Article
Clinical Neurology
Nazleen F. Khan, Katsiaryna Bykov, Michael Barnett, Robert Glynn, Seanna M. Vine, Joshua J. Gagne
Summary: This study compares the risk of opioid overdose among patients on long-term opioid therapy who concurrently initiate skeletal muscle relaxants. The study found that the use of baclofen, compared to cyclobenzaprine, was associated with opioid overdose, while the relationship between the use of other drugs and overdose risk was unclear.
Article
Medicine, General & Internal
Denis Agniel, Gabriel A. Brat, Jayson S. Marwaha, Kathe Fox, Daniel Knecht, Harold L. Paz, Mark C. Bicket, Brian Yorkgitis, Nathan Palmer, Isaac Kohane
Summary: This cohort study found that family members of patients who received prescription opioid refills after surgery had an increased risk of opioid misuse and chronic opioid use.
Article
Chemistry, Medicinal
Matthew S. Ellis, Zachary A. Kasper, Mark Gold, Theodore J. Cicero
Summary: The study found that most patients had low awareness of the risks associated with taking opioids, with some not having discussed the risks with their doctors. In addition to dose-response relationship, organizations should focus on enhancing patient education on overdose risk and evaluating behaviors or characteristics that may increase an individual's risk of opioid overdose.
Article
Public, Environmental & Occupational Health
Gisele Carriere, Rochelle Garner, Claudia Sanmartin
Summary: Reliance on opioids for pain management has increased over time, leading to higher morbidity and deaths. In 2018, 12.7% of Canadians reported using opioid pain relief medications, with 9.6% engaging in problematic use. Factors such as gender, age, mental health, substance use needs, smoking, and household arrangement were significantly associated with problematic opioid use, highlighting the importance of considering subjective experiences in addition to socioeconomic factors in addressing opioid harms.
Review
Medicine, General & Internal
Alex S. Bennett, Honoria Guarino, Peter C. Britton, Dan O'Brien-Mazza, Stephanie H. Cook, Franklin Taveras, Juan Cortez, Luther Elliott
Summary: U.S. military veterans have been significantly affected by the opioid overdose crisis, with a 53% increase in drug overdose mortality rates from 2010 to 2019. The risk of overdose among veterans is influenced by various factors, including physiological, psychological, and social factors. Addressing the overdose crisis in this population requires comprehensive interventions that consider pain, pain treatment, stress, and psychological and social experiences before, during, and after military service.
ANNALS OF MEDICINE
(2022)
Article
Medicine, General & Internal
Michael L. L. Barnett, Ellen Meara, Terri Lewinson, Brianna Hardy, Deanna Chyn, Moraa Onsando, Haiden A. A. Huskamp, Ateev Mehrotra, Nancy E. E. Morden
Summary: An analysis of Medicare claims data from 2016-2019 revealed that white patients were more likely to receive medications for opioid use disorder (OUD) compared to black and Hispanic patients. Despite an increase in opioid overdose-related mortality among black individuals, racial and ethnic disparities in the use of OUD medications remained consistent and substantial over time.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Health Care Sciences & Services
Bradley D. Stein, Rosanna Smart, Christopher M. Jones, Flora Sheng, David Powell, Mark Sorbero
Summary: This study examined naloxone co-prescribing in long-term opioid therapy episodes and found that the rate of co-prescribing is low overall, with variations based on different individual and community characteristics.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Medicine, General & Internal
Yu-Jung Jenny Wei, Cheng Chen, Motomori O. Lewis, Siegfried O. Schmidt, Almut G. Winterstein
Summary: This study aimed to compare opioid dose trajectories in older patients with chronic noncancer pain (CNCP) before an opioid-related adverse event (ORAE). The study found that patients who had a gradual increase in opioid dose or who maintained a low-to-moderate dose had a higher risk for ORAE. This suggests the need for further investigation into the vulnerability of older patients to low opioid doses.
Review
Health Care Sciences & Services
Leen Magarbeh, Ilona Gorbovskaya, Richard Wells, Reuven Jhirad, Bernard Le Foll, Daniel J. Mueller
Summary: There has been an increase in accidental opioid-overdose deaths worldwide. This review focuses on the use of pharmacogenetics to predict causes of accidental opioid-overdose death, supported by a literature search and pilot study. The review includes 18 studies that demonstrate the potential of genetic testing, particularly CYP2D6, CYP2B6, and CYP3A4/5 genotyping, in identifying abnormal opioid and metabolite blood concentrations. The pilot study shows an enrichment of the CYP2B6*4 allele in methadone-overdose cases compared to the general population. These findings emphasize the importance of pharmacogenetics in determining vulnerability to opioid overdose.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Substance Abuse
Bryce Pardo, Jirka Taylor, Jon Caulkins, Peter Reuter, Beau Kilmer
Summary: The influx of illegally manufactured synthetic opioids into street drugs is increasing the risk of fatal overdoses. In some areas, synthetic opioids like fentanyl have virtually replaced traditional drugs like heroin. The concealment of synthetic opioids in substances sold as heroin or counterfeit medications is causing significant harm and poses unprecedented challenges to drug policy.
Article
Anesthesiology
Sara E. Hallvik, Sanae El Ibrahimi, Kirbee Johnston, Jonah Geddes, Gillian Leichtling, P. Todd Korthuis, Daniel M. Hartung
Summary: This study examines the impact of dose reductions in patients undergoing high-dose chronic opioid therapy. The findings suggest that abrupt discontinuation of opioid prescriptions significantly increases the risk of suicide, while dose reduction reduces the risk of overdose.
Article
Multidisciplinary Sciences
Tse Yang Lim, Erin J. Stringfellow, Celia A. Stafford, Catherine DiGennaro, Jack B. Homer, Wayne Wakeland, Sara L. Eggers, Reza Kazemi, Lukas Glos, Emily G. Ewing, Calvin B. Bannister, Keith Humphreys, Douglas C. Throckmorton, Mohammad S. Jalali
Summary: The opioid crisis in the United States is a significant public health challenge, and addressing its complexity requires a quantitative systems model. The SOURCE model tracks the stages of opioid use, addiction treatment, and overdose death, providing insights into the historical trajectory of the crisis and informing policy planning.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2022)
Article
Substance Abuse
Anna Kline, Dina Mattern, Nina Cooperman, Jill M. Williams, Patricia Dooley-Budsock, Ralph Foglia, Suzanne Borys
Summary: This study examined the association between attitudes/behaviors related to fentanyl and overdose risk in three subpopulations of overdose survivors. Findings revealed a high proportion of respondents knowingly using fentanyl, with those experiencing persistent overdoses accounting for the highest proportion of lifetime overdose deaths. PTSD and seeking fentanyl were identified as significant overdose risk factors only in this subgroup.
INTERNATIONAL JOURNAL OF DRUG POLICY
(2021)
Article
Substance Abuse
Michele J. Buonora, David B. Hanna, Chenshu Zhang, Marcus A. Bachhuber, Lorlette H. Moir, Pooja S. Salvi, Chinazo O. Cunningham, Joanna L. Starrels
Summary: This study examined the impact of opioid-prescribing policies in the United States on opioid overdose mortality. The findings suggest that policies focusing on prescriber training and limiting opioid dose can reduce prescription opioid overdose mortality, but have little effect on non-prescription opioid overdose mortality.
INTERNATIONAL JOURNAL OF DRUG POLICY
(2022)
Article
Substance Abuse
Lili Zhou, Sandipan Bhattacharjee, C. Kent Kwoh, Patrick J. Tighe, Gary M. Reisfield, Daniel C. Malone, Marion Slack, Debbie L. Wilson, Ching-Yuan Chang, Wei-Hsuan Lo-Ciganic
Summary: The study found that there is a positive correlation between the duration and dosage patterns of opioid and gabapentinoid (OPI-GABA) use with the risk of drug overdose among US Medicare beneficiaries.
Article
Health Policy & Services
Sadiq Y. Patel, Haiden A. Huskamp, Michael L. Barnett, Jose R. Zubizarreta, Kori S. Zachrison, Alisa B. Busch, Andrew D. Wilcock, Ateev Mehrotra
Summary: Due to limited access to psychiatrists, patients with acute mental illness in some emergency departments may wait days for consultation or admission. A study found that telepsychiatry can improve access to care but may increase ED wait times and hospital admissions.
PSYCHIATRIC SERVICES
(2022)
Letter
Medicine, General & Internal
Caroline L. Behr, Karen E. Joynt Maddox, Ellen Meara, Arnold M. Epstein, E. John Orav, Michael L. Barnett
Summary: This study assesses the allocation of limited monoclonal antibody therapy to the Medicare beneficiaries with the highest risk of severe COVID-19 among a population of fee-for-service patients between November 2020 and August 2021.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)
Article
Health Care Sciences & Services
Haiden A. Huskamp, Lauren Riedel, Lori Uscher-Pines, Alisa B. Busch, Michael L. Barnett, Pushpa Raja, Ateev Mehrotra
Summary: A national survey conducted in the fall of 2020 with 602 clinicians revealed varying degrees of comfort and usage of telemedicine for initiating medication for opioid use disorder (OUD). While approximately 25% of clinicians used telemedicine for most initiations, 40% relied solely on in-person visits. The majority of clinicians expressed at least some discomfort with using telemedicine for treating new OUD patients, though those with more OUD patients were less likely to feel discomfort.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Clinical Neurology
Nazleen F. Khan, Katsiaryna Bykov, Michael Barnett, Robert Glynn, Seanna M. Vine, Joshua J. Gagne
Summary: This study compares the risk of opioid overdose among patients on long-term opioid therapy who concurrently initiate skeletal muscle relaxants. The study found that the use of baclofen, compared to cyclobenzaprine, was associated with opioid overdose, while the relationship between the use of other drugs and overdose risk was unclear.
Article
Immunology
Stephen M. Kissler, Bill Wang, Ateev Mehrotra, Michael Barnett, Yonatan H. Grad
Summary: Privately insured children in the United States receive many antibiotics early in life, largely due to respiratory infections. Antibiotic dispensing varies widely among children, with more antibiotics dispensed to children with pulmonary/respiratory, otologic, and/or immunological comorbidities.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Medicine, General & Internal
Junyi Wang, Joshua J. Gagne, Sushama Kattinakere-Sreedhara, Michael A. Fischer, Katsiaryna Bykov
Summary: This study evaluated the association between the use of fluoroquinolones and hospital admission or emergency department visits for suicidal thoughts. The results showed that there was no significantly increased risk of suicidal thoughts associated with the use of fluoroquinolones compared to other antibiotics.
BMJ-BRITISH MEDICAL JOURNAL
(2022)
Editorial Material
Medicine, General & Internal
Michael L. Barnett, Paul E. Sax
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Geriatrics & Gerontology
Agne Ulyte, Ateev Mehrotra, Haiden A. Huskamp, David C. Grabowski, Michael L. Barnett
Summary: The use of specialty care significantly decreases after patients transition to a nursing home. Residents who require specialty care have fewer visits after the transition, with a decreasing trend in all specialties. Patients with severe conditions have a larger decrease. Among residents who continue to visit specialists, 78.9% see the same provider as before the transition.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Medicine, General & Internal
Anna L. Goldman, Michael L. Barnett
Summary: This study found that physician work hours have consistently declined in the past 20 years, resulting in physician workforce hours per capita lagging behind US population growth. However, the hours contributed by advanced practice professionals have rapidly increased, potentially leading to diverging implications for gender equity.
JAMA INTERNAL MEDICINE
(2023)
Article
Geriatrics & Gerontology
Amanda C. C. Chen, Arnold M. Epstein, Karen E. Joynt E. Maddox, David C. Grabowski, E. John Orav, Michael L. Barnett
Summary: The study aims to investigate the care delivery approaches and perceived barriers of skilled nursing facilities (SNFs) in providing care for short-stay residents. The findings suggest that there is a wide range of care delivery approaches implemented by SNFs, but staffing issues and limited resources are the dominant barriers to care delivery.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Medicine, General & Internal
Brian E. McGarry, Ashvin D. Gandhi, Michael L. Barnett
Summary: A study found that widespread surveillance testing among staff members in nursing homes can reduce Covid-19 cases and deaths among residents, especially before the availability of vaccines.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Michael L. L. Barnett, Ellen Meara, Terri Lewinson, Brianna Hardy, Deanna Chyn, Moraa Onsando, Haiden A. A. Huskamp, Ateev Mehrotra, Nancy E. E. Morden
Summary: An analysis of Medicare claims data from 2016-2019 revealed that white patients were more likely to receive medications for opioid use disorder (OUD) compared to black and Hispanic patients. Despite an increase in opioid overdose-related mortality among black individuals, racial and ethnic disparities in the use of OUD medications remained consistent and substantial over time.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Editorial Material
Health Care Sciences & Services
Suhas Gondi, Michael L. Barnett
Article
Geriatrics & Gerontology
Amanda C. Chen, Arnold M. Epstein, Karen E. Joynt Maddox, David C. Grabowski, E. John Orav, Michael L. Barnett
Summary: This study investigated the association between dementia-focused care strategies and clinical outcomes, utilization, and costs for short-stay dementia patients in nursing homes. The results showed that the presence of dementia care units was associated with improved outcomes, while cognitive deficiency training and dementia-specific occupational therapy had mixed effects.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Letter
Medicine, General & Internal
Max Jordan Nguemeni Tiako, Autumn Nobles, Muzzammil Muhammad, Marcella Nunez-Smith, Michael Barnett
ANNALS OF INTERNAL MEDICINE
(2023)