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.

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.