substance use disorders and related issues?

35) Chronic pain medication management of older populations: Key points from a national conference and innovative opportunities for pharmacy practice.

Gilmartin-Thomas JF, Bell JS, Liew D, Arnold CA, Buchbinder R, Chapman C, Cicuttini F, Dobbin M, Gibson SJ, Giummarra MJ, Gowan J, Katz B, Lubman DI, McCrone M, Pilgrim J, Synnot A, van Dyk E, Workman B, McNeil J.

Res Social Adm Pharm. 2018 Mar 19. pii: S1551-7411(17)30669-1. doi: 10.1016/j.sapharm.2018.03.060. [Epub ahead of print]

Comments: How pharmacists can help.

36) Establishment of a pharmacist-led service for patients at high risk for opioid overdose.

Tewell R, Edgerton L, Kyle E.

Am J Health Syst Pharm. 2018 Mar 15;75(6):376-383. doi: 10.2146/ajhp170294.

Comments: Pharmacists are good at getting naloxone to people who may need it.

37) Naloxone for Opioid Overdose and the Role of the Pharmacist.

Toderika Y, Williams S.

Consult Pharm. 2018 Feb 1;33(2):98-104. doi: 10.4140/TCP.n.2018.98.

Comments: As above!

38) Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.

Meyerson BE, Davis A, Agley JD, Shannon DJ, Lawrence CA, Ryder PT, Ritchie K, Gassman R.

Int J Drug Policy. 2018 Mar 17;56:46-53. doi: 10.1016/j.drugpo.2018.02.024. [Epub ahead of print]

Comments: Communities with high rates of opioid overdose death were less likely to have pharmacies that dispensed syringes to PWID.

9 papers on fentanyl:

39) Abuse of fentanyl: An emerging problem to face.

Kuczyńska K, Grzonkowski P, Kacprzak Ł, Zawilska JB.

Forensic Sci Int. 2018 Aug;289:207-214. doi: 10.1016/j.forsciint.2018.05.042. Epub 2018 Jun 2. Review.

Comments: Reviewing emerging presence of fentanyl in Poland.

40) Fentanyl-contaminated drugs and non-fatal overdose among people who inject drugs in Baltimore, MD.

Park JN, Weir BW, Allen ST, Chaulk P, Sherman SG.

Harm Reduct J. 2018 Jul 5;15(1):34. doi: 10.1186/s12954-018-0240-z.

Comments: While this is an interesting effort, I’m not convinced that “perceived fentanyl presence” as a risk factor for overdose is particularly useful.

41) Fentanyl self-testing outside supervised injection settings to prevent opioid overdose: Do we know enough to promote it?

McGowan CR, Harris M, Platt L, Hope V, Rhodes T.

Int J Drug Policy. 2018 May 11;58:31-36. doi: 10.1016/j.drugpo.2018.04.017. [Epub ahead of print]

Comments: Not really, but we are desparate.

42)Community-Based Response to Fentanyl Overdose Outbreak, San Francisco, 2015.

Rowe C, Wheeler E, Stephen Jones T, Yeh C, Coffin PO.

J Urban Health. 2018 May 3. doi: 10.1007/s11524-018-0250-x. [Epub ahead of print]

Comments: Another role for naloxone distribution programs is as an early warning system of changes in the opioid market. In this case, a locality was alerted to fentanyl entering the supply by an increase in naloxone reversals, with no associated deaths. Of note, this clearly overlaps with the “naloxone” section above.

43) Characteristics of opioid-maintained clients smoking fentanyl patches: The importance of confirmatory drug analysis illustrated by a case series and mini-review.

Kimergård A, Dunne J, Bøgen A, Hindersson P, Breindahl T.

Drug Test Anal. 2018 Apr 19. doi: 10.1002/dta.2397. [Epub ahead of print]

Comments: Testing for fentanyl can be tricky in clinical practice.

44) Efficacious Vaccine against Heroin Contaminated with Fentanyl.

Hwang CS, Smith LC, Natori Y, Ellis B, Zhou B, Janda KD.

ACS Chem Neurosci. 2018 Mar 23. doi: 10.1021/acschemneuro.8b00079. [Epub ahead of print]

Comments: Interesting idea.

45) Fentanyl related overdose in Indianapolis: Estimating trends using multilevel Bayesian models.

Phalen P, Ray B, Watson DP, Huynh P, Greene MS.

Addict Behav. 2018 Mar 20. pii: S0306-4603(18)30121-7. doi: 10.1016/j.addbeh.2018.03.010. [Epub ahead of print]

Comments: Fentanyl deaths became predominant.

46) How Did We Get Here? Heroin and Fentanyl Trafficking Trends: A Law Enforcement Perspective.

Dismukes LC.

N C Med J. 2018 May-Jun;79(3):181-184. doi: 10.18043/ncm.79.3.181.

Comments: Describes a focus on the dark net.

47) Amount of naloxone used to reverse opioid overdoses outside of medical practice in a city with increasing illicitly manufactured fentanyl in illicit drug supply.

Bell A, Bennett AS, Jones TS, Doe-Simkins M, Williams LD.

Subst Abus. 2018 Mar 20:1-12. doi: 10.1080/08897077.2018.1449053. [Epub ahead of print]

Comments: There was no change in the dose or amount of lay-administered naloxone required to reverse overdoses in the community, regardless of a rapid increase in fentanyl-related overdoses.

13 papers on medications for opioid use disorder:

48) Effects of medication-assisted treatment on mortality among opioids users: a systematic review and meta-analysis.

Ma J, Bao YP, Wang RJ, Su MF, Liu MX, Li JQ, Degenhardt L, Farrell M, Blow FC, Ilgen M, Shi J, Lu L.

Mol Psychiatry. 2018 Jun 22. doi: 10.1038/s41380-018-0094-5. [Epub ahead of print]

Comments: Our medications for opioid use disorder – methadone, buprenorphine, and extended-release naltrexone – reduce mortality, particularly if used for over a year.

49) Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study.

Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, Bagley SM, Liebschutz JM, Walley AY.

Ann Intern Med. 2018 Jun 19. doi: 10.7326/M17-3107. [Epub ahead of print]

Comments: Another fascinating analysis out of a powerful dataset. After overdose, 11% enrolled in methadone for a median of 5 months, 17% buprenorphine for 4 months, and naltrexone for 1 month. Methadone and buprenorphine were associated with similar reductions in mortality (adjusted hazard ratio 0.47 and 0.41, respectively). Naltrexone was not associated with a mortality benefit, although the AHR was 1.44, suggesting a possible increase in mortality.

50) Developing an opioid use disorder treatment cascade: A review of quality measures.

Williams AR, Nunes EV, Bisaga A, Pincus HA, Johnson KA, Campbell AN, Remien RH, Crystal S, Friedmann PD, Levin FR, Olfson M.

J Subst Abuse Treat. 2018 Aug;91:57-68. doi: 10.1016/j.jsat.2018.06.001. Epub 2018 Jun 2. Erratum in: J Subst Abuse Treat. 2018 Sep;92:99.

Comments: There’s a lot of work going on now to determine the markers of successful care for patients with opioid use disorder. It’s an exciting time in which we are hopefully seeing a transformation in which substance use disorders are treated as chronic diseases, rather than somebody else’s problem.

51) Trends in engagement in the cascade of care for opioid use disorder, Vancouver, Canada, 2006-2016.

Socías ME, Wood E, Kerr T, Nolan S, Hayashi K, Nosova E, Montaner J, Milloy MJ.

Drug Alcohol Depend. 2018 Aug 1;189:90-95. doi: 10.1016/j.drugalcdep.2018.04.026. Epub 2018 May 29.

Comments: Generated 4 stages of OUD care: linkage to care, linkage to methadone/buprenorphine, retention on medications, and stability – and evaluated changes from 2006 to 2016. They found that all parameters improved, but retention on medications was lower than goal (about a third of patients).

52) Opioid Use Disorders: Perioperative Management of a Special Population.

Ward EN, Quaye AN, Wilens TE.

Anesth Analg. 2018 May 25. doi: 10.1213/ANE.0000000000003477. [Epub ahead of print]

Comments: Great topic. So much mismanagement, particularly of patients on buprenorphine as it is too often stopped leading to chaos in the hospital. The general rule is to continue buprenorphine!!! Use ancillary pain medications. Dose the bup 3-4 times a day. Use hydromorphone or fentanyl if necessary.

53) National Institute on Drug Abuse International Program: improving opioid use disorder treatment through international research training.

Gust SW, McCormally J.

Curr Opin Psychiatry. 2018 Jul;31(4):287-293. doi: 10.1097/YCO.0000000000000426.

Comments: International research on OUD treatment and overdose prevention.

54) Stigma associated with medication treatment for young adults with opioid use disorder: a case series.

Hadland SE, Park TW, Bagley SM.

Addict Sci Clin Pract. 2018 May 7;13(1):15. doi: 10.1186/s13722-018-0116-2.

Comments: Case reports of patients being denied proper medical care. Grrr. If you had type 2 diabetes and were kicked off your insulin due to the ignorance of supposed “providers”, you’d make millions in court. Honestly, I can’t wait to see those cases emerge for people with opioid use disorder. Sadly, that is often the best way to change practice in the overly litigious United States.

55) Buprenorphine Therapy for Opioid Use Disorder.

Zoorob R, Kowalchuk A, Mejia de Grubb M.

Am Fam Physician. 2018 Mar 1;97(5):313-320.

Comments: A review of above.

56) Methadone maintenance treatment: A 15-year retrospective study in Split-Dalmatia County, Croatia.

Sutlovic D, Kljucevic Z, Sliskovic L, Susnjar H, Viskovic I, Definis-Gojanovic M.

Ther Drug Monit. 2018 Apr 11. doi: 10.1097/FTD.0000000000000519. [Epub ahead of print]

Comments: Programmatic data review.

57) Pharmacogenetics of Opioid Use Disorder Treatment.

Crist RC, Clarke TK, Berrettini WH.

CNS Drugs. 2018 Apr;32(4):305-320. doi: 10.1007/s40263-018-0513-9.

Comments: Metabolism, clearance, treatment outcomes for OUD meds.

58) Effectiveness of Tapering from Methadone or Buprenorphine Maintenance Treatment Compared to Traditional Maintenance Treatment for People with Opiate Addiction: Systematic Review [Internet].

Dalsbø TK, Steiro A, Strømme H, Reinar LM.

Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2017 Mar 2.

Comments: Insufficient data, although it’s clear from clinical practice that treatment should be provided as long as the patient will accept it, ideally at least a year.

59) The effect of Housing First on adherence to methadone maintenance treatment.

Parpouchi M, Moniruzzaman A, Rezansoff SN, Russolillo A, Somers JM.

Int J Drug Policy. 2018 Mar 30;56:73-80. doi: 10.1016/j.drugpo.2018.03.012. [Epub ahead of print]

Comments: No effect on adherence to OUD treatment with methadone.

60) Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment.

Havens JR, Walsh SL, Korthuis PT, Fiellin DA.

Curr HIV/AIDS Rep. 2018 Aug;15(4):315-323. doi: 10.1007/s11904-018-0402-3. Review.

Comments: 3% of primary care providers can provide buprenorphine. Can we please throw out the waiver requirement?

7 more emergency medical care papers (there’s overlap here, obviously):

61) Catch and release: evaluating the safety of non-fatal heroin overdose management in the out-of-hospital environment.

Stam NC, Pilgrim JL, Drummer OH, Smith K, Gerostamoulos D.

Clin Toxicol (Phila). 2018 Jun 6:1-7. doi: 10.1080/15563650.2018.1478093. [Epub ahead of print]

Comments: Not withstanding the remarkably offensive title, in effect describing people who use drugs as fish, the study shows no risk to releasing patients after initial paramedic treatment for opioid overdose.

62) Substance use and homelessness among emergency department patients.

Doran KM, Rahai N, McCormack RP, Milian J, Shelley D, Rotrosen J, Gelberg L.

Drug Alcohol Depend. 2018 May 22;188:328-333. doi: 10.1016/j.drugalcdep.2018.04.021. [Epub ahead of print]

Comments: Patients in emergency departments who are homeless have higher rates of problematic substance use.

63) Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.

Sanello A, Gausche-Hill M, Mulkerin W, Sporer KA, Brown JF, Koenig KL, Rudnick EM, Salvucci AA, Gilbert GH.

West J Emerg Med. 2018 May;19(3):527-541. doi: 10.5811/westjem.2018.1.36559. Epub 2018 Mar 8. Review.

Comments: Criteria for naloxone were – respiratory rate under 12, pinpoint pupils, presence of drug paraphernalia, and altered mental status. Interesting and may account for why we didn’t see as much naloxone given for prescription opioid overdose events during that era.

64) Safety of a Brief Emergency Department Observation Protocol for Patients With Presumed Fentanyl Overdose.

Scheuermeyer FX, DeWitt C, Christenson J, Grunau B, Kestler A, Grafstein E, Buxton J, Barbic D, Milanovic S, Torkjari R, Sahota I, Innes G.

Ann Emerg Med. 2018 Mar 9. pii: S0196-0644(18)30082-9. doi: 10.1016/j.annemergmed.2018.01.054. [Epub ahead of print]

Comments: Brief observation is fine. Similar to the above “catch and release” paper.

65) Rate of patients at elevated risk of opioid overdose visiting the emergency department.

Pedigo JR, Seifert CF.

Am J Emerg Med. 2018 Mar 22. pii: S0735-6757(18)30247-X. doi: 10.1016/j.ajem.2018.03.055. [Epub ahead of print]

Comments: More opioid overdose ED visits.

66) A Descriptive Analysis of Care Provided by Law Enforcement Prior to EMS Arrival in the United States.

Klassen AB, Core SB, Lohse CM, Sztajnkrycer MD.

Prehosp Disaster Med. 2018 Apr;33(2):165-170. doi: 10.1017/S1049023X18000213. Epub 2018 Mar 13.

Comments: Overall police provide the initial care in 2% of cases and 13% of drug overdoses – in Norway (rates probably much higher in other countries like the U.S.).

67) Ambulance-attended opioid overdoses: an examination into overdose locations and the role of a safe injection facility.

Madah-Amiri D, Skulberg AK, Braarud AC, Dale O, Heyerdahl F, Lobmaier P, Clausen T.

Subst Abus. 2018 Jun 27:1-17. doi: 10.1080/08897077.2018.1485130. [Epub ahead of print]

Comments: Fascinating look at overdose ambulance calls – where they happen, if they are transported, overdose severity. Useful for a deeper understanding of the epidemiology of serious overdose.

7 surveillance-esque papers:

68) Standard Death Certificates Versus Enhanced Surveillance to Identify Heroin Overdose-Related Deaths.

Horon IL, Singal P, Fowler DR, Sharfstein JM.

Am J Public Health. 2018 Apr 19:e1-e5. doi: 10.2105/AJPH.2018.304385. [Epub ahead of print]

Comments: I love these type of projects. Basically re-litigating the cause of death from the medical examiner’s conclusion. This may sound bad, but the decision the medical examiner makes should be extremely conservative – based only upon what they are quite sure is true. By re-evaluating the data, we can identify a great many more probable heroin overdose events.

69) Accurate identification of opioid overdose deaths using coronial data.

Roxburgh A, Pilgrim JL, Hall WD, Burns L, Degenhardt L.

Forensic Sci Int. 2018 Mar 26;287:40-46. doi: 10.1016/j.forsciint.2018.03.032. [Epub ahead of print]

Comments: One quarter of “morphine” deaths were re-attributed to heroin on review of the clinical record. This passes my sniff test.

70) Mapping Drug Overdose Demographic and Socioeconomic Characteristics in the Community.

Rooney BL, Voter MT, Eberlein CM, Schossow AJ, Fischer CL.

WMJ. 2018 Mar;117(1):18-23.

Comments: Interesting chart review project of overdoses showing up in an emergency department in Wisconsin.

71) Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses – United States, July 2016-September 2017.

Vivolo-Kantor AM, Seth P, Gladden RM, Mattson CL, Baldwin GT, Kite-Powell A, Coletta MA.

MMWR Morb Mortal Wkly Rep. 2018 Mar 9;67(9):279-285. doi: 10.15585/mmwr.mm6709e1.

Comments: Up and up.

72) Prevalence of gabapentin in drug overdose postmortem toxicology testing results.

Slavova S, Miller A, Bunn TL, White JR, Kirschke D, Light T, Christy D, Thompson G, Winecker R.

Drug Alcohol Depend. 2018 May 1;186:80-85. doi: 10.1016/j.drugalcdep.2018.01.018. Epub 2018 Mar 10.

Comments: I remain doubtful that this represents a problem with gabapentin.

73) Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants – United States, 2015-2016.

Seth P, Scholl L, Rudd RA, Bacon S.

MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):349-358. doi: 10.15585/mmwr.mm6712a1.

Comments: We really need a major effort on surveillance.

74) Trends in Injector Deaths in Ireland, as Recorded by the National Drug-Related Deaths Index, 1998-2014.

Lynn TM, Lynn E, Keenan E, Lyons S.

J Stud Alcohol Drugs. 2018 Mar;79(2):286-292.

Comments: 90% of deaths were overdose (poisoning) deaths.

And lots (35) more!

75) Opioid tolerance and clinically recognized opioid poisoning among patients prescribed extended-release long-acting opioids.

Young JC, Lund JL, Dasgupta N, Jonsson Funk M.

Pharmacoepidemiol Drug Saf. 2018 Jun 11. doi: 10.1002/pds.4572. [Epub ahead of print]

Comments: Wow. Honestly surprising results. One-third of patients started on >=90 morphine equivalent milligrams (MEMs) had no been receiving >=60 MEMs for 7 of the prior 14 days.

76) Prescription opioid use among individuals with serious mental illness.

Spivak S, Cullen B, Eaton W, Nugent K, Spivak A, Fenton A, Rodriguez K, Mojtabai R.

Psychiatry Res. 2018 May 31;267:85-87. doi: 10.1016/j.psychres.2018.05.075. [Epub ahead of print]

Comments: The intersection of mental illness, opioid use, and benzodiazepine use is fascinating and potentially quite complex. This study found that 12.9% of patients at two urban psychiatry clinics were prescribed opioids, and that being prescribed opioids was associated with having used heroin and using benzos; using benzos was associated with suicidal ideation. This doesn’t account for chicken or egg, but is interesting nonetheless.

77) Medical, psychosocial, and treatment predictors of opioid overdose among high risk opioid users.

Schiavon S, Hodgin K, Sellers A, Word M, Galbraith JW, Dantzler J, Cropsey KL.

Addict Behav. 2018 May 30. pii: S0306-4603(18)30575-6. doi: 10.1016/j.addbeh.2018.05.029. [Epub ahead of print]

Comments: Some unusual associations with overdose: HCV infection, witnessing an overdose, or more buprenorphine treatment episodes.

78) Polydrug use patterns, risk behavior and unmet healthcare need in a community-based sample of women who use cocaine, heroin or methamphetamine.

Lorvick J, Browne EN, Lambdin BH, Comfort M.

Addict Behav. 2018 Oct;85:94-99. doi: 10.1016/j.addbeh.2018.05.013. Epub 2018 May 24.

Comments: Polydrug use is associated with lots of health problems and risk behaviors.

79) Not just heroin: Extensive polysubstance use among US high school seniors who currently use heroin.

Palamar JJ, Le A, Mateu-Gelabert P.

Drug Alcohol Depend. 2018 Jul 1;188:377-384. doi: 10.1016/j.drugalcdep.2018.05.001. Epub 2018 Jun 4.

Comments: Interesting analysis. Alcohol use is less likely as heroin use increases, but benzodiazepine use is.

80) Methodologic limitations of prescription opioid safety research and recommendations for improving the evidence base.

Ranapurwala SI, Naumann RB, Austin AE, Dasgupta N, Marshall SW.

Pharmacoepidemiol Drug Saf. 2018 Jun 3. doi: 10.1002/pds.4564. [Epub ahead of print] Review.

Comments: Concerns with studies used to justify the CDC opioid prescribing guidelines.

81) Quantity fluctuations of illicitly used opioids and overdose risk.

Rowe C, Wheeler E, Vittinghoff E, Santos GM, Behar E, Coffin PO.

Int J Drug Policy. 2018 May 25;58:64-70. doi: 10.1016/j.drugpo.2018.05.004. [Epub ahead of print]

Comments: An interesting analysis of data from a randomized trial of overdose prevention, finding that variations in the amount of opioids used over time was associated with subsequent overdose.

82) Association Between Prescription Drug Monitoring Programs and Nonfatal and Fatal Drug Overdoses: A Systematic Review.

Fink DS, Schleimer JP, Sarvet A, Grover KK, Delcher C, Castillo-Carniglia A, Kim JH, Rivera-Aguirre AE, Henry SG, Martins SS, Cerdá M.

Ann Intern Med. 2018 May 8. doi: 10.7326/M17-3074. [Epub ahead of print]

Comments: First, can we please call these what they are: Controlled Substance Monitoring Programs (CSMPs)? Please? Second, as the review concludes data are insufficient.

83) Risk factors for opioid overdose among hospitalized patients.

Vu Q, Beselman A, Monolakis J, Wang A, Rastegar D.

J Clin Pharm Ther. 2018 May 23. doi: 10.1111/jcpt.12701. [Epub ahead of print]

Comments: For patients in the hospital, risk of overdose was associated with older age, being in the ICU, getting other depressants, and impaired kidneys.

84) Trends in non-medical prescription opioids and heroin co-use among adults, 2003-2014.

Mital S, Windle M, Cooper HLF, Crawford ND.

Addict Behav. 2018 May 16. pii: S0306-4603(18)30468-4. doi: 10.1016/j.addbeh.2018.05.005. [Epub ahead of print]

Comments: Pulling trends from the National Survey on Drug Use and Health is tough work. Authors found increasing co-use of these opioids.

85) Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency.

Mars SG, Ondocsin J, Ciccarone D.

Harm Reduct J. 2018 May 16;15(1):26. doi: 10.1186/s12954-018-0232-z.

Comments: Such important work! Not just tester shots. Also “slow shots”, trying the drug through other routes of administration first, watching someone else use first, etc.

86) Post-stroke Intranasal (+)-Naloxone Delivery Reduces Microglial Activation and Improves Behavioral Recovery from Ischemic Injury.

Anttila JE, Albert K, Wires ES, Mätlik K, Loram LC, Watkins LR, Rice KC, Wang Y, Harvey BK, Airavaara M.

eNeuro. 2018 Apr 18;5(2). pii: ENEURO.0395-17.2018. doi: 10.1523/ENEURO.0395-17.2018. eCollection 2018 Mar-Apr.

Comments: I’m so intrigued by this. Clinically, I have sometimes seen a slight reaction to naloxone when given for a non-opioid arrest event – have always wondered what was going on.

87) Young adults’ opioid use trajectories: From nonmedical prescription opioid use to heroin, druginjection, drug treatment and overdose.

Guarino H, Mateu-Gelabert P, Teubl J, Goodbody E.

Addict Behav. 2018 May 1. pii: S0306-4603(18)30362-9. doi: 10.1016/j.addbeh.2018.04.017. [Epub ahead of print]

Comments: Use started with Rx opioids, 83% transitioned to heroin and 64% to heroin injection, generally within 4 years of initial nonmedical use. First overdose occurred on average <1 year after starting heroin.

88) Harm Reduction Strategies for the Opiod [sic] Crisis.

Castillo T.

N C Med J. 2018 May-Jun;79(3):192-194. doi: 10.18043/ncm.79.3.192.

Comments: What’s happening in North Carolina.

89) Perceptions of Health-Related Community Reentry Challenges among Incarcerated Drug Users in Azerbaijan, Kyrgyzstan, and Ukraine.

Rozanova J, Morozova O, Azbel L, Bachireddy C, Izenberg JM, Kiriazova T, Dvoryak S, Altice FL.

J Urban Health. 2018 May 4. doi: 10.1007/s11524-018-0256-4. [Epub ahead of print]

Comments: Prisoners did not prioritize getting on methadone for opioid use disorder prior to release. Presumably this is related to both access and competing priorities.

90) Physician Prescribing of Opioids to Patients at Increased Risk of Overdose From Benzodiazepine Use in the United States.

Ladapo JA, Larochelle MR, Chen A, Villalon MM, Vassar S, Huang DYC, Mafi JN.

JAMA Psychiatry. 2018 Apr 12. doi: 10.1001/jamapsychiatry.2018.0544. [Epub ahead of print]

Comments: Although new opioid prescriptions have been declining, including among patients taking benzodiazepines, getting started on opioids is still more likely for patients already using benzodiazepines compared to those not using benzos. Authors conclude that other factors appear to be contributing to overdose, rather than prescribing practices.

91)Addressing the growing opioid and heroin abuse epidemic: a call for medical school curricula.

Ratycz MC, Papadimos TJ, Vanderbilt AA.

Med Educ Online. 2018 Dec;23(1):1466574. doi: 10.1080/10872981.2018.1466574.

Comments: Yes, please! All medical students should get buprenorphine waivered in order to complete pre-clinical training.

92)The long-term impact of post traumatic stress disorder on recovery from heroin dependence.

Mills KL, Marel C, Darke S, Ross J, Slade T, Teesson M.

J Subst Abuse Treat. 2018 Jun;89:60-66. doi: 10.1016/j.jsat.2018.04.001. Epub 2018 Apr 4.

Comments: Patients with PTSD and opioid use disorder did just as well as those without PTSD with regard to recovery, but had higher rates of major depression, attempted suicide, trauma, and poor occupational function.

93)Re-racialization of Addiction and the Redistribution of Blame in the White Opioid Epidemic.

Mendoza S, Rivera AS, Hansen HB.

Med Anthropol Q. 2018 Apr 27. doi: 10.1111/maq.12449. [Epub ahead of print]

Comments: Such complicated issues. Overall, the narrative of white opioid users opened an opportunity for us to treat ALL people with substance use disorders with respect.

94)The U.S. opioid epidemic: One disease, diverging tales.

McBain R, Rose AJ, LaRochelle MR.

Prev Med. 2018 Apr 20. pii: S0091-7435(18)30134-8. doi: 10.1016/j.ypmed.2018.04.023. [Epub ahead of print] No abstract available.

Comments: Interesting discussion of opioid health outcomes in older versus younger adults.

95) Survey Assessing Medical Student and Physician Knowledge and Attitudes Regarding the Opioid Crisis.

Chouinard S, Prasad A, Brown R.

WMJ. 2018 Mar;117(1):34-37.

Comments: A lot of education is needed.

96) Delayed Cerebral Edema Leading to Cerebral Hernia in a Patient With Heroin Overdose.

Amjad W, Qureshi WT, Farooq AU.

Am J Ther. 2018 Apr 11. doi: 10.1097/MJT.0000000000000761. [Epub ahead of print] No abstract available.

Comments: I have no way to access.

97) Safe and unsafe spaces: Non-fatal overdose, arrest, and receptive syringe sharing among people who inject drugs in public and semi-public spaces in Baltimore City.

Hunter K, Park JN, Allen ST, Chaulk P, Frost T, Weir BW, Sherman SG.

Int J Drug Policy. 2018 Apr 13;57:25-31. doi: 10.1016/j.drugpo.2018.03.026. [Epub ahead of print]

Comments: Injecting in public spaces was associated with overdose, arrest, and receptive syringe sharing.

98) Implementation of Online Opioid Prevention, Recognition and Response Trainings for Laypeople: Year 1 Survey Results.

Simmons J, Rajan S, Goldsamt LA, Elliott L.

Subst Use Misuse. 2018 Apr 11:1-6. doi: 10.1080/10826084.2018.1451891. [Epub ahead of print]

Comments: Online training in naloxone is certainly sufficient.

99) America’s Opioid Epidemic: a Comprehensive Review and Look into the Rising Crisis.

Ostling PS, Davidson KS, Anyama BO, Helander EM, Wyche MQ, Kaye AD.

Curr Pain Headache Rep. 2018 Apr 4;22(5):32. doi: 10.1007/s11916-018-0685-5. Review.

Comments: Review of issues related to opioid crisis.

100) Blocking interleukin-4 enhances efficacy of vaccines for treatment of opioid abuse and prevention of opioid overdose.

Laudenbach M, Baruffaldi F, Robinson C, Carter P, Seelig D, Baehr C, Pravetoni M.

Sci Rep. 2018 Apr 3;8(1):5508. doi: 10.1038/s41598-018-23777-6.

Comments: Given the diversity of opioids, I remain skeptical that a vaccine specific to an individual opioid would be particularly beneficial.

101) Fatal and non-fatal overdose among opiate users in South Wales: A qualitative study of peer responses.

Holloway K, Hills R, May T.

Int J Drug Policy. 2018 Mar 29;56:56-63. doi: 10.1016/j.drugpo.2018.03.007. [Epub ahead of print]

Comments: Hm. These results seem a bit odd and may be specific to South Wales. Overdose isn’t that hard to identify…

102) An electronic intervention to improve safety for pain patients co-prescribed chronic opioids and benzodiazepines.

Zaman T, Rife TL, Batki SL, Pennington DL.

Subst Abus. 2018 Mar 29:1-8. doi: 10.1080/08897077.2018.1455163. [Epub ahead of print]

Comments: The VA has done some remarkable work, always with attention to the needs of its patients.

103) Preventing Opioid Overdose in the Clinic and Hospital: Analgesia and Opioid Antagonists.

Peglow SL, Binswanger IA.

Med Clin North Am. 2018 Jul;102(4):621-634. doi: 10.1016/j.mcna.2018.02.005. Review.

Comments: Review of overdose prevention plans.

104) Opioid use and harms associated with a sustained-release tapentadol formulation: a postmarketing study protocol.

Peacock A, Larance B, Farrell M, Cairns R, Buckley N, Degenhardt L.

BMJ Open. 2018 Mar 23;8(3):e020006. doi: 10.1136/bmjopen-2017-020006.

Comments: Methods for a postmarketing study that has not yet been conducted.

105) The President’s Commission on Combating Drug Addiction and the Opioid Crisis: Origins and Recommendations.

Madras BK.

Clin Pharmacol Ther. 2018 Mar 23. doi: 10.1002/cpt.1050. [Epub ahead of print]

Comments: As title says.

106) Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA.

Poowanawittayakom N, Dutta A, Stock S, Touray S, Ellison RT 3rd, Levitz SM.

Emerg Infect Dis. 2018 Apr;24(4). doi: 10.3201/eid2404.171807.

Comments: As title says. Hopefully an inspiration for infectious disease providers to engage in addiction medicine.

107) Beyond the walls: Risk factors for overdose mortality following release from the Philadelphia Department of Prisons.

Pizzicato LN, Drake R, Domer-Shank R, Johnson CC, Viner KM.

Drug Alcohol Depend. 2018 Aug 1;189:108-115. doi: 10.1016/j.drugalcdep.2018.04.034. Epub 2018 Jun 5.

Comments: In Pennsylvania, former inmates released from state prison. 3% died and one-third were due to overdose. Whites were at higher risk than Blacks and Latinos and serious mental illness predicted overdose death.

108) Criminal justice continuum for opioid users at risk of overdose.

Brinkley-Rubinstein L, Zaller N, Martino S, Cloud DH, McCauley E, Heise A, Seal D.

Addict Behav. 2018 Feb 24. pii: S0306-4603(18)30089-3. doi: 10.1016/j.addbeh.2018.02.024. [Epub ahead of print]

Comments: Criminal justice settings need to take substance use disorders seriously, providing services that can greatly improve health and post-release survival.

109) “Taking away the chaos”: a health needs assessment for people who inject drugs in public places in Glasgow, Scotland.

Tweed EJ, Rodgers M, Priyadarshi S, Crighton E.

BMC Public Health. 2018 Jul 4;18(1):829. doi: 10.1186/s12889-018-5718-9.

Comments: Support for safer consumptions spaces in Scotland.

Onward!

1) Simulation of the Effects of Co-Locating Naloxone with Automated External Defibrillators.

Salerno JE, Weiss LS, Salcido DD.

Prehosp Emerg Care. 2018 Mar 1:1-6. doi: 10.1080/10903127.2018.1439128. [Epub ahead of print]

Comments: Not a lot of correlation between AED and naloxone need.

2) Fentanyl and heroin contained in seized illicit drugs and overdose-related deaths in British Columbia, Canada: An observational analysis.

Baldwin N, Gray R, Goel A, Wood E, Buxton JA, Rieb LM.

Drug Alcohol Depend. 2018 Feb 20;185:322-327. doi: 10.1016/j.drugalcdep.2017.12.032. [Epub ahead of print]

Comments: More fentanyl around is associated with more deaths.

3) National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels’ Authority to Administer Opioid Antagonists.

Kinsman JM, Robinson K.

Prehosp Emerg Care. 2018 Feb 27:1-5. doi: 10.1080/10903127.2018.1439129. [Epub ahead of print]

Comments: 49 of 52 US jurisdictions now authorize all levels of emergency responders to administer naloxone.

4) Opioid Overdose Education for Individuals Prescribed Opioids for Pain Management: Randomized Comparison of Two Computer-Based Interventions.

Huhn AS, Garcia-Romeu AP, Dunn KE.

Front Psychiatry. 2018 Feb 12;9:34. doi: 10.3389/fpsyt.2018.00034. eCollection 2018.

Comments: Online naloxone education.

5) Observational study of dermatological manifestations in patients admitted to a tertiary poison center in Iran

Talaie H, Nasiri S, Gheisari M, Dadkhahfar S, Ahmadi S.

Turk J Med Sci. 2018 Feb 23;48(1):136-141. doi: 10.3906/sag-1707-141.

Comments: Interesting study. Dry skin associated with methadone toxicity. Lead exposure leads to shin hyperpigmentation.

6) Dispensing Naloxone Without a Prescription: Survey Evaluation of Ohio Pharmacists.

Thompson EL, Rao PSS, Hayes C, Purtill C.

J Pharm Pract. 2018 Jan 1:897190018759225. doi: 10.1177/0897190018759225. [Epub ahead of print]

Comments: Lots of pharmacists not aware.

7) Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs.

Dietze PM, Draper B, Olsen A, Chronister KJ, van Beek I, Lintzeris N, Dwyer R, Nelson M, Lenton S.

Drug Alcohol Rev. 2018 Feb 22. doi: 10.1111/dar.12680. [Epub ahead of print]

Comments: Yes.

8) Outcomes of compulsory detention compared to community-based voluntary methadone maintenance treatment in Vietnam.

Vuong T, Ritter A, Shanahan M, Ali R, Nguyen N, Pham K, Vuong TTA, Le GM.

J Subst Abuse Treat. 2018 Apr;87:9-15. doi: 10.1016/j.jsat.2018.01.011. Epub 2018 Jan 16.

Comments: Voluntary methadone better than forced treatment. Not much of a surprise here.

9) Socioeconomic and geographical disparities in prescription and illicit opioid related overdose deaths in Orange County, California from 2010-2014.

Marshall JR, Gassner SF, Anderson CL, Cooper RJ, Lotfipour S, Chakravarthy B.

Subst Abus. 2018 Feb 21:1-25. doi: 10.1080/08897077.2018.1442899. [Epub ahead of print]

Comments: If you know Orange County, you know it is fascinating to see a report on overdose deaths in Orange County.

10) The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions.

Perlman DC, Jordan AE.

Curr HIV/AIDS Rep. 2018 Feb 19. doi: 10.1007/s11904-018-0390-3. [Epub ahead of print] Review.

Comments: A look at the multiple issues.

11) Risk of fentanyl-involved overdose among those with past year incarceration: Findings from a recent outbreak in 2014 and 2015.

Brinkley-Rubinstein L, Macmadu A, Marshall BDL, Heise A, Ranapurwala SI, Rich JD, Green TC.

Drug Alcohol Depend. 2018 Feb 9;185:189-191. doi: 10.1016/j.drugalcdep.2017.12.014. [Epub ahead of print]

Comments: Interesting that risk of death extended past 90 days after release, whereas traditionally the highest risk is in the first week or two.

12) Past-Year Nonmedical Use of Prescription Drugs among Women on Probation and Parole: A Cross-Sectional Study.

Hall MT, Ball D, Sears J, Higgins GE, Logan TK, Golder S.

Subst Abus. 2018 Feb 16:1-23. doi: 10.1080/08897077.2018.1442382. [Epub ahead of print]

Comments: Strong associations between opioid use and trauma history.

13) Characteristics of adherence to methadone maintenance treatment over a 15-year period among homeless adults experiencing mental illness.

Parpouchi M, Moniruzzaman A, Rezansoff SN, Russolillo A, Somers JM.

Addict Behav Rep. 2017 Sep 23;6:106-111. doi: 10.1016/j.abrep.2017.09.001. eCollection 2017 Dec.

Comments: Poor adherence to methadone among homeless – we need innovative solutions!

14) Impacts of an opioid overdose prevention intervention delivered subsequent to acute care.

Banta-Green CJ, Coffin PO, Merrill JO, Sears JM, Dunn C, Floyd AS, Whiteside LK, Yanez ND, Donovan DM.

Inj Prev. 2018 Feb 7. pii: injuryprev-2017-042676. doi: 10.1136/injuryprev-2017-042676. [Epub ahead of print]

Comments: This study didn’t find a significant impact of delivering a brief education-based overdose prevention intervention among a population with extensive morbidity. No surprise to have a study with a negative finding – it expands our knowledge of what can make a difference.

15) Pharmaceutical opioid overdose deaths and the presence of witnesses.

Ogeil RP, Dwyer J, Bugeja L, Heilbronn C, Lubman DI, Lloyd B.

Int J Drug Policy. 2018 Feb 9;55:8-13. doi: 10.1016/j.drugpo.2017.12.020. [Epub ahead of print]

Comments: Witnessed overdoses don’t have to result in death.

16) Overcoming medication stigma in peer recovery: a new paradigm.

Krawczyk N, Negron T, Nieto M, Agus D, Fingerhood MI.

Subst Abus. 2018 Feb 12:0. doi: 10.1080/08897077.2018.1439798. [Epub ahead of print]

Comments: Yeah – this is a real, and very sad, problem. Imagine a diabetes support group that stigmatized / didn’t allow anyone who took medications for their diabetes.

17) The relationship between drug use settings, roles in the drug economy, and witnessing a drug overdose in Baltimore, Maryland.

Latkin CA, Edwards C, Davey-Rothwell MA, Yang C, Tobin KE.

Subst Abus. 2018 Feb 12:0. doi: 10.1080/08897077.2018.1439801. [Epub ahead of print]

Comments: Public drug use.

18) Retention of student pharmacists’ knowledge and skills regarding overdose management with naloxone.

Jacobson AN, Bratberg JP, Monk M candidate, Ferrentino J candidate.

Subst Abus. 2018 Feb 12:0. doi: 10.1080/08897077.2018.1439797. [Epub ahead of print]

Comments: Pharmacist student education on overdose and naloxone.

19) An opioid overdose curriculum for medical residents: Impact on naloxone prescribing, knowledge, and attitudes.

Taylor JL, Rapoport AB, Rowley CF, Mukamal KJ, Stead W.

Subst Abus. 2018 Feb 12:0. doi: 10.1080/08897077.2018.1439800. [Epub ahead of print]

Comments: Resident education increased prescribing.

20) From Peers to Lay Bystanders: Findings from a Decade of Naloxone Distribution in Pittsburgh, PA.

Bennett AS, Bell A, Doe-Simkins M, Elliott L, Pouget E, Davis C.

J Psychoactive Drugs. 2018 Feb 9:1-7. doi: 10.1080/02791072.2018.1430409. [Epub ahead of print]

Comments: People who use opioids are more likely than others to come for a naloxone refill. Consistent with prior studies.

21) Commentary on McDonald et al. (2018): Intranasal naloxone-from the laboratory to the real world.

Nielsen S, Larney S, Farrell M.

Addiction. 2018 Mar;113(3):494-495. doi: 10.1111/add.14087. No abstract available.

Comments: Comments on intranasal naloxone.

22) High willingness to use rapid fentanyl test strips among young adults who use drugs.

Krieger MS, Yedinak JL, Buxton JA, Lysyshyn M, Bernstein E, Rich JD, Green TC, Hadland SE, Marshall BDL.

Harm Reduct J. 2018 Feb 8;15(1):7. doi: 10.1186/s12954-018-0213-2.

Comments: Fentanyl test strips are in high demand.

23) Low-energy Bluetooth for detecting real-world penetrance of bystander naloxone kits: a pilot study.

Lai JT, Chapman BP, Boyle KL, Boyer EW, Chai PR.

Proc Annu Hawaii Int Conf Syst Sci. 2018 Jan 3;2018:3253-3258.

Comments: Hmm. People who got naloxone carried it off the hospital campus – that’s as far as the detector could detect.

24) Expected and actual fentanyl exposure among persons seeking opioid withdrawal management.

Kenney SR, Anderson BJ, Conti MT, Bailey GL, Stein MD.

J Subst Abuse Treat. 2018 Mar;86:65-69. doi: 10.1016/j.jsat.2018.01.005. Epub 2018 Jan 4.

Comments: Fentanyl exposure goes further than people who use drugs realize?

25) Opioid recovery initiation: Pilot test of a peer outreach and modified Recovery Management Checkup intervention for out-of-treatment opioid users.

Scott CK, Grella CE, Nicholson L, Dennis ML.

J Subst Abuse Treat. 2018 Mar;86:30-35. doi: 10.1016/j.jsat.2017.12.007. Epub 2017 Dec 19.

Comments: Authors report that there’s a high-risk subgroup of people who carry naloxone who don’t engage in treatment.

26) Associations between pharmacotherapy for opioid dependence and clinical and criminal justice outcomes among adults with co-occurring serious mental illness.

Robertson AG, Easter MM, Lin HJ, Frisman LK, Swanson JW, Swartz MS.

J Subst Abuse Treat. 2018 Mar;86:17-25. doi: 10.1016/j.jsat.2017.12.003. Epub 2017 Dec 12.

Comments: Big reductions in crisis-driven service utilization.

27) Assessment of potential opioid toxicity and response to naloxone by rapid response teams at an urban Melbourne hospital.

Gunasekaran B, Weil J, Whelan T, Santamaria J, Boughey M.

Intern Med J. 2018 Feb;48(2):198-200. doi: 10.1111/imj.13692.

Comments: Authors report variation in naloxone dosing and utilization. I’m not certain that’s a bad thing. There is certainly some variation by provider, but there’s also a lot of variation by situation. Yes, opioid overdose can be simply managed, but if you have the clinical expertise, there’s no reason not to manage it in a more sophisticated, individualized manner.

28) Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.

Formica SW, Apsler R, Wilkins L, Ruiz S, Reilly B, Walley AY.

Int J Drug Policy. 2018 Jan 23;54:43-50. doi: 10.1016/j.drugpo.2018.01.001. [Epub ahead of print]

Comments: Descriptive paper on types of linkage programs after an overdose.

29) Reducing opioid overdose in Kazakhstan: A randomized controlled trial of a couple-based integrated HIV/HCV and overdose prevention intervention “Renaissance”.

Gilbert L, Hunt T, Primbetova S, Terlikbayeva A, Chang M, Wu E, McCrimmon T, El-Bassel N.

Int J Drug Policy. 2018 Jan 27;54:105-113. doi: 10.1016/j.drugpo.2018.01.004. [Epub ahead of print]

Comments: Pre-post suggested a reduction in overdose events with naloxone receipt.

30) Factors associated with sedative use and misuse among heroin users.

Moses TEH, Lundahl LH, Greenwald MK.

Drug Alcohol Depend. 2018 Feb 2;185:10-16. doi: 10.1016/j.drugalcdep.2017.11.035. [Epub ahead of print]

Comments: Interesting that use of prescribed sedatives was not associated with more problems, but non-medical use was. I wonder what that means in the era when we are rapidly removing benzodiazepines from the medication profiles of any patients who use opioids… is that misguided?

31) Naloxone for Opioid Overdose and the Role of the Pharmacist.

Toderika Y, Williams S.

Consult Pharm. 2018 Feb 1;33(2):98-104. doi: 10.4140/TCP.n.2018.98.

Comments: Pharmacists’ role.

32) Intravenous fentanyl use among people who inject drugs in Australia.

Geddes L, Iversen J, Memedovic S, Maher L.

Drug Alcohol Rev. 2018 Feb 6. doi: 10.1111/dar.12668. [Epub ahead of print]

Comments: People who inject fentanyl were 2.16 times more likely to report past-year overdose.

33) A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release.

Brinkley-Rubinstein L, McKenzie M, Macmadu A, Larney S, Zaller N, Dauria E, Rich J.

Drug Alcohol Depend. 2018 Mar 1;184:57-63. doi: 10.1016/j.drugalcdep.2017.11.023. Epub 2018 Jan 31. Erratum in: Drug Alcohol Depend. 2018 Mar 6;186:9.

Comments: All of the findings suggest that continued methadone was superior to detoxing off methadone while in corrections, but the study was almost certainly underpowered to detect a significant difference. The as-treated analysis showed a substantial benefit to continued methadone, but it’s really the intent-to-treat that matters.

34) Injectable Extended-Release Naltrexone to Treat Opioid Use Disorder.

Ndegwa S, Pant S, Pohar S, Mierzwinski-Urban M.

CADTH Issues in Emerging Health Technologies. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016-. 163.

Comments: We still have a lot to learn.

35) Extended-release injectable naltrexone for opioid use disorder: a systematic review.

Jarvis BP, Holtyn AF, Subramaniam S, Tompkins DA, Oga EA, Bigelow GE, Silverman K.

Addiction. 2018 Feb 3. doi: 10.1111/add.14180. [Epub ahead of print] Review.

Comments: Authors determine that lots of people who want to start don’t and those who do often stop treatment early – and there are limited data on efficacy.

36) Why It’s Inappropriate Not to Treat Incarcerated Patients with Opioid Agonist Therapy.

Wakeman SE.

AMA J Ethics. 2017 Sep 1;19(9):922-930. doi: 10.1001/journalofethics.2017.19.9.stas1-1709.

Comments: No different from other healthcare.

1) Using Group Visits to Provide Overdose Education and Distribute Naloxone to High-Risk Primary Care Patients.

Bair MJ.

Pain Med. 2017 Nov 1. doi: 10.1093/pm/pnx279. [Epub ahead of print] No abstract available.

Comment: Described in the title, this is a commentary on a quasi-experimental study in Veterans’ Administration clinics.

2) Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative.

Spelman JF, Peglow S, Schwartz AR, Burgo-Black L, McNamara K, Becker WC.

Pain Med. 2017 Oct 16. doi: 10.1093/pm/pnx243. [Epub ahead of print]

Comment: The paper discussed in the above commentary.

3) Willingness to receive intravenous buprenorphine treatment in opioid-dependent people refractory to oral opioid maintenance treatment: results from a community-based survey in France.

Roux P, Rojas Castro D, Ndiaye K, Briand Madrid L, Laporte V, Mora M, Maradan G, Morel S, Spire B, Carrieri P.

Subst Abuse Treat Prev Policy. 2017 Nov 2;12(1):46. doi: 10.1186/s13011-017-0131-4.

Comment: If oral therapy did not work, some people would accept supervised IV buprenorphine treatment.

4) Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 – 10 States, July-December 2016.

O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM.

MMWR Morb Mortal Wkly Rep. 2017 Nov 3;66(43):1197-1202. doi: 10.15585/mmwr.mm6643e1.

Comment: >10% of deaths involved fentanyl and analogues.

5) Trends in Hospitalization for Opioid Overdose among Rural Compared to Urban Residents of the United States, 2007-2014.

Mosher H, Zhou Y, Thurman AL, Sarrazin MV, Ohl ME.

J Hosp Med. 2017 Nov;12(11):925-929. doi: 10.12788/jhm.2793.

Comment: Can’t access full article, but this seems to compare overdose hospitalizations between urban and rural sites and urban and rural residents.

6) Is systematic training in opioid overdose prevention effective?

Espelt A, Bosque-Prous M, Folch C, Sarasa-Renedo A, Majó X, Casabona J, Brugal MT; REDAN Group.

PLoS One. 2017 Oct 31;12(10):e0186833. doi: 10.1371/journal.pone.0186833. eCollection 2017.

Comment: Yes. Improved knowledge and a possible slight decline in regional fatal overdoses.

7) Heroin Contaminated with Fentanyl Dramatically Enhances Brain Hypoxia and Induces Brain Hypothermia.

Solis E Jr, Cameron-Burr KT, Kiyatkin EA.

eNeuro. 2017 Oct 30;4(5). pii: ENEURO.0323-17.2017. doi: 10.1523/ENEURO.0323-17.2017. eCollection 2017 Sep-Oct.

Comment: As the title says.

8) A Survey of Prescribers’ Attitudes, Knowledge, Comfort, and Fear of Consequences Related to an Opioid Overdose Education and Naloxone Distribution Program.

Peckham AM, Niculete ME, Steinberg H, Boggs DL.

J Public Health Manag Pract. 2017 Oct 27. doi: 10.1097/PHH.0000000000000668. [Epub ahead of print]

Comment: Providers still need individualized training for this.

9) Intranasal naloxone and related strategies for opioid overdose intervention by nonmedical personnel: a review.

Lewis CR, Vo HT, Fishman M.

Subst Abuse Rehabil. 2017 Oct 11;8:79-95. doi: 10.2147/SAR.S101700. eCollection 2017. Review.

Comment: Progress has been made but we have a long way to go.

10) Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial.

Coffin PO, Santos GM, Matheson T, Behar E, Rowe C, Rubin T, Silvis J, Vittinghoff E.

PLoS One. 2017 Oct 19;12(10):e0183354. doi: 10.1371/journal.pone.0183354. eCollection 2017.

Comment: Talking about overdose regularly can reduce overdose events…

11) Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas – United States.

Mack KA, Jones CM, Ballesteros MF.

MMWR Surveill Summ. 2017 Oct 20;66(19):1-12. doi: 10.15585/mmwr.ss6619a1.

Comment: Not as simple as we’ve been told.

12) The US Opioid Crisis: Current Federal and State Legal Issues.

Soelberg CD, Brown RE Jr, Du Vivier D, Meyer JE, Ramachandran BK.

Anesth Analg. 2017 Nov;125(5):1675-1681. doi: 10.1213/ANE.0000000000002403. Review.

Comment: Legal and policy approaches.

13) Increasing availability of illicit and prescription opioids among people who inject drugs in a Canadian setting, 2010-2014.

Ho J, DeBeck K, Milloy MJ, Dong H, Wood E, Kerr T, Hayashi K.

Am J Drug Alcohol Abuse. 2017 Oct 19:1-10. doi: 10.1080/00952990.2017.1376678. [Epub ahead of print]

Comment: As title says, and in some contrast to the U.S. experience in which prescription opioid availability began to decline after 2010.

14) Imaging Sex Differences in Regional Brain Metabolism during Acute Opioid Withdrawal.

Santoro GC, Carrion J, Dewey SL.

J Alcohol Drug Depend. 2017 Apr;5(2). pii: 262. doi: 10.4172/2329-6488.1000262. Epub 2017 Apr 6.

Comment: Differences between men and women may help to explain different responsiveness to opioid use disorder treatment.

15) Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone”.

Salama A, Levin Y, Jha P, Alweis R.

J Community Hosp Intern Med Perspect. 2017 Sep 19;7(4):222-226. doi: 10.1080/20009666.2017.1351290. eCollection 2017 Oct.

Comment: Yikes.

16) Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU.

Orsini J, Din N, Elahi E, Gomez A, Rajayer S, Malik R, Jean E.

J Community Hosp Intern Med Perspect. 2017 Sep 19;7(4):202-207. doi: 10.1080/20009666.2017.1356189. eCollection 2017 Oct.

Comment: This was a study of ICU admissions for acute drug poisoning in a single facility in NYC over 6 months from late 2015 to early 2016. The 65 patients accounted for 19% of all ICU admissions during the period; 8 signed out AMA while in the ICU and 5 patients died. The most common drugs positive on serumor urine testing were alcohol (35%), opioids (33%), cocaine (24%), methadone (22%), benzodiazepines (18%), and marijuana (16%). Among the 35% with negative screens, causes of the admission including tylenol, ethylene gycol, isopropyl alcohol, bleach, NSAIDS, and antidepressants. Mean cost of ICU care was $16k.

I don’t see a report on length of stay or on disposition (i.e. did they go home, to skilled nursing, were they vegetative, etc.).

17) Naloxone Counseling for Harm Reduction and Patient Engagement.

Han JK, Hill LG, Koenig ME, Das N.

Fam Med. 2017 Oct;49(9):730-733.

Comment: Family health providers providing naloxone kits.

18) National trends and outcomes of cardiac arrest in opioid overdose.

Sakhuja A, Sztajnkrycer M, Vallabhajosyula S, Cheungpasitporn W, Patch R 3rd, Jentzer J.

Resuscitation. 2017 Oct 14;121:84-89. doi: 10.1016/j.resuscitation.2017.10.010. [Epub ahead of print]

Comment: Interesting. Mortality in the hospital for drug poisoning 1.5%: heroin overdose 4.4% (61.8% if arrived in cardiac arrest), prescription opioid overdose 2.3% (58.3% for cardiac arrest), non-opioid 1.2% (54.7% for cardiac arrest). Authors report increasing rate of cardiac arrest presentations for heroin overdose from 2000-2013, and most presentations are for prescription opioids. Trying to tease this apart is a bit tricky. Does this mean heroin overdoses are getting more dangerous? If the data went to 2015 or 2016 the answer would likely be yes, due to fentanyl, but earlier years didn’t see much of that so I don’t think this is explained by fentanyl. Were more heroin overdoses being managed in the field, either by lay persons or paramedics with more lenient transport policies, and thus not presenting to the hospital unless they had serious complications?

19) Three Cases of Fatal Acrylfentanyl Toxicity in the United States and a Review of Literature.

Butler DC, Shanks K, Behonick GS, Smith D, Presnell SE, Tormos LM.

J Anal Toxicol. 2017 Sep 28:1-6. doi: 10.1093/jat/bkx083. [Epub ahead of print]

Comment: Hard to detect.

20) Opioid use disorder and misuse: A review of the epidemiology and medical implications for pediatric anesthesiologists.

Knipper E, Banta-Green CJ, Jimenez N.

Paediatr Anaesth. 2017 Nov;27(11):1070-1076. doi: 10.1111/pan.13225. Review.

Comment: Discussion of disordered opioid use by pediatric patients.

21) Pharmaceutical opioid use and harm in Australia: The need for proactive and preventative responses.

Larance B, Degenhardt L, Peacock A, Gisev N, Mattick R, Colledge S, Campbell G.

Drug Alcohol Rev. 2017 Oct 12. doi: 10.1111/dar.12617. [Epub ahead of print]

Comment: Not much harm yet and interest in developing policies and practices to prevent them.

22) Basic and Advanced EMS Providers Are Equally Effective in Naloxone Administration for Opioid Overdose in Northern New England.

Gulec N, Lahey J, Suozzi JC, Sholl M, MacLean CD, Wolfson DL.

Prehosp Emerg Care. 2017 Oct 12:1-7. doi: 10.1080/10903127.2017.1371262. [Epub ahead of print]

Comment: It’s a remarkably safe and straightforward drug.

23) Use of on-site detoxification services co-located with a supervised injection facility.

Gaddis A, Kennedy MC, Nosova E, Milloy MJ, Hayashi K, Wood E, Kerr T.

J Subst Abuse Treat. 2017 Nov;82:1-6. doi: 10.1016/j.jsat.2017.08.003. Epub 2017 Aug 8.

Comment: Insite has a detox service. 11% of Insite attendees utilized it in a 2 year period. A recent overdose roughly doubled the chances that a participant would access the service (adjusted odds ratio 1.90).

24) Acute eosinophilic pneumonia secondary to heroin inhalation.

Eyüpoğlu D, Ortaç Ersoy E, Rollas K, Topeli A.

Tuberk Toraks. 2017 Jun;65(2):154-156. doi: 10.5578/tt.10438.

Comment: Treated with steroids.

25) Patterns of substance use and mortality risk in a cohort of “hard-to-reach” polysubstance users.

Gjersing L, Bretteville-Jensen AL.

Addiction. 2017 Oct 7. doi: 10.1111/add.14053. [Epub ahead of print]

Comment: 6% reported an overdose in the preceding 30 days. Crude mortality was 2.52/100py, 57% of which was due to overdose. A past-four week overdose quadrupled the risk of death and agonist treatment halved mortality. Using a latent class analysis among those not in agonist treatment, polysubstance injectors and somewhat frequent injectors were the most likely to die.

26) Combatting the opioid epidemic: Baltimore’s experience and lessons learned.

Wen LS, Warren KE.

J Public Health (Oxf). 2017 Jul 19:1-5. doi: 10.1093/pubmed/fdx093. [Epub ahead of print]

Comment: Summary of actions in Baltimore

27) Beyond rescue: Implementation and evaluation of revised naloxone training for law enforcement officers.

Dahlem CHG, King L, Anderson G, Marr A, Waddell JE, Scalera M.

Public Health Nurs. 2017 Oct 6. doi: 10.1111/phn.12365. [Epub ahead of print]

Comment: Description of naloxone use by law enforcement.

28) Opioid crisis at the Jersey Shore-special report.

Dudley LS, Konomos D, Robbins V, Qiu L, Bauter R, Merlin MA.

J Public Health (Oxf). 2017 Aug 31:1-6. doi: 10.1093/pubmed/fdx106. [Epub ahead of print]

Comment: Jersey Shore overdoses seen by advanced EMS. 312 cases. 212 got first naloxone by lay person, police, or other BLS provider. Of those 5.2% died. Of those who got first naloxone dose by paramedics, 19.3% died.

29) A Novel Oral Fluid Assay (LC-QTOF-MS) for the Detection of Fentanyl and Clandestine Opioids in Oral Fluid After Reported Heroin Overdose.

Griswold MK, Chai PR, Krotulski AJ, Friscia M, Chapman BP, Varma N, Boyer EW, Logan BK, Babu KM.

J Med Toxicol. 2017 Oct 2. doi: 10.1007/s13181-017-0632-6. [Epub ahead of print]

Comment: Oral fluid testing.

30) The Opioid Epidemic: Crisis and Solutions.

Skolnick P.

Annu Rev Pharmacol Toxicol. 2017 Oct 2. doi: 10.1146/annurev-pharmtox-010617-052534. [Epub ahead of print]

Comment: Discussion of need for alternative pharmacotherapies for pain.

31) Take-home naloxone provision cuts opioid overdose deaths.

Thompson J.

Practitioner. 2016 Nov;260(1798):7. No abstract available.

Comment: Letter. Can’t access.

32) Fentanyl and the Evolving Opioid Epidemic: What Strategies Should Policy Makers Consider?

Barry CL.

Psychiatr Serv. 2017 Oct 2:appips201700235. doi: 10.1176/appi.ps.201700235. [Epub ahead of print]

Comment: Several harm reduction approaches discussed.

33) Who is Overdosing? An Updated Picture of Overdose Deaths From 2008 to 2015.

Eigner G, Henriksen B, Huynh P, Murphy D, Brubaker C, Sanders J, McMahan D.

Health Serv Res Manag Epidemiol. 2017 Sep 8;4:2333392817727424. doi: 10.1177/2333392817727424. eCollection 2017 Jan-Dec.

Comment: Opioid deaths in Allen County, Indiana.

34) Heroin-Related Compartment Syndrome: An Increasing Problem for Acute Care Surgeons.

Benns M, Miller K, Harbrecht B, Bozeman M, Nash N.

Am Surg. 2017 Sep 1;83(9):962-965.

Comment: Unable to access, but I assume this is in Kentucky. Heroin is now the second most common etiology for compartment syndrome. Compartment syndrome is basically when there is so much swelling in a part of the body that blood can no longer flow to that region.

35) Concurrent Use of Opioids and Benzodiazepines: Evaluation of Prescription Drug Monitoring by a United States Laboratory.

McClure FL, Niles JK, Kaufman HW, Gudin J.

J Addict Med. 2017 Sep 28. doi: 10.1097/ADM.0000000000000354. [Epub ahead of print]

Comment: Among people who were prescribed either an opioid or a benzodiazepine and who were urine tox tested, 25% had the other drug class – half of those cases were not prescribed the other class of drugs. 19% of specimens testing positive for prescribed opioids also had non-prescribed benzodiazepines and 15% of specimens testing positive for prescribed benzodiazepines also had non-prescribed opioids. These data are a bit confusing as many are presented as specimen data rather than patient data; clearly a person who is tested frequently is more likely to have non-prescribed use and results would be similar within-person.

36) The Curious (Dis)Connection between the Opioid Epidemic and Crime.

Szalavitz M, Rigg KK.

Subst Use Misuse. 2017 Sep 27:1-5. doi: 10.1080/10826084.2017.1376685. [Epub ahead of print]

Comment: “That trend—towards viewing addiction as a medical, rather than a moral problem—has also been given a tremendous boost by the media focus on opioid addiction as a white problem.”

37) Community use of naloxone for opioid overdose.

Jauncey ME, Nielsen S.

Aust Prescr. 2017 Aug;40(4):137-140. doi: 10.18773/austprescr.2017.043. Epub 2017 Aug 1. Review. No abstract available.

Comment: Pharmacy review.

38) Modifiable risk factors for external cause mortality after release from prison: a nested case-control study.

Spittal MJ, Forsyth S, Borschmann R, Young JT, Kinner SA.

Epidemiol Psychiatr Sci. 2017 Sep 25:1-10. doi: 10.1017/S2045796017000506. [Epub ahead of print]

Comment: Use of opioids in the community more than doubles the risk of death on prison release.

39) Methods for delivering the UK’s multi-centre prison-based naloxone-on-release pilot randomised trial (N-ALIVE): Europe’s largest prison-based randomised controlled trial.

Meade AM, Bird SM, Strang J, Pepple T, Nichols LL, Mascarenhas M, Choo L, Parmar MKB.

Drug Alcohol Rev. 2017 Sep 21. doi: 10.1111/dar.12592. [Epub ahead of print]

Comment: Feasibility of RCT in prison.

40) Opioid Overdose Outbreak – West Virginia, August 2016.

Massey J, Kilkenny M, Batdorf S, Sanders SK, Ellison D, Halpin J, Gladden RM, Bixler D, Haddy L, Gupta R.

MMWR Morb Mortal Wkly Rep. 2017 Sep 22;66(37):975-980. doi: 10.15585/mmwr.mm6637a3.

Comment: 20 overdoses in 2 days in a town in West Virginia, lots of fentanyl products.

41) A Case of Opioid Overdose and Subsequent Death After Medically Supervised Withdrawal: The Problematic Role of Rapid Tapers for Opioid Use Disorder.

Chang DC, Klimas J, Wood E, Fairbairn N.

J Addict Med. 2017 Sep 19. doi: 10.1097/ADM.0000000000000359. [Epub ahead of print]

Comment: Are we still surprised by this? Detox is extremely dangerous.

42) Emergency physicians’ attitudes and perceived barriers to the implementation of take-home naloxone programs in Canadian emergency departments.

Lacroix L, Thurgur L, Orkin AM, Perry JJ, Stiell IG.

CJEM. 2017 Sep 18:1-7. doi: 10.1017/cem.2017.390. [Epub ahead of print]

Comment: 86% of ED docs were willing to prescribe naloxone. That’s substantial.

43) Advances in the delivery of buprenorphine for opioid dependence.

Rosenthal RN, Goradia VV.

Drug Des Devel Ther. 2017 Aug 28;11:2493-2505. doi: 10.2147/DDDT.S72543. eCollection 2017. Review.

Comment: Patches, injections, and implants, oh my.

44) Deaths from Opioid Overdosing: Implications of Coroners’ Inquest Reports 2008-2012 and Annual Rise in Opioid Prescription Rates: A Population-Based Cohort Study.

Shipton EE, Shipton AJ, Williman JA, Shipton EA.

Pain Ther. 2017 Sep 8. doi: 10.1007/s40122-017-0080-7. [Epub ahead of print]

Comment: A 33% increase in opioid death from 2001 to 2012 in New Zealand.

45) Treating Acute Pain in the Opiate-Dependent Patient.

Dever C.

J Trauma Nurs. 2017 Sep/Oct;24(5):292-299. doi: 10.1097/JTN.0000000000000309.

Comment: Per title, can’t access.

46) Mobile Technology to Increase HIV/HCV Testing and Overdose Prevention/Response among People Who Inject Drugs.

Aronson ID, Bennett A, Marsch LA, Bania TC.

Front Public Health. 2017 Aug 23;5:217. doi: 10.3389/fpubh.2017.00217. eCollection 2017.

Comment: Combining HIV, HCV, and overdose into a tablet.

47) Association between public injecting and drug-related harm among HIV-positive people who use injection drugs in a Canadian setting: A longitudinal analysis.

Ickowicz S, Wood E, Dong H, Nguyen P, Small W, Kerr T, Montaner JSG, Milloy MJ.

Drug Alcohol Depend. 2017 Aug 10;180:33-38. doi: 10.1016/j.drugalcdep.2017.07.016. [Epub ahead of print]

Comment: Public injecting was associated with detectable HIV viral load, incarceration, and daily injection. Overdose was more likely in bivariate but not adjusted analyses.

48) Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region – United States, 2006-2015.

O’Donnell JK, Gladden RM, Seth P.

MMWR Morb Mortal Wkly Rep. 2017 Sep 1;66(34):897-903. doi: 10.15585/mmwr.mm6634a2.

Comment: Mortality increased throughout the nation, least in the West and most in the Northeast

49) Overdose Deaths Related to Fentanyl and Its Analogs – Ohio, January-February 2017.

Daniulaityte R, Juhascik MP, Strayer KE, Sizemore IE, Harshbarger KE, Antonides HM, Carlson RR.

MMWR Morb Mortal Wkly Rep. 2017 Sep 1;66(34):904-908. doi: 10.15585/mmwr.mm6634a3.

Comment: Fentanyl and related products overtaking

50) Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid.

Frazier W, Cochran G, Lo-Ciganic WH, Gellad WF, Gordon AJ, Chang CH, Donohue JM.

JAMA. 2017 Aug 22;318(8):750-752. doi: 10.1001/jama.2017.7818. No abstract available.

Comment: Slight increase in pharmacotherapy for opioid use disorder after overdose event

51) Awareness, Possession, and Use of Take-Home Naloxone Among Illicit Drug Users, Vancouver, British Columbia, 2014-2015.

Nolan S, Buxton J, Dobrer S, Dong H, Hayashi K, Milloy MJ, Kerr T, Montaner J, Wood E.

Public Health Rep. 2017 Sep/Oct;132(5):563-569. doi: 10.1177/0033354917717230. Epub 2017 Jul 27.

Comment: 22% of people who inject drugs had take-home naloxone.

108 articles in four months. The fentanyl ones are all at the end in a special section, as are the injection facility ones. The rest you will have to parse through. Okay, that’s it – I feel myself turning into a pumpkin.

1) A mapping review of take-home naloxone for people released from correctional settings.

Horton M, McDonald R, Green TC, Nielsen S, Strang J, Degenhardt L, Larney S.

Int J Drug Policy. 2017 May 30;46:7-16. doi: 10.1016/j.drugpo.2017.05.015. [Epub ahead of print]

Comment: Naloxone pre-release is totally doable, but outcome studies have run into some challenges.

2) Buprenorphine implants in medical treatment of opioid addiction.

Chavoustie S, Frost M, Snyder O, Owen J, Darwish M, Dammerman R, Sanjurjo V.

Expert Rev Clin Pharmacol. 2017 Jun 2. doi: 10.1080/17512433.2017.1336434. [Epub ahead of print]

Comment: Looking forward to this. It should overcome a lot of the misinformed resistance.

3) The societal cost of heroin use disorder in the United States.

Jiang R, Lee I, Lee TA, Pickard AS.

PLoS One. 2017 May 30;12(5):e0177323. doi: 10.1371/journal.pone.0177323. eCollection 2017.

Comment: I haven’t read this in depth, but find it a bit disturbing. It always seems a bit off in economic models when you “charge” people for incarcerating them.

4) DNA Methylation Profiling of Human Prefrontal Cortex Neurons in Heroin Users Shows Significant Difference between Genomic Contexts of Hyper- and Hypomethylation and a Younger Epigenetic Age.

Kozlenkov A, Jaffe AE, Timashpolsky A, Apontes P, Rudchenko S, Barbu M, Byne W, Hurd YL, Horvath S, Dracheva S.

Genes (Basel). 2017 May 30;8(6). pii: E152. doi: 10.3390/genes8060152.

Comment: Possible heroin-associated changes in the prefrontal cortex.

5) Overdose Education and Naloxone Distribution for Veterans with Opioid Use Disorder: Results from a Pilot Initiative.

Chang G, Davids M, Kershaw A.

J Addict Dis. 2017 May 26:0. doi: 10.1080/10550887.2017.1333331. [Epub ahead of print]

Comment: 89% of outpatient and 63% of inpatient veterans accepted take-home naloxone.

6) A New Tool to Tackle the Opioid Epidemic: Description, Utility, and Results from the Maine Diversion Alert Program.

Piper BJ, Desrosiers CE, Fisher HC, McCall KL, Nichols SD.

Pharmacotherapy. 2017 May 19. doi: 10.1002/phar.1952. [Epub ahead of print]

Comment: A registry of drug arrests including type of drug.

7) Frequency and severity of non-fatal opioid overdoses among clients attending the Sydney Medically Supervised Injecting Centre.

Roxburgh A, Darke S, Salmon AM, Dobbins T, Jauncey M.

Drug Alcohol Depend. 2017 May 17;176:126-132. doi: 10.1016/j.drugalcdep.2017.02.027. [Epub ahead of print]

Comment: Great data. 12.7 overdose events per 1,000 heroin injections; 4.1 oxycodone overdoses per 1,000 injections. Another confirmation that injecting prescribed opioids is safer than heroin / street drugs, and thus possibly explaining at least part of the increase in overdose death while we pull back on opioid prescribing.

8) Use of naloxone nasal spray 4 mg in the community setting: a survey of use by community organizations.

Avetian GK, Fiuty P, Mazzella S, Koppa D, Heye V, Hebbar P.

Curr Med Res Opin. 2017 May 23:1-9. doi: 10.1080/03007995.2017.1334637. [Epub ahead of print]

Comment: Some good initial field data on the 4mg nasal spray. We were worried about precipitated withdrawal, but the results seem to be pretty similar to the other doses. 98.8% survived and 2 of the 3 deaths were thought to be already dead when naloxone was administered (there was no further info for the third case). 14% had withdrawal, 10% had retching/vomiting type symptoms, and 9% were angry. Interestingly, given the “high” dose and exposure of this product, a second dose was used 33% of the time, with >=3 doses in 2.4% of cases. As we know, it is difficult to wait for naloxone to start to work, and many of the second doses are administered in a panic rather than due to lack of effect of the first dose.

9) Rapid widespread distribution of intranasal naloxone for overdose prevention.

Madah-Amiri D, Clausen T, Lobmaier P.

Drug Alcohol Depend. 2017 Apr 1;173:17-23. doi: 10.1016/j.drugalcdep.2016.12.013. Epub 2017 Jan 28.

Comment: Government-supported program gets the product out fast.

10) Increases in prescription opioid injection abuse among treatment admissions in the United States, 2004-2013.

Jones CM, Christensen A, Gladden RM.

Drug Alcohol Depend. 2017 May 16;176:89-95. doi: 10.1016/j.drugalcdep.2017.03.011. [Epub ahead of print]

Comment: When you look at the years in Figure 1, once again the biggest change centers around 2010, a key year in all of the opioid trend graphs.

11) Update on Barriers to Pharmacotherapy for Opioid Use Disorders.

Sharma A, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Schwartz RP.

Curr Psychiatry Rep. 2017 Jun;19(6):35. doi: 10.1007/s11920-017-0783-9. Review.

Comment: Financial, regulatory, geographic, attitudinal, and logistic.

12) Telling our stories: heroin-assisted treatment and SNAP activism in the Downtown Eastside of Vancouver.

Boyd S, Murray D; SNAP, MacPherson D.

Harm Reduct J. 2017 May 18;14(1):27. doi: 10.1186/s12954-017-0152-3.

Comment: Some powerful activism in Vancouver.

13) Safety profile of injectable hydromorphone and diacetylmorphine for long-term severe opioid use disorder.

Oviedo-Joekes E, Brissette S, MacDonald S, Guh D, Marchand K, Jutha S, Harrison S, Janmohamed A, Zhang DZ, Anis AH, Krausz M, Marsh DC, Schechter MT.

Drug Alcohol Depend. 2017 May 10;176:55-62. doi: 10.1016/j.drugalcdep.2017.02.021. [Epub ahead of print]

Comment: Generally, in a chronic disease that requires ongoing management and can be extremely morbid, we accept with open arms any treatment that has at least some benefit.

14) Patient Characteristics and Outcomes in Unintentional, Non-fatal Prescription Opioid Overdoses: A Systematic Review.

Elzey MJ, Barden SM, Edwards ES.

Pain Physician. 2016 May;19(4):215-28. Review.

Comment: We need to study non-fatal overdose more.

15) Comparison of a New Intranasal Naloxone Formulation to Intramuscular Naloxone: Results from Hypothesis-generating Small Clinical Studies.

Gufford BT, Ainslie GR, White JR Jr, Layton ME, Padowski JM, Pollack GM, Paine MF.

Clin Transl Sci. 2017 May 15. doi: 10.1111/cts.12473. [Epub ahead of print]

Comment: Interesting data comparing the products; overall 2mg IN and 2mg IM naloxone were pretty similar.

16) Risk to heroin users of polydrug use of pregabalin or gabapentin.

Lyndon A, Audrey S, Wells C, Burnell ES, Ingle S, Hill R, Hickman M, Henderson G.

Addiction. 2017 May 10. doi: 10.1111/add.13843. [Epub ahead of print]

Comment: Interesting. Initially I suspected that the association of increased prescribing of gabapentins and increased opioid overdose mortality was a nature of the growing population of opioid dependent persons, but the authors present some interview data and animal data suggesting that these agents lessen the tolerance to the respiratory depressive effects of opioids. Is this yet another combination we should try to avoid clinically? We are running out of options.

17) Medical providers’ knowledge and concerns about opioid overdose education and take-home naloxone rescue kits within Veterans Affairs health care medical treatment settings.

Winograd RP, Davis CS, Niculete M, Oliva E, Martielli RP.

Subst Abus. 2017 Apr-Jun;38(2):135-140. doi: 10.1080/08897077.2017.1303424.

Comment: I find it so weird that a physician would say that prescribing naloxone would increase opioid use. I doubt any would say the same about prescribing or recommending insulin, glucagon, epinephrine pens, or fire extinguishers.

18) Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing.

Faul M, Lurie P, Kinsman JM, Dailey MW, Crabaugh C, Sasser SM.

Prehosp Emerg Care. 2017 May 8:1-8. doi: 10.1080/10903127.2017.1315203. [Epub ahead of print]

Comment: Pretty good analysis.

19) Beliefs about the consequences of using benzodiazepines among persons with opioid use disorder.

Stein MD, Anderson BJ, Kenney SR, Bailey GL.

J Subst Abuse Treat. 2017 Jun;77:67-71. doi: 10.1016/j.jsat.2017.03.002. Epub 2017 Mar 9.

Comment: Benzo users generally know that they are risky.

20) Past-year prevalence of prescription opioid misuse among those 11 to 30years of age in the United States: A systematic review and meta-analysis.

Jordan AE, Blackburn NA, Des Jarlais DC, Hagan H.

J Subst Abuse Treat. 2017 Jun;77:31-37. doi: 10.1016/j.jsat.2017.03.007. Epub 2017 Mar 12.

Comment: Increased through the 2000s.

21) Treatment of opioid overdose: a brief review of naloxone pharmacology and delivery.

Hendley TM, Hersh EV, Moore PA, Stahl B, Saraghi M.

Gen Dent. 2017 May-Jun;65(3):18-21. No abstract available.

Comment: Can’t access.

22) Drug users’ experiences of witnessing overdoses: what do they know and what do they need to know?

Best D, Man LH, Gossop M, Noble A, Strang J.

Drug Alcohol Rev. 2000 Dec;19(4):407-412. doi: 10.1080/713659420.

Comment: Drug users are interested in overdose prevention…

23) Correction: Cost-Effectiveness of Distributing Naloxone to Heroin Users for Lay Overdose Reversal.

Ann Intern Med. 2017 May 2;166(9):687. doi: 10.7326/M17-0652. No abstract available.

Comment: This is a small correction in one of the appendix tables from the Coffin cost-effectiveness paper. There was an error in Appendix Table 3, where the total number of overdose events was overcounted. The correction is in the online table only:

24) Naloxone rescheduling in Australia: Processes, implementation and challenges with supply of naloxone as a ‘pharmacist only’ over-the-counter medicine.

Pricolo A, Nielsen S.

Drug Alcohol Rev. 2017 Apr 27. doi: 10.1111/dar.12547. [Epub ahead of print]

Comment: Overcomes the standing order barrier that the U.S. has.

25) Supervised dosing with a long-acting opioid medication in the management of opioid dependence.

Saulle R, Vecchi S, Gowing L.

Cochrane Database Syst Rev. 2017 Apr 27;4:CD011983. doi: 10.1002/14651858.CD011983.pub2. Review.

Comment: Not much data comparing supervised to unsupervised dosing.

26) Pharmacokinetics after a single dose of naloxone administered as a nasal spray in healthy volunteers.

Vanky E, Hellmundt L, Bondesson U, Eksborg S, Lundeberg S.

Acta Anaesthesiol Scand. 2017 Jul;61(6):636-640. doi: 10.1111/aas.12898. Epub 2017 Apr 25.

Comment: Using a 0.4mg/mL formulation intranasally (which nobody uses), uptake was fast and concentration highly variable.

27) Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study.

Wiessing L, Ferri M, Běláčková V, Carrieri P, Friedman SR, Folch C, Dolan K, Galvin B, Vickerman P, Lazarus JV, Mravčík V, Kretzschmar M, Sypsa V, Sarasa-Renedo A, Uusküla A, Paraskevis D, Mendão L, Rossi D, van Gelder N, Mitcheson L, Paoli L, Gomez CD, Milhet M, Dascalu N, Knight J, Hay G, Kalamara E, Simon R; EUBEST working group, Comiskey C, Rossi C, Griffiths P.

Harm Reduct J. 2017 Apr 22;14(1):19. doi: 10.1186/s12954-017-0141-6.

Comment: Really cool set of best practice indicators.

28) Pharmacokinetics of concentrated naloxone nasal spray over first 30 minutes post-dosing: analysis of suitability for opioid overdose reversal.

Mundin G, McDonald R, Smith K, Harris S, Strang J.

Addiction. 2017 Apr 21. doi: 10.1111/add.13849. [Epub ahead of print]

Comment: Concentrated nasal naloxone pk data.

29) Expanding access to naloxone for family members: The Massachusetts experience.

Bagley SM, Forman LS, Ruiz S, Cranston K, Walley AY.

Drug Alcohol Rev. 2017 Apr 20. doi: 10.1111/dar.12551. [Epub ahead of print]

Comment: Good experience.

30) Peripartum Anesthetic Management of the Opioid-tolerant or Buprenorphine/Suboxone-dependent Patient.

Pan A, Zakowski M.

Clin Obstet Gynecol. 2017 Jun;60(2):447-458. doi: 10.1097/GRF.0000000000000288.

Comment: As above.

31) Assessing causality in drug policy analyses: How useful are the Bradford Hill criteria in analysing take-home naloxone programs?

Olsen A, McDonald D, Lenton S, Dietze PM.

Drug Alcohol Rev. 2017 Apr 18. doi: 10.1111/dar.12523. [Epub ahead of print]

Comment: There’s more than Bradford Hill criteria supporting naloxone. Very little we do in medicine has RCT data.

32) Risk Factors for Serious Prescription Opioid-Induced Respiratory Depression or Overdose: Comparison of Commercially Insured and Veterans Health Affairs Populations.

Nadpara PA, Joyce AR, Murrelle EL, Carroll NW, Carroll NV, Barnard M, Zedler BK.

Pain Med. 2017 Apr 13. doi: 10.1093/pm/pnx038. [Epub ahead of print]

Comment: Risk factors were similar in the two populations, including substance use disorder, depression, other mental health disorders, organ dysfunction, higher doses, fentanyl/morphine/methadone, and other psychoactive medications.

33) Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

Stopka TJ, Donahue A, Hutcheson M, Green TC.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S34-S44. doi: 10.1016/j.japh.2016.12.077. Epub 2017 Feb 8.

Comment: 45% of surveyed pharmacies stocked naloxone.

34) Underestimated impact of novel psychoactive substances: laboratory confirmation of recreational drug toxicity in Oslo, Norway.

Vallersnes OM, Persett PS, Øiestad EL, Karinen R, Heyerdahl F, Hovda KE.

Clin Toxicol (Phila). 2017 Apr 13:1-9. doi: 10.1080/15563650.2017.1312002. [Epub ahead of print]

Comment: There are drug fads, but there are core drugs that dominate the scene and tend to stick around.

35) Naloxone Administration for Opioid Overdose Reversal in the Prehospital Setting: Implications for Pharmacists.

Weaver L, Palombi L, Bastianelli KM.

J Pharm Pract. 2017 Jan 1:897190017702304. doi: 10.1177/0897190017702304. [Epub ahead of print]

Comment: Information on naloxone formulations for pharmacists.

36) Scotland’s national naloxone program: The prison experience.

Horsburgh K, McAuley A.

Drug Alcohol Rev. 2017 Apr 10. doi: 10.1111/dar.12542. [Epub ahead of print]

Comment: Implementation challenges.

37) How Would You Manage Opioid Use in These Three Patients?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Alford DP, Cohen ML, Reynolds EE.

Ann Intern Med. 2017 Apr 4;166(7):506-513. doi: 10.7326/M17-0287.

Comment: Case review for clinicians.

38) Institutional Substance Use Disorder Intervention Improves General Internist Preparedness, Attitudes, and Clinical Practice.

Wakeman SE, Kanter GP, Donelan K.

J Addict Med. 2017 Apr 3. doi: 10.1097/ADM.0000000000000314. [Epub ahead of print]

Comment: Not so long ago, a physician was on their own in treating diabetes.
They had a ton of medications, so the situation was better than for most substance use disorders. But they didn’t have nutritionists and other services to round off care and ensure patients were well taken care of; it was tough and often dissatisfying. Now they have more wraparound services. Do it for substance use disorders and you get a similar improvement in satisfaction all around.

39) Proceedings from Bridging Health Disparities to Address the Opioid Epidemic: A Symposium at the Warren Alpert Medical School of Brown University.

Dumenco L, Monteiro K, Mello M, Collins S, Operario D, Scanlan K, Dollase R, George P.

R I Med J (2013). 2017 Apr 3;100(4):16-18.

Comment: Addressing the Rhode Island crisis.

40) When to Pick the Nose: Out-of-Hospital and Emergency Department Intranasal Administration of Medications.

Rech MA, Barbas B, Chaney W, Greenhalgh E, Turck C.

Ann Emerg Med. 2017 Mar 25. pii: S0196-0644(17)30194-4. doi: 10.1016/j.annemergmed.2017.02.015.

Comment: Naloxone, fentanyl, and midazolam are often used intranasal in emergency settings.

41) Buprenorphine physician supply: Relationship with state-level prescription opioid mortality.

Knudsen HK, Havens JR, Lofwall MR, Studts JL, Walsh SL.

Drug Alcohol Depend. 2017 Apr 1;173 Suppl 1:S55-S64. doi: 10.1016/j.drugalcdep.2016.08.642.

Comment: these ecologic studies are hard to interpret.

42) Randomized controlled trial of a computerized opioid overdose education intervention.

Dunn KE, Yepez-Laubach C, Nuzzo PA, Fingerhood M, Kelly A, Berman S, Bigelow GE.

Drug Alcohol Depend. 2017 Apr 1;173 Suppl 1:S39-S47. doi: 10.1016/j.drugalcdep.2016.12.003.

Comment: Interesting data from an online training

43) Development of a targeted naloxone coprescribing program in a primary care practice.

Wilson CG, Rodriguez F, Carrington AC, Fagan EB.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S130-S134. doi: 10.1016/j.japh.2016.12.076. Epub 2017 Feb 9.

Comment: Chart review identified a large number of patients eligible for naloxone and only about 3% had the medication on their med list.

44) Methadone Prescribing and Overdose and the Association with Medicaid Preferred Drug List Policies – United States, 2007-2014.

Faul M, Bohm M, Alexander C.

MMWR Morb Mortal Wkly Rep. 2017 Mar 31;66(12):320-323. doi: 10.15585/mmwr.mm6612a2.

Comment: As we shifted away from methadone for pain, there were fewer methadone deaths. I’m think deck chairs, Titanic …

45) Use of Intranasal Naloxone by Basic Life Support Providers.

Weiner SG, Mitchell PM, Temin ES, Langlois BK, Dyer KS.

Prehosp Emerg Care. 2017 May-Jun;21(3):322-326. doi: 10.1080/10903127.2017.1282562. Epub 2017 Feb 6.

Comment: BLS naloxone is a good thing.

46) Knowledge of Opioid Overdose and Attitudes to Supply of Take-Home Naloxone Among People with Chronic Noncancer Pain Prescribed Opioids.

Nielsen S, Peacock A, Lintzeris N, Bruno R, Larance B, Degenhardt L.

Pain Med. 2017 Mar 13. doi: 10.1093/pm/pnx021. [Epub ahead of print]

Comment: 14% had experienced overdose symptoms They liked the idea of naloxone but didn’t know much about overdose.

47) Physician Dispensing of Oxycodone and Other Commonly Used Opioids, 2000-2015, United States.

Mack KA, Jones CM, McClure RJ.

Pain Med. 2017 Mar 15. doi: 10.1093/pm/pnx007. [Epub ahead of print]

Comment: Radical shifts in direct dispensing of opioids, particularly in Florida. Wow.

48) Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico.

Meacham MC, Roesch SC, Strathdee SA, Lindsay S, Gonzalez-Zuniga P, Gaines TL.

Drug Alcohol Rev. 2017 Mar 24. doi: 10.1111/dar.12524. [Epub ahead of print]

Comment: Polydrug use (and polyroute) and HIV & overdose risk.

49) Revisiting the ‘paradigm shift’ in opioid use: Developments and implications 10 years later.

Fischer B, Rehm J.

Drug Alcohol Rev. 2017 Mar 23. doi: 10.1111/dar.12539. [Epub ahead of print]

Comment: This is an interesting one. The authors describe the situation well. The interesting part, however, is that they write “little did we know” how bad it was going to get. Well … the piece they refer to was written by them in 2009 (Thinking the unthinkable: could the increasing misuse of prescription opioids among street drug users offer benefits for public health? Public Health. 2009). In that same issue, I wrote a companion piece in which I disagreed with their thesis that overprescribing opioids could be a good thing and emphasized the need to respond to the overdose epidemic (Balancing the costs and benefits of opioid analgesics in the United States. Public Health. 2009). My point is that, certainly by 2009, we did know.

50) No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone.

Jones JD, Campbell A, Metz VE, Comer SD.

Addict Behav. 2017 Mar 9;71:104-106. doi: 10.1016/j.addbeh.2017.03.008. [Epub ahead of print]

Comment: The best study to-date demonstrating the lack of risk compensation associated with naloxone provision.

51) Heroin and Methamphetamine Injection: An Emerging Drug Use Pattern.

Al-Tayyib A, Koester S, Langegger S, Raville L.

Subst Use Misuse. 2017 Mar 21:1-8. doi: 10.1080/10826084.2016.1271432. [Epub ahead of print]

Comment: Methamphetamine has largely replaced cocaine as the stimulant injected alongside heroin in much of the U.S. There are suggestions that the apparent role of cocaine in contributing to heroin overdose may also apply to methamphetamine.

52) Benzodiazepine, z-drug and pregabalin prescriptions and mortality among patients in opioid maintenance treatment-A nation-wide register-based open cohort study.

Abrahamsson T, Berge J, Öjehagen A, Håkansson A.

Drug Alcohol Depend. 2017 Feb 28;174:58-64. doi: 10.1016/j.drugalcdep.2017.01.013. [Epub ahead of print]

Comment: Sedating drugs are associated with mortality in methadone patients. It’s important to ask, however, the mechanism of this. Those in need of these medications may simply be at higher risk of death. In the absence of randomized trial data, it is hard to rule out such a confounder – see paper #16 however, which gets pretty close.

53) The social logic of naloxone: Peer administration, harm reduction, and the transformation of social policy.

Faulkner-Gurstein R.

Soc Sci Med. 2017 Mar 9;180:20-27. doi: 10.1016/j.socscimed.2017.03.013. [Epub ahead of print]

Comment: The utilization of the context of drug use as an opportunity for intervention.

54) Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

Brinkley-Rubinstein L, Cloud DH, Davis C, Zaller N, Delany-Brumsey A, Pope L, Martino S, Bouvier B, Rich J.

Int J Prison Health. 2017 Mar 13;13(1):25-31. doi: 10.1108/IJPH-08-2016-0039.

Comment: Yup.

55) Body pushing, prescription drugs and hospital admission.

Byard RW, Kenneally M.

Forensic Sci Med Pathol. 2017 Mar 15. doi: 10.1007/s12024-017-9855-8. [Epub ahead of print]

Comment: Authors suggest that the patient intended to overdose and get admitted to a secure psychiatric facility, with pills stored in the rectum for use while in the facility, but died by accident.

56) Medicalizing the Opioid Epidemic in the U.S. in the Era of Health Care Reform.

Smith DE.

J Psychoactive Drugs. 2017 Mar 15:1-7. doi: 10.1080/02791072.2017.1295334. [Epub ahead of print]

Comment: Challenges.

57) Naloxone for Outpatients at Risk of Opioid Overdose #328.

Chwistek M, Wolf M.

J Palliat Med. 2017 Mar 15. doi: 10.1089/jpm.2017.0087. [Epub ahead of print] No abstract available.

Comment: A summary of co-prescribing for palliative care providers.

58) Primary care management of opioid use disorders: Abstinence, methadone, or buprenorphine-naloxone?

Srivastava A, Kahan M, Nader M.

Can Fam Physician. 2017 Mar;63(3):200-205. Review.

Comment: Agonist treatment is more effective.

59) Pharmacy-based statewide naloxone distribution: A novel “top-down, bottom-up” approach.

Morton KJ, Harrand B, Floyd CC, Schaefer C, Acosta J, Logan BC, Clark K.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S99-S106.e5. doi: 10.1016/j.japh.2017.01.017.

Comment: Great program they describe, but not clear if the claims for naloxone were related to direct provision from pharmacy or an increase in prescriptions from physicians and mid-level providers. Also the increase in provision was co-incident with the availability of the new nasal naloxone that made provision easier.

60) Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration’s national program.

Oliva EM, Christopher ML, Wells D, Bounthavong M, Harvey M, Himstreet J, Emmendorfer T, Valentino M, Franchi M, Goodman F, Trafton JA; Veterans Health Administration Opioid Overdose Education and Naloxone Distribution National Support and Development Workgroup..

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S168-S179.e4. doi: 10.1016/j.japh.2017.01.022.

Comment: 39,000 VA patients got naloxone by the end of 2016. Seriously impressive work by those who coordinated the project and the many VA providers.

61) Indian Health Service pharmacists engaged in opioid safety initiatives and expanding access to naloxone.

Duvivier H, Gustafson S, Greutman M, Jangchup T, Harden AK, Reinhard A, Warshany K.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S135-S140. doi: 10.1016/j.japh.2017.01.005.

Comment: More on pharmacists and opioid safety/naloxone.

62) Overdose Education and Naloxone Distribution Program Attendees: Who Attends, What Do They Know, and How Do They Feel?

Heavey SC, Burstein G, Moore C, Homish GG.

J Public Health Manag Pract. 2017 Mar 1. doi: 10.1097/PHH.0000000000000538. [Epub ahead of print]

Comment: Can only access abstract, but looks like they did surveys and follow ups for trainees in a naloxone program in Erie County NY. They found that a lot of trainees were family rather than drug users themselves.

63) Drug Overdose Deaths in the United States, 1999-2015.

Hedegaard H, Warner M, Minino AM.

NCHS Data Brief. 2017 Feb;(273):1-8.

Comment: Deaths from stimulants and all classes of opioids, with the exception of methadone, have been increasing since 2010.

64) Opiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision.

Barry T, Klimas J, Tobin H, Egan M, Bury G.

Br J Gen Pract. 2017 Apr;67(657):e267-e273. doi: 10.3399/bjgp17X689857. Epub 2017 Feb 28.

Comment: In Ireland, 75% of general practitioners had patients who used illicit opioids, 25% provided methadone treatment, and two-thirds supported increased access to naloxone.

65) Public sector low threshold office-based buprenorphine treatment: outcomes at year 7.

Bhatraju EP, Grossman E, Tofighi B, McNeely J, DiRocco D, Flannery M, Garment A, Goldfeld K, Gourevitch MN, Lee JD.

Addict Sci Clin Pract. 2017 Feb 28;12(1):7. doi: 10.1186/s13722-017-0072-2.

Comment: Home inductions with buprenorphine lead to similar outcomes as in-clinic efforts. This is a big deal as in-clinic inductions are a barrier to broadening the base of providers willing to address the – largely iatrogenic – opioid epidemic.

66) Mortality trends among heroin users treated between 1975 and 2013 in Northern Italy: Results of a longitudinal study.

Pavarin RM, Fioritti A, Sanchini S.

J Subst Abuse Treat. 2017 Feb 23. pii: S0740-5472(16)30376-2. doi: 10.1016/j.jsat.2017.02.009. [Epub ahead of print]

Comment: HIV, overdose, and liver disease. The age range in which heroin users die at the most increased rate relative to the general population is 25-34 years.

67) Implementing an overdose education and naloxone distribution program in a health system.

Devries J, Rafie S, Polston G.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S154-S160. doi: 10.1016/j.japh.2017.01.002. Epub 2017 Feb 21.

Comment: UC San Diego, implemented electronic health record alert, saw an increase from 4.5 to 46 naloxone prescriptions per month.

68) Overdose Risk in Young Children of Women Prescribed Opioids.

Finkelstein Y, Macdonald EM, Gonzalez A, Sivilotti ML, Mamdani MM, Juurlink DN; Canadian DrugSafety And Effectiveness Research Network (CDSERN)..

Pediatrics. 2017 Mar;139(3). pii: e20162887. doi: 10.1542/peds.2016-2887. Epub 2017 Feb 20.

Comment: If you have opioids in the house, you should have naloxone there too.

69) [Misuse and dependence on prescription opioids: Prevention, identification and treatment].

Rolland B, Bouhassira D, Authier N, Auriacombe M, Martinez V, Polomeni P, Brousse G, Schwan R, Lack P, Bachellier J, Rostaing S, Bendimerad P, Vergne-Salle P, Dematteis M, Perrot S.

Rev Med Interne. 2017 Feb 14. pii: S0248-8663(17)30021-8. doi: 10.1016/j.revmed.2016.12.024. [Epub ahead of print] French.

Comment: Just as complicated in French as in English.

70) Implementing take-home naloxone in an urban community pharmacy.

Akers JL, Hansen RN, Oftebro RD.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S161-S167. doi: 10.1016/j.japh.2017.01.006. Epub 2017 Feb 13.

Comment: Process outcomes.

71) Hospitalizations, costs and outcomes associated with heroin and prescription opioid overdoses in the United States 2001-12.

Hsu DJ, McCarthy EP, Stevens JP, Mukamal KJ.

Addiction. 2017 Feb 13. doi: 10.1111/add.13795. [Epub ahead of print]

Comment: Rising.

72) Strategies and policies to address the opioid epidemic: A case study of Ohio.

Penm J, MacKinnon NJ, Boone JM, Ciaccia A, McNamee C, Winstanley EL.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S148-S153. doi: 10.1016/j.japh.2017.01.001. Epub 2017 Feb 8.

Comment: Challenges.

73) A nationwide pharmacy chain responds to the opioid epidemic.

Shafer E, Bergeron N, Smith-Ray R, Robson C, O’Koren R.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S123-S129. doi: 10.1016/j.japh.2016.12.075. Epub 2017 Feb 3.

Comment: Drug disposal, naloxone, patient education.

74) Epidemiology of naloxone use for opioid overdose in a tertiary care medical center.

Rudd-Barnard G, Pangarkar S, Moaleji N, Glassman P.

J Pain. 2016 Apr;17(4S):S11. doi: 10.1016/j.jpain.2016.01.044. Epub 2016 Mar 24. No abstract available.

Comment: Some largely inpatient data on naloxone use.

75) Development and delivery of a pharmacist training program to increase naloxone access in Kentucky.

Palmer E, Hart S, Freeman PR.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S118-S122. doi: 10.1016/j.japh.2016.12.071. Epub 2017 Feb 1.

Comment: Increased number of pharmacists that have gotten certified to dispense naloxone under a physician protocol.

76) Does exposure to opioid substitution treatment in prison reduce the risk of death after release? A national prospective observational study in England.

Marsden J, Stillwell G, Jones H, Cooper A, Eastwood B, Farrell M, Lowden T, Maddalena N, Metcalfe C, Shaw J, Hickman M.

Addiction. 2017 Feb 4. doi: 10.1111/add.13779. [Epub ahead of print]

Comment: Wow! Prison agonist treatment was associated with 75% reduction in all-cause death and 85% reduction in drug overdose death in the first month out of prison.

77) An interprofessional education workshop to develop health professional student opioid misuse knowledge, attitudes, and skills.

Monteiro K, Dumenco L, Collins S, Bratberg J, MacDonnell C, Jacobson A, Dollase R, George P.

J Am Pharm Assoc (2003). 2017 Mar – Apr;57(2S):S113-S117. doi: 10.1016/j.japh.2016.12.069. Epub 2017 Jan 31.

Comment: I’ve always felt that health professionals respond better to any disease where they learn interventions to treat it.

78) Do heroin overdose patients require observation after receiving naloxone?

Willman MW, Liss DB, Schwarz ES, Mullins ME.

Clin Toxicol (Phila). 2017 Feb;55(2):81-87. doi: 10.1080/15563650.2016.1253846. Epub 2016 Nov 16. Review.

Comment: No.

79) The authors reply regarding “Do heroin overdose patients require observation after receiving naloxone?”

Willman MW, Liss DB, Schwarz ES, Mullins ME.

Clin Toxicol (Phila). 2017 Apr;55(4):309-310. doi: 10.1080/15563650.2017.1284337. Epub 2017 Feb 3. No abstract available.

Comment: Authors defend their conclusion that people who respond to naloxone given for presumed heroin overdose can safely refuse transport if there is no sign of returning opioid toxicity after an hour.

80) The Opioid Epidemic: What Does it Mean for Nurses?

Leahy LG.

J Psychosoc Nurs Ment Health Serv. 2017 Jan 1;55(1):18-23. doi: 10.3928/02793695-20170119-03.\

Comment: Medications to treat opioid use disorder.

81) A case of massive methadone overdose presented with refractory hypoglycemia.

Li AT, Chu FK.

Clin Toxicol (Phila). 2017 Mar;55(3):233. doi: 10.1080/15563650.2016.1277236. Epub 2017 Jan 24. No abstract available.

Comment: Fascinating. I love these case reports.

82) Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not severe toxicity.

Isbister GK, Heppell SP, Page CB, Ryan NM.

Clin Toxicol (Phila). 2017 Mar;55(3):187-192. doi: 10.1080/15563650.2016.1277234. Epub 2017 Jan 20.

Comment: Again, case reports are fascinating.

83) Prescription drug abuse – A timely update.

Monheit B, Pietrzak D, Hocking S.

Aust Fam Physician. 2016 Dec;45(12):862-866.

Comment: Review for Australian physicians.

84) Process evaluation of the Prevent Overdose in Toronto (POINT) program.

Leece P, Gassanov M, Hopkins S, Marshall C, Millson P, Shahin R.

Can J Public Health. 2016 Oct 20;107(3):e224-e230. doi: 10.17269/cjph.107.5480.

Comment: Process outcomes.

85) Performance Measures of Diagnostic Codes for Detecting Opioid Overdose in the Emergency Department.

Rowe C, Vittinghoff E, Santos GM, Behar E, Turner C, Coffin PO.

Acad Emerg Med. 2017 Apr;24(4):475-483. doi: 10.1111/acem.13121. Epub 2017 Mar 17.

Comment: ICD codes for opioid poisoning only identified 25% of opioid overdose events identified by clinical chart review, and naloxone administration didn’t help to refine that. Such a bummer that DAWN isn’t around anymore, because we just can’t get good enough substance use-related data from coding / big data – we need manual reviews.

86) Clinical effects of unintentional pediatric buprenorphine exposures: experience at a single tertiary care center.

Toce MS, Burns MM, O’Donnell KA.

Clin Toxicol (Phila). 2017 Jan;55(1):12-17. doi: 10.1080/15563650.2016.1244337. Epub 2016 Oct 19.

Comment: Most develop signs of toxicity within 8 hours of exposure.

87) President’s message: Food and Drug Administration approved naloxone and continued use of improvised nasal naloxone: What is a treatment advocate and educator to do?

Morrone WR.

J Addict Dis. 2016 Oct-Dec;35(4):339-345. No abstract available.

Comment: Can’t access.

88) Caring for patients with opioid use disorder in the hospital.

Donroe JH, Holt SR, Tetrault JM.

CMAJ. 2016 Dec 6;188(17-18):1232-1239. Epub 2016 Sep 19. Review. No abstract available.

Comment: We have treatments! Use them.

89) Five minutes with . . . Steve Rolles, drug policy analyst.

Gulland A.

BMJ. 2016 Sep 14;354:i4930. doi: 10.1136/bmj.i4930. No abstract available.

Comment: Focus on public health.

90) Combating Opioid Overdose With Public Access to Naloxone.

Mitchell KD, Higgins LJ.

J Addict Nurs. 2016 Jul-Sep;27(3):160-79. doi: 10.1097/JAN.0000000000000132. Review.

Comment: Can’t access.

91) A case of U-47700 overdose with laboratory confirmation and metabolite identification.

Jones MJ, Hernandez BS, Janis GC, Stellpflug SJ.

Clin Toxicol (Phila). 2017 Jan;55(1):55-59. doi: 10.1080/15563650.2016.1209767. Epub 2016 Aug 23. Erratum in: Clin Toxicol (Phila). 2017 Jan;55(1):76.

Comment: Responded to naloxone in the field.

92) Will Adding Methadone to Controlled Substance Monitoring Programs Help Psychiatrists Prevent Prescription Drug Overdoses?

DiPrinzio D, Sethi R.

Prim Care Companion CNS Disord. 2016 Apr 7;18(2). doi: 10.4088/PCC.15l01871. eCollection 2016. No abstract available.

Comment: Authors argue that methadone used in opioid use disorder treatment should show up in prescription drug monitoring programs. As an individual clinician, that would be helpful for me. However, the stigma around opioid use disorder treatment is still massive.

93) The pharma-fever that almost got away.

Zhang XC, Siket M, Binder W.

R I Med J (2013). 2016 Jul 1;99(7):29-31. No abstract available.

Comment: Can’t access.

94) Opioid Use Disorders.

Sharma B, Bruner A, Barnett G, Fishman M.

Child Adolesc Psychiatr Clin N Am. 2016 Jul;25(3):473-87. doi: 10.1016/j.chc.2016.03.002. Epub 2016 Apr 9. Review.

Comment: A review.

95) Weighing the Risks and Benefits of Chronic Opioid Therapy.

Lembke A, Humphreys K, Newmark J.

Am Fam Physician. 2016 Jun 15;93(12):982-90.

Comment: Again, this is so complicated.

96) Methadone-Related Overdose Deaths in a Liberal Opioid Maintenance Treatment Programme.

Tjagvad C, Skurtveit S, Linnet K, Andersen LV, Christoffersen DJ, Clausen T.

Eur Addict Res. 2016;22(5):249-58. doi: 10.1159/000446429. Epub 2016 Jun 1.

Comment: This is difficult to tease out, as liberal methadone can reach the highest risk persons, who would also have a higher risk of death.

Fentanyl:

97) Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

Moore PQ, Weber J, Cina S, Aks S.

Am J Emerg Med. 2017 May 8. pii: S0735-6757(17)30367-4. doi: 10.1016/j.ajem.2017.05.003. [Epub ahead of print]

Comment: Other studies have found these data to have real limitations, but in general they should pick up on large trends. The other issue is that lay naloxone responders may not call EMS after a successful reversal, so a community with excellent naloxone coverage may not experience EMS upticks in the context of a small outbreak.

98) Characteristics of Fentanyl Overdose – Massachusetts, 2014-2016.

Somerville NJ, O’Donnell J, Gladden RM, Zibbell JE, Green TC, Younkin M, Ruiz S, Babakhanlou-Chase H, Chan M, Callis BP, Kuramoto-Crawford J, Nields HM, Walley AY.

MMWR Morb Mortal Wkly Rep. 2017 Apr 14;66(14):382-386. doi: 10.15585/mmwr.mm6614a2.

Comment: Just read it. It’s too important to summarize.

99) Fentanyl laced heroin and its contribution to a spike in heroin overdose in Miami-Dade County.

Bode AD, Singh M, Andrews J, Kapur GD, Baez AA.

Am J Emerg Med. 2017 Feb 28. pii: S0735-6757(17)30158-4. doi: 10.1016/j.ajem.2017.02.043. [Epub ahead of print] No abstract available.

Comment: Authors report increased opioid overdose and a greater increase in naloxone, arguing that this means the increase was likely driven by fentanyl. I’m not sure I buy this analysis, in part because of some basic math errors (e.g. “The greatest increase in OOD was observed during the month of September with 65 cases in 2015 and 266 cases in 2016 (182% [sic – should read 326%]) (Fig. 1a/Table 1). The number of naloxone vials used from July–September rose from 212 in 2015 to 1221 in 2016, a 476% increase (Table 2a).” The analysis also doesn’t account for the number of naloxone doses actually used on individual cases (not all naloxone administrations are coded as overdose events).

100) Increase in Drug Overdose Deaths Involving Fentanyl-Rhode Island, January 2012-March 2014.

Mercado MC, Sumner SA, Spelke MB, Bohm MK, Sugerman DE, Stanley C.

Pain Med. 2017 Mar 6. doi: 10.1093/pm/pnx015. [Epub ahead of print]

Comment: Ugh.

101) Addressing the Fentanyl Threat to Public Health.

Frank RG, Pollack HA.

N Engl J Med. 2017 Feb 16;376(7):605-607. doi: 10.1056/NEJMp1615145. No abstract available.

Comment: Nope, still don’t like street use of fentanyl.

102) High Concomitant Misuse of Fentanyl in Subjects on Opioid Maintenance Treatment.

Krause D, Plörer D, Koller G, Martin G, Winter C, Adam R, Canolli M, Al-Iassin J, Musselmann R, Walcher S, Schäfer F, Pogarell O.

Subst Use Misuse. 2017 Apr 16;52(5):639-645. doi: 10.1080/10826084.2016.1246571. Epub 2017 Feb 3.

Comment: Interesting – high rates of fentanyl use in a population of users in Munich, Germany.

103) Multiple Fentanyl Overdoses – New Haven, Connecticut, June 23, 2016.

Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D’Onofrio G.

MMWR Morb Mortal Wkly Rep. 2017 Feb 3;66(4):107-111. doi: 10.15585/mm6604a4.

Comment: Again, just read it.

104) Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings.

Lee D, Chronister CW, Broussard WA, Utley-Bobak SR, Schultz DL, Vega RS, Goldberger BA.

J Anal Toxicol. 2016 Oct;40(8):588-594.

Comment: Lots of it.

105) Fentanyl misuse.

Ruzycki S, Yarema M.

CMAJ. 2016 Jun 14;188(9):673. doi: 10.1503/cmaj.151378. Epub 2016 Apr 18. No abstract available.

Comment: Brief overview.

Injection Facilities

106) Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility.

Irwin A, Jozaghi E, Weir BW, Allen ST, Lindsay A, Sherman SG.

Harm Reduct J. 2017 May 12;14(1):29. doi: 10.1186/s12954-017-0153-2.

Comment: The data support these facilities as an important element of the overdose response.

107) Willingness to use a supervised injection facility among young adults who use prescription opioids non-medically: a cross-sectional study.

Bouvier BA, Elston B, Hadland SE, Green TC, Marshall BD.

Harm Reduct J. 2017 Feb 20;14(1):13. doi: 10.1186/s12954-017-0139-0.

Comment: The opioid users who could most benfit from an injection facility are the most likely to want to use an injection facility.

108) Another Senseless Death – The Case for Supervised Injection Facilities.

Wakeman SE.

N Engl J Med. 2017 Mar 16;376(11):1011-1013. doi: 10.1056/NEJMp1613651. No abstract available.

Comment: See title.

1) New Drugs of Abuse.

Rech MA, Donahey E, Cappiello Dziedzic JM, Oh L, Greenhalgh E.

Pharmacotherapy. 2014 Dec 4. doi: 10.1002/phar.1522. [Epub ahead of print]

Comment: Review of management of drug toxicities among novel, synthetic compounds.

2) Police officer attitudes towards intranasal naloxone training.

Ray B, O’Donnell D, Kahre K.

Drug Alcohol Depend. 2015 Jan 1;146:107-10. doi: 10.1016/j.drugalcdep.2014.10.026. Epub 2014 Nov 8.

Comment: Police officers like being trained to carry naloxone.

3) Intranasal naloxone administration for treatment of opioid overdose.

Robinson A, Wermeling DP.

Am J Health Syst Pharm. 2014 Dec 15;71(24):2129-35. doi: 10.2146/ajhp130798.

Comment: Review of intranasal naloxone for overdose reversal.

4) Observed transition from opioid analgesic deaths toward heroin.

Dasgupta N, Creppage K, Austin A, Ringwalt C, Sanford C, Proescholdbell SK.

Drug Alcohol Depend. 2014 Dec 1;145:238-41. doi: 10.1016/j.drugalcdep.2014.10.005. Epub 2014 Oct 18.

Comment: Heroin overdoses are increasing.

5) Brief overdose education can significantly increase accurate recognition of opioid overdose amongheroin users.

Jones JD, Roux P, Stancliff S, Matthews W, Comer SD.

Int J Drug Policy. 2014 Jan;25(1):166-70. doi: 10.1016/j.drugpo.2013.05.006. Epub 2013 Jun 15.

Comment: Brief overdose training works for naloxone distribution. This is important because many places are requiring prolonged trainings that end up limiting access to those who are unable or unwilling to invest that degree of time.

6) Brief overdose education is sufficient for naloxone distribution to opioid users.

Behar E, Santos GM, Wheeler E, Rowe C, Coffin PO.

Drug Alcohol Depend. 2015 Mar 1;148:209-12. doi: 10.1016/j.drugalcdep.2014.12.009. Epub 2014 Dec 19.

Comment: Again, brief overdose training works for naloxone distribution.

7) Novel Interventions to Prevent HIV and HCV Among Persons Who Inject Drugs.

Coffin PO, Rowe C, Santos GM.

Curr HIV/AIDS Rep. 2015 Jan 15. [Epub ahead of print]

Comment: Review of interventions for PWIDs in 2013 and 2014, including naloxone.

8) Supervised injection services: What has been demonstrated? A systematic literature review.

Potier C, Laprévote V, Dubois-Arber F, Cottencin O, Rolland B.

Drug Alcohol Depend. 2014 Dec 1;145C:48-68. doi: 10.1016/j.drugalcdep.2014.10.012. Epub 2014 Oct 23. Review.

Comment: The attract the most marginalized drug users, promote safer injection, enhance primary care access, reduce overdose frequency, reduce public injecting and improper syringe disposal. They don’t increase drug injecting, drug trafficking or crime.

9) What we know, and don’t know, about the impact of state policy and systems-level interventions on prescription drug overdose.

Haegerich TM, Paulozzi LJ, Manns BJ, Jones CM.

Drug Alcohol Depend. 2014 Dec 1;145C:34-47. doi: 10.1016/j.drugalcdep.2014.10.001. Epub 2014 Oct 14. Review.

Comment: We don’t know anything

10) Drug scene, drug use and drug-related health consequences and responses in Kulob and Khorog, Tajikistan.

Latypov A, Otiashvili D, Zule W.

Int J Drug Policy. 2014 Oct 7;25(6):1204-1214. doi: 10.1016/j.drugpo.2014.09.011. [Epub ahead of print]

Comment: Takikistan has a dire need for vast expansion in agonist maintenance and naloxone services.

11) “It’s Russian roulette”: Adulteration, adverse effects and drug use transitions during the 2010/2011 United Kingdom heroin shortage.

Harris M, Forseth K, Rhodes T.

Int J Drug Policy. 2015 Jan;26(1):51-8. doi: 10.1016/j.drugpo.2014.09.009. Epub 2014 Sep 28.

Comment: A discussion of the downsides of a heroin drought and how drug users cope.

12) Coverage of overdose prevention programs for opiate users and injectors: a cross-sectional study.

Arribas-Ibar E, Sánchez-Niubò A, Majó X, Domingo-Salvany A, Brugal MT.

Harm Reduct J. 2014 Nov 22;11(1):33. doi: 10.1186/1477-7517-11-33.

Comment: I’m not entirely clear that these programs involve naloxone distribution, but it looks like they do with a 1-hour training. When they recruited from sites with programs, 43.5% of drug users had participated.

13) Evaluation of drug-drug interaction between daclatasvir and methadone orbuprenorphine/naloxone.

Garimella T, Wang R, Luo WL, Wastall P, Kandoussi H, Demicco M, Bruce D, Hwang C, Bertz R, Bifano M.

J Int AIDS Soc. 2014 Nov 2;17(4 Suppl 3):19628. doi: 10.7448/IAS.17.4.19628. eCollection 2014.

Comment: Another hepatitis C medication being tested for use in people on opioid agonist maintenance treatment. No meaningful interaction.

14) Effect of steady-state faldaprevir on the pharmacokinetics of steady-state methadone andbuprenorphine-naloxone in subjects receiving stable addiction management therapy.

Joseph D, Schobelock MJ, Riesenberg RR, Vince BD, Webster LR, Adeniji A, Elgadi M, Huang F.

Antimicrob Agents Chemother. 2015 Jan;59(1):498-504. doi: 10.1128/AAC.04046-14. Epub 2014 Nov 10.

Comment: Another hepatitis C medication being tested for use in people on opioid agonist maintenance treatment. No meaningful interaction.

15) Take-home emergency naloxone to prevent deaths from heroin overdose.

Strang J, Bird SM, Dietze P, Gerra G, McLellan AT.

BMJ. 2014 Nov 4;349:g6580. doi: 10.1136/bmj.g6580. No abstract available.

Comment: England seems to be creeping forward with naloxone even in the absence of final data from large randomized trials.

16) Diversion of methadone and buprenorphine from opioid substitution treatment: a staff perspective.

Johnson B, Richert T.

J Psychoactive Drugs. 2014 Nov-Dec;46(5):427-35. doi: 10.1080/02791072.2014.960109.

Comment: This is an interesting issue. Agonist agents are often in short supply and can help people in withdrawal, who want to self-detox, etc. As the authors write: “Patients who share their medication with opioid-dependent friends are seen as less culpable than those who sell to anyone for money.”

17) Naloxone for opioid overdose prevention: pharmacists’ role in community-based practice settings.

Bailey AM, Wermeling DP.

Ann Pharmacother. 2014 May;48(5):601-6. doi: 10.1177/1060028014523730. Epub 2014 Feb 12.

Comment: Pharmacists and naloxone!

18) Opiate- and cocaine-related fatal overdoses in Luxembourg from 1985 to 2011: a study on gender differences.

Origer A, Lopes da Costa S, Baumann M.

Eur Addict Res. 2014;20(2):87-93. doi: 10.1159/000355170. Epub 2013 Oct 31.

Comment: Interesting look at male versus female decedents. While men were more likely to die, women were more likely to die earlier in their drug use career and to use other psychoactive prescription medicaitons.

19) Assisted injection among people who inject drugs in Thailand.

Lee WK, Ti L, Hayashi K, Kaplan K, Suwannawong P, Wood E, Kerr T.

Subst Abuse Treat Prev Policy. 2013 Sep 10;8:32. doi: 10.1186/1747-597X-8-32.

Comment: This study found no association between needing assistance with injection and non-fatal overdose. The data on this has been mixed, with some studies finding an association and some finding no association. As women are more likely to get assistance with injection and men are more likely to overdose, I wonder if the effect may wash out and more gender-specific analyses may make sense.

20) Associations between injection risk and community disadvantage among suburban injection drugusers in southwestern Connecticut, USA.

Heimer R, Barbour R, Palacios WR, Nichols LG, Grau LE.

AIDS Behav. 2014 Mar;18(3):452-63. doi: 10.1007/s10461-013-0572-3.

Comment: Interesting use of geocoding by mapping overdose deaths on top of the sample for the study. Frequent overdoses and poor knowledge about overdose in rural CT. Important work.

21) Sublingual buprenorphine for chronic pain: a survey of clinician prescribing practices.

Rosen K, Gutierrez A, Haller D, Potter JS.

Clin J Pain. 2014 Apr;30(4):295-300. doi: 10.1097/AJP.0b013e318298ddad.

Comment: Interesting survey of American Pain Society members showing that buprenorphine is indeed being used to treat chronic pain and is viewed as safer due to partial agonist activity (and reduced overdose risk).

22) Increased somatic morbidity in the first year after leaving opioid maintenance treatment: results from a Norwegian cohort study.

Skeie I, Brekke M, Clausen T, Gossop M, Lindbaek M, Reinertsen E, Thoresen M, Waal H.

Eur Addict Res. 2013;19(4):194-201. doi: 10.1159/000345229. Epub 2012 Dec 21.

Comment: As has been well-documented in the past, terminating opioid agonist maintenance therapy has a heighted risk of overdose.

23) Illicit use of opioid substitution drugs: Prevalence, user characteristics, and the association with non-fatal overdoses.

Bretteville-Jensen AL, Lillehagen M, Gjersing L, Andreas JB.

Drug Alcohol Depend. 2014 Dec 13. pii: S0376-8716(14)01981-4. doi: 10.1016/j.drugalcdep.2014.12.002. [Epub ahead of print]

Comment: Interesting assessment of overdose risk among those who use diverted substitution medications. The only associated with overdose was infrequent buprenorphine use. As using buprenorphine requires one to detox beforehand, and detox is associated with overdose, I wonder if this is picking up people who are really trying to cut back their use and thus increasing overdose risks.

24) Alcohol-induced sedation and synergistic interactions between alcohol and morphine: A key mechanistic role for Toll-like receptors and MyD88-dependent signaling.

Corrigan F, Wu Y, Tuke J, Coller JK, Rice KC, Diener KR, Hayball JD, Watkins LR, Somogyi AA, Hutchinson MR.

Brain Behav Immun. 2014 Dec 24. pii: S0889-1591(14)00608-4. doi: 10.1016/j.bbi.2014.12.019. [Epub ahead of print]

Comment: Morphine and alcohol appear to interact in surprising ways neurochemically, perhaps accounting for heightened overdose risk.

25) Preventing Iatrogenic Overdose: A Review of In-Emergency Department Opioid-Related Adverse Drug Events and Medication Errors.

Beaudoin FL, Merchant RC, Janicki A, McKaig DM, Babu KM.

Ann Emerg Med. 2014 Dec 17. pii: S0196-0644(14)01514-5. doi: 10.1016/j.annemergmed.2014.11.016. [Epub ahead of print]

Comment: The majority of events were due to medication error.

26) High prevalence of non-fatal overdose among people who inject drugs in Malaysia: Correlates of overdose and implications for overdose prevention from a cross-sectional study.

Bazazi AR, Zelenev A, Fu JJ, Yee I, Kamarulzaman A, Altice FL.

Int J Drug Policy. 2014 Dec 2. pii: S0955-3959(14)00334-X. doi: 10.1016/j.drugpo.2014.11.010. [Epub ahead of print]

Comment: Amazing to have this work out of Malaysia. Shows more or less standard rates of overdose that have been documented in multiple other settings.

27) Administration of Naloxone in a Home or Community Setting: A Review of the Clinical Effectiveness, Cost-effectiveness, and Guidelines [Internet].

Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Jun 20.

Comment: There are no data comparing lay naloxone to healthcare professional administered naloxone.

28) Reversal of Opioid Overdose Syndrome in Morphine-Dependent Rats Using Buprenorphine.

Zamani N, Hassanian-Moghaddam H, Hossein Bayat A, Haghparast A, Shadnia S, Rahimi M, Demaneh BH.

Toxicol Lett. 2014 Dec 12. pii: S0378-4274(14)01514-8. doi: 10.1016/j.toxlet.2014.12.007. [Epub ahead of print]

Comment: “Buprenorphine recovers opioid-overdose in morphine-dependent rats and bypasses the withdrawal-syndrome due to administration of naloxone.”

29) Adolescents at Risk: Pain Pills to Heroin: Part II.

Fogger S, McGuinness TM.

J Psychosoc Nurs Ment Health Serv. 2015 Feb 1;53(2):27-30. doi: 10.3928/02793695-20150106-01.

Comment: A review of substituting prescription opioids with heroin due to cost of the former, and using opioid substitution therapy.

30) Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access.

Wermeling DP.

Ther Adv Drug Saf. 2015 Feb;6(1):20-31. doi: 10.1177/2042098614564776. Review.

Comment: As the title says.

31) Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis.

Nielsen MK, Johansen SS, Linnet K.

Forensic Sci Int. 2015 Mar;248:134-9. doi: 10.1016/j.forsciint.2015.01.004. Epub 2015 Jan 12.

Comment: Interesting work. No evidence of decreased exposure to methadone (so reduced tolerance of methadone unlikely a factor here). Evidence of multiple other depressant agents, including frequent heroin exposure.

32) Long-term mortality, remission, criminality and psychiatric comorbidity of heroin dependence: 11-year findings from the Australian Treatment Outcome Study.

Teesson M, Marel C, Darke S, Ross J, Slade T, Burns L, Lynskey M, Memedovic S, White J, Mills KL.

Addiction. 2015 Jan 23. doi: 10.1111/add.12860. [Epub ahead of print]

Comment: Really useful data here. After 11 years, 10.2% of the population had died and 24.8% were still using heroin; 46.6% were in current substance use disorder treatment. Major depression was a driver of poor outcomes.

33) Out-of-Hospital Mortality Among Patients Receiving Methadone for Noncancer Pain.

Ray WA, Chung CP, Murray KT, Cooper WO, Hall K, Stein CM.

JAMA Intern Med. 2015 Mar 1;175(3):420-427. doi: 10.1001/jamainternmed.2014.6294.

Comment: Methadone was more risky than other opioids, even at low doses (<20mg per day). Still, it’s not possible to tease out all of the differences, such as why methadone was prescribed to one person and morphine to another.

34) The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction.

Kolodny A, Courtwright DT, Hwang CS, Kreiner P, Eadie JL, Clark TW, Alexander GC.

Annu Rev Public Health. 2015 Jan 12. [Epub ahead of print]

Comment: A review of prescription opioid overdose.

35) Community Management of Opioid Overdose.

Geneva: World Health Organization; 2014.

Comment: WHO endorses lay naloxone.

36) Ventricular dysrhythmias associated with poisoning and drug overdose: a 10-year review of statewide poison control center data from california.

Al-Abri SA, Woodburn C, Olson KR, Kearney TE.

Am J Cardiovasc Drugs. 2015 Feb;15(1):43-50. doi: 10.1007/s40256-014-0104-1.

Comment: Stimulants, antidepressants, etc.

37) Overdose Education and Naloxone Rescue Kits for Family Members of Opioid Users: Characteristics, Motivations and Naloxone Use.

Bagley SM, Peterson J, Cheng DM, Jose C, Quinn E, O’Connor PG, Walley AY.

Subst Abus. 2015 Jan 7:0. [Epub ahead of print]

Comment: Makes sense.

38) Methadone and prescription drug overdose.

Hendrikson H, Hansen M.

NCSL Legisbrief. 2014 Dec;22(45):1-2.

Comment: More on methadone as being of high risk when used for pain management.

39) Diversion of methadone and buprenorphine from opioid substitution treatment: a staff perspective.

Johnson B, Richert T.

J Psychoactive Drugs. 2014 Nov-Dec;46(5):427-35. doi: 10.1080/02791072.2014.960109.

Comment: “Patients who share their medication with opioid-dependent friends are seen as less culpable than those who sell to anyone for money.”

40) Unexpected variation of the codeine/morphine ratio following fatal heroin overdose.

Gambaro V, Argo A, Cippitelli M, Dell’Acqua L, Farè F, Froldi R, Guerrini K, Roda G, Rusconi C, Procaccianti P.

J Anal Toxicol. 2014 Jun;38(5):289-94. doi: 10.1093/jat/bku016. Epub 2014 Apr 11.

Comment: Establishing overdose as caused by heroin can be tricky these days and work like this is important.

41) Risk of anaphylaxis in opioid dependent persons: effects of heroin versus substitution substance.

Maurer U, Kager C, Fellinger C, Loader D, Pollesböck A, Spitzer B, Jarisch R.

Subst Abuse Treat Prev Policy. 2014 Feb 27;9:12. doi: 10.1186/1747-597X-9-12.

Comment: Heroin injectors have high baseline rates of histamine, suggesting that they be at higher risk than others for allergic reactions to substances.

42) The potential threat of acetyl fentanyl: legal issues, contaminated heroin, and acetyl fentanyl “disguised” as other opioids.

Stogner JM.

Ann Emerg Med. 2014 Dec;64(6):637-9. doi: 10.1016/j.annemergmed.2014.07.017. Epub 2014 Aug 18. No abstract available.

Comment: Acetyl fentanyl is a major problem in the eastern half of the U.S. these days.

43) Drug-related deaths between 2002 and 2013 with accent to methadone and benzodiazepines.

Petrushevska T, Jakovski Z, Poposka V, Stefanovska VV.

J Forensic Leg Med. 2015 Apr;31:12-8. doi: 10.1016/j.jflm.2014.12.013. Epub 2015 Jan 7.

Comment: Survey of drug-related deaths in Macedonia.

44) Factors associated with health-related quality of life among injection drug users atmethadone clinics in Taipei, Taiwan.

Yen YF, Chou P, Lin YS, Deng CY.

J Chin Med Assoc. 2015 Feb 26. pii: S1726-4901(15)00005-2. doi: 10.1016/j.jcma.2015.01.001. [Epub ahead of print]

Comment: History of overdose was associated with a poor quality of life.

45) Opioid treatment at release from jail using extended-release naltrexone: a pilot proof-of-concept randomized effectiveness trial.

Lee JD, McDonald R, Grossman E, McNeely J, Laska E, Rotrosen J, Gourevitch MN.

Addiction. 2015 Feb 23. doi: 10.1111/add.12894. [Epub ahead of print]

Comment: Compared to nothing, there was less relapse in the first 4 weeks out of jail with injected naltrexone, which blocks opioid receptors for 4 weeks.

46) [The message of the heroin overdoses].

Pap Á, Hegedűs K.

Orv Hetil. 2015 Mar 1;156(9):352-7. doi: 10.1556/OH.2015.30091. Hungarian.

Comment: Comments on overdose and naloxone from Hungary.

47) Take-home emergency naloxone to prevent deaths from heroin overdose.

Strang J, Bird SM, Dietze P, Gerra G, McLellan AT.

BMJ. 2014 Nov 4;349:g6580. doi: 10.1136/bmj.g6580. No abstract available.

Comment: Authors state their belief that waiting for data should not delay implementation of naloxone programs.

48) Expanding access to naloxone in the United States.

Doyon S, Aks SE, Schaeffer S; American Academy of Clinical Toxicology; American College of Medical Toxicology; American Association of Poison Control Centers.

Clin Toxicol (Phila). 2014 Dec;52(10):989-92. doi: 10.3109/15563650.2014.968657. Epub 2014 Oct 6. No abstract available.

Comment: Thanks to Corey Davis for sending, this is a position statement strongly in support of naloxone availability.

49) Emergency hospitalizations for unsupervised prescription medication ingestions by young children.

Lovegrove MC, Mathew J, Hampp C, Governale L, Wysowski DK, Budnitz DS.

Pediatrics. 2014 Oct;134(4):e1009-16. doi: 10.1542/peds.2014-0840. Epub 2014 Sep 15.

Comment: Buprenorphine was associated with quite a number of accidental pediatric ingestions.

50) Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries.

Hammett TM, Phan S, Gaggin J, Case P, Zaller N, Lutnick A, Kral AH, Fedorova EV, Heimer R, Small W, Pollini R, Beletsky L, Latkin C, Des Jarlais DC.

BMC Health Serv Res. 2014 Jun 17;14:261. doi: 10.1186/1472-6963-14-261.

Comment: There are lots of barriers to pharmacists serving in this role.

51) Another chance to reformulate racemic methadone.

Karch SB.

J Addict Med. 2014 May-Jun;8(3):217-9. doi: 10.1097/ADM.0000000000000036. No abstract available.

Comment: Unable to access. Racemic methadone may be associated with cardiac arrhythmias like torsades de pointes.

1) Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose-Naloxone-Good Samaritan Law.

Banta-Green CJ, Beletsky L, Schoeppe JA, Coffin PO, Kuszler PC.

J Urban Health. 2013 Jul 31. [Epub ahead of print]

Comment: Expands on the limited data we have regarding police and paramedics knowledge and opinions regarding opioid overdose prevention initiatives.

2) [Heroin].

Demaret I, Lemaître A, Ansseau M.

Rev Med Liege. 2013 May-Jun;68(5-6):287-93. French.

Comment: Only saw the abstract, but appears to be a nice summary of heroin, particularly overdose risk factors.

3) Potential P-glycoprotein Pharmacokinetic Interaction of Telaprevir With Morphine or Methadone.

Fudin J, Fontenelle DV, Fudin HR, Carlyn C, Hinden DA, Ashley CC.

J Pain Palliat Care Pharmacother. 2013 Jul 24. [Epub ahead of print]

Comment: Some potential interactions of the HCV protease inhibitor with selected opioids. Hopefully we won’t be using telaprevir too much longer as more advanced, effective, and easily tolerated regimens are expected as early as the end of 2013.

4) Non-fatal overdose among adult prisoners with a history of injecting drug use in two Australian states.

Moore E, Winter R, Indig D, Greenberg D, Kinner SA.

Drug Alcohol Depend. 2013 Jul 15. doi:pii: S0376-8716(13)00220-2.

Comments: Survey of prisoners lifetime history of overdose.

5) Factors associated with high-frequency illicit methadone use among rural Appalachian drug users.

Hall MT, Leukefeld CG, Havens JR.

Am J Drug Alcohol Abuse. 2013 Jul;39(4):241-6. doi:

Comment: I can’t access this article, but have some concerns about the utility of the analysis of covariates presented in the abstract.

6) Methadone-Related Overdose Deaths in Rural Virginia: 1997 to 2003.

Wunsch MJ, Nuzzo PA, Behonick G, Massello W, Walsh SL.

J Addict Med. 2013 Jul 8. [Epub ahead of print]

Comments: Analysis of methadone-related deaths.

7) The Economic Burden of Opioid-Related Poisoning in the United States.

Inocencio TJ, Carroll NV, Read EJ, Holdford DA.

Pain Med. 2013 Jul 10. doi: 10.1111/pme.12183. [Epub ahead of print]

Comments: Intriguing analysis of costs of opioid overdose, focusing on the costs to the healthcare system.

8) A drug fatality involving Kratom.

Neerman MF, Frost RE, Deking J.

J Forensic Sci. 2013 Jan;58 Suppl 1:S278-9. doi: 10.1111/1556-4029.12009. Epub 2012 Oct 19.

Comments: Kratom is a plant that grows in North America (this case is from Texas) and many other parts of the world. Its use is prohibited in Thailand. It acts as a mu-opioid receptor agonist.