Patterns Of Substance Use And Buprenorphine Utilization To Predict Treatment Utilization For Opioid Use Disorder, Nicole M. Kent

Doctoral Dissertations

Substance use continues to rise in the United States. In 2021, 5.6 million people had an opioid use disorder (OUD). OUD is highly stigmatized and is not treated as a chronic condition. People with OUD have been denied treatment for a single positive urine drug test. Pregnant women are further at risk of criminal charges or losing custody of their child. OUD treatment success is defined as opioid abstinence and the goal of treatment is to taper off medication, despite evidence that treatment retention leads to better outcomes. The purpose of this study was to identify patterns of buprenorphine utilization …

The Opioid Epidemic: Effects On Recidivism In West Virginia, Emilee Frye, Elizabeth Williams

Theses, Dissertations and Capstones

The opioid epidemic began in the 1990s with an increased prescribing of opioids across the nation. Between the years 2013 and 2014, opioid overdose death rates began to increase in West Virginia. By the year 2015, West Virginia held the highest number of opioid overdose death rates in the country. In 2021, fatal overdoses claimed more than 1,417 lives in West Virginia and of those 1,417, an estimated 1,201 of them were due to opioid use.

West Virginia had the highest opioid drug overdose rate in the nation and one of the highest incarceration rates for opioid-dependent individuals. West Virginia …

Trends In Cannabis-Related And Opioid-Related Hospitalization Rates In Maine, 2010-2020, Suzanne Mcmahon, Katherine Ahrens

Journal of Maine Medical Center

Introduction: Medical marijuana use became legal in the state of Maine in 1999, and recreational adult-use marijuana became legal in 2016. However, the rates of hospitalization related to marijuana (also known as cannabis) use have not been studied. We estimated trends in cannabis-related hospitalization rates in Maine based on rurality and descriptively compared these trends to opioid-related hospitalization rates during the past decade.

Methods: We obtained de-identified data of inpatient encounters for Maine residents between 2010 and 2020 from MaineHealth Data Organization. We then calculated age-standardized rates of cannabis-related and opioid-related hospitalizations overall and by rural-urban residence using International Classification …

Factors Associated With Nonmedical Prescription Opioid Use And Prescription Opioid Misuse Among Rural Americans, Brittany Cox

Walden Dissertations and Doctoral Studies

Opioid misuse is a rapidly evolving health epidemic in the United States, leading to opioid use disorders, overdose deaths, and disparities in treatment. The rural population may be more susceptible given socioeconomic status, less educational attainment, and lower income. The impact on specific populations is not well understood. The purpose of this study was to identify the association of nonmedical prescription opioid use (NPOU), prescription opioid misuse (POM), and treatment-seeking with race, age, sex, education, and insurance status among rural Americans. The social-ecological model (SEM) served as the theoretical framework. The SEM described the interplay between individual, relationship, community, and …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Police Officers' Perceptions Of The Law Enforcement Narcan Program And The Effectiveness In Fighting The Opioid Epidemic, James Russo

Seton Hall University Dissertations and Theses (ETDs)

Abstract

The purpose of this study was to investigate how police officers perceived the N.J. Narcan policy and standards in saving lives and deterring opioid use. This study also examined the impact of the law enforcement Narcan program in reducing the opioid overdose death rate. Participant interviews will be conducted, and thematic coding will be utilized to capture the dominant themes associated with the police officers’ perceptions of the N.J. Narcan policy and standards in reducing the opioid overdose death rate. Fifteen police officers will participate in the study, and their anonymity will be maintained to elicit transparent responses. This …

Understanding The Stigma And Feasibility Of Opening A Safe Injection Facility In Baltimore City: A Qualitative Case Study, Timothy Dupree, Caroline I. Wood, Andrea M. Brace

The Qualitative Report

Supervised injection facilities (SIFs) are medically supervised facilities designed to provide a hygienic environment in which drug users can consume illicit drugs intravenously. SIFs can be cost saving, help to reduce transmission of disease, and decrease drug overdoses. There are no SIFs in the United States. In this study we used a multiple case study design to understand the stigma surrounding the use of a SIF and the feasibility of implementing the drug prevention strategy in Baltimore City by comparing experiences with opening a SIF in Sydney, Australia. We interviewed one healthcare worker at the Sydney SIF and ten community …

The Impact Two Opioid Prescription Protocols Had On Provider Prescription Patterns Following Ankle Fracture Repair Surgeries, Charles Jiang, Joshua Hester, Luke Wesemann

Medical Student Research Symposium

Introduction

This study aims to evaluate the impact that an urban multi-center trauma department’s previous narcotic prescription protocols have had on provider opioid prescription patterns and the effect a change in protocol will have. This study will also determine an optimal post-op opioid prescription duration for ankle fracture repair surgery.

Methods

Data were collected retrospectively. CPT codes were used to identify subjects who had undergone lateral malleolus repair surgery. Patient data were separated by the respective year of their repair surgery from January 2016 to October 2020. PROMIS survey results and pain VAS scores were collected in the hospital’s electronic …

Comprehensive Care: Harm Reduction And The Opioid Epidemic, Riley Tinlin

Global Sustainable Development Projects

Comprehensive Care: Harm Reduction and the Opioid Epidemic aims to delve deeper into the realities of opioid addiction and assess proposed prevention strategies by acknowledging the driving factors (biological, psychological, and social) and consequences of opioid abuse. Intervention strategies are offered from various access points ranging from the federal to individual level. The research conducted has shown that all access points must be considered for the success of prevention and treatment efforts. The intent of this paper is to argue that the proposed strategies are necessary steps to be taken if the United Nations Sustainable Development Goals 3 (good health …

Lived Experiences Of Police Officers And Their Roles During Opioid Overdose, Sean Banks

Walden Dissertations and Doctoral Studies

Researchers have conducted multiple studies regarding opioid users, opioid addicts, relatives of addicts, and health professional responses. The opioid crisis has been a focus for scholars following the first wave of prescription in 1991 (CDC, 2016). However, there is limited research that examines the lived experiences of law enforcement officers and their roles during an opioid overdose. As the opioid crisis has continued to negatively affect individuals, families, communities, cities, and countries, federal, state, and local policymakers have searched for ways to combat the opioid crisis. For many law enforcement agencies, policymakers have enacted policy that mandates patrol officers carry …

Developing Interagency Collaboration To Address The Opioid Epidemic: A Scoping Review Of Joint Criminal Justice And Healthcare Initiatives., Andrea J Yatsco, Tiffany Champagne-Langabeer, Travis F Holder, Angela L Stotts, James R Langabeer

Library Staff Publications

BACKGROUND: With the current opioid epidemic impacting well over half of all counties across the United States, initiatives that encourage interagency collaboration between first responder organizations appear necessary to comprehensively address this crisis. Police, fire, and emergency medical services (EMS) are in a unique position to identify substance users and provide necessary resources to initiate treatment, yet there is not sufficient evidence of joint collaborative programs between law enforcement/first responders and healthcare providers.

METHODS: In this scoping review we examine the current state of joint criminal justice and healthcare interventions, specifically, opioid and substance use pre-arrest initiatives via emergency first …

Medication Assisted Treatment For Opioid Use Disorder, Michael Ray Anderson

Nursing Capstones

No abstract provided.

A Study Of Addiction: The Opioid Epidemic, An Analysis At The State And County Level, Jamey Van Dyke

Undergraduate Theses

Addictive diseases such as those stemming from the use of alcohol, cocaine and opioids lead to serious negative consequences at both the individual and societal level. Over the last two decades, there has been a significant increase in opioid prescriptions and addiction. The potential for addiction is related to factors that include genetics, prescriber behavior, user behavior and characteristics, in addition to environmental and systemic determinants. One measure of the seriousness of the opioid epidemic is the number of overdose deaths. In 2017, drug overdoses killed over seventy thousand Americans, and overdose deaths are projected to increase in the future. …

Safe Consumption Sites And The Perverse Dynamics Of Federalism In The Aftermath Of The War On Drugs, Deborah Ahrens

Dickinson Law Review (2017-Present)

In this Article, I explore the complicated regulatory and federalism issues posed by creating safe consumption sites for drug users—an effort which would regulate drugs through use of a public health paradigm. This Article details the difficulties that localities pursuing such sites and other non-criminal-law responses have faced as a result of both federal and state interference. It contrasts those difficulties with the carte blanche local and state officials typically receive from federal regulators when creatively adopting new punitive policies to combat drugs. In so doing, this Article identifies systemic asymmetries of federalism that threaten drug policy reform. While traditional …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Bioethics, Law, And The Opioid Crisis: Revisiting The Concept Of Incarceration Versus Rehabilitation, Zachary J. Krauss

Bioethics in Faith and Practice

The opioid crisis has taken America by storm and is causing more deaths each year than ever originally anticipated. Our current approach to addressing the opioid crisis involves two separate approaches, one from the medical/rehabilitation side of the problem, and one from the criminal justice side. This article serves as a revisiting of the discussion of the intricate balance that must be reached between rehabilitation and incarceration in order to adequately address the problem.

Predictors Of Short-Term Residential Treatment Completion Preceded By Detoxification For Opioid Use Disorder, Christopher Gideon

Dissertations & Theses (Open Access)

Background and Significance: Deaths related to opioid overdose are increasing. Treatment for opioid use disorder (OUD) is necessary to help prevent future opioid abuse, and often involves opioid detoxification, followed by short-term residential treatment, typically lasting about 28 days. Literature regarding OUD and short-term residential treatment is limited. Predictors of short-term residential completion, including whether detoxification was performed, may help addiction professionals individualize treatments. This study’s purpose was to determine predictors of short-term residential completion treatment for OUD, and whether detoxification prior to entering residential treatment may also be a factor in residential completion.

Method: De-identified data regarding …

Trends And Associated Factors Of Use Of Opioid, Heroin, And Cannabis Among Patients For Emergency Department Visits In Nevada: 2009–2017, Pearl C. Kim, Ji Won Yoo, Chris R. Cochran, Seong Min Park, Sungyoun Chun, Yong-Jae Lee, Jay J. Shen

School of Medicine Faculty Publications

To examine trends and contributing factors of opioid, heroin, and cannabis-associated emergency department (ED) visits in Nevada. The 2009 to 2017 Nevada State ED database (n = 7,950,554 ED visits) were used. Use of opioid, heroin, and cannabis, respectively, was identified by the International Classification of Diseases, 9th & 10th Revisions. Three multivariable models, one for each of the 3 dependent variables, were conducted. Independent variables included year, insurance status, race/ethnicity, use of other substance, and mental health conditions. The number of individuals with opioid, heroin, cannabis-associated ED visits increased 3%, 10%, and 23% annually from 2009 to 2015, particularly …

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

Latest Trends In The Heroin Epidemic And The Responsibility Of The Pharmacist In Controlling Heroin Abuse, Alexandra Herman, Cassandra Hacker, Emily Wells, Sabrina Hamman, Manoranjan D'Souza

Pharmacy and Wellness Review

Over the last few years, there has been an exponential increase in morbidity and mortality associated with heroin abuse. The current rise in heroin abuse and overdose is attributed to widespread use and abuse of prescription opioids, which can produce significant euphoric effects in humans. In fact, reports suggest that heroin abusers initially become addicted to prescription opioids but subsequently switch to heroin because it is cheaper and more easily available than prescription opioids. Over the years, the purity of heroin available for illicit use has been on the decline. Smugglers and heroin vendors have started mixing heroin with other …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

Public Health Faculty Publications

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

Prenatal Opioid Maintenance In The U.S. And Its Effect On Neo-Natal Abstinence Syndrome: The Case Of West Virginia's Opioid Epidemic, Morgan Ruley, Alberto Coustasse

Management Faculty Research

In 2017, West Virginia’s opioid epidemic was the cause of about 1000 deaths. Opioid abuse has become an issue among pregnant mothers and has increased the effects of Neonatal Abstinence Syndrome (NAS) in infants. The purpose of this study was to evaluate the participation of prenatal opioid maintenance to determine if it has decreased the amount of treatment needed for NAS in infants in West Virginia. The methodology utilized a literature review complemented with a semi-structured interview. Thirty-six sources were referenced for this literature review. It was found that Buprenorphine Maintenance Therapy had the most positive effect on NAS after …

Health And Social Disparities Influence Opioid Misuse Among Adult Females Living In Rural Areas, Tequila Porter

Master of Science in Integrative Biology Theses

Since the early 1800s scientists have been working to create the best non-addictive pain medication derived from opium. In the early 1800s morphine was distilled from opium extracted from opium poppy plants (Quinones, 2015). Soon after a chemist invents a synthetic derivative of opium and names it diacetylmorphine (heroin) (Quinones, 2015, (Drugs and Morphine Text, 2018). Heroin originally was a safe cure for morphine addiction. Once this was proven to be false, and as having addictive properties, the government intervened and began initiatives to address the issue. This public crisis quickly grew to what modern scientists and healthcare professionals know …

Escaping Death: Naloxone's Chemical Nature And Potential To Combat The Opioid Epidemic, Abigale Miller

Honors Theses

Naloxone is a life-saving drug with the ability to reverse an opioid overdose. As the opioid epidemic’s death toll rises, we can turn to Naloxone as a tool to combat the crisis. The epidemic, born of corruption, has a wide reach among the people of the United States, with especially firm grasps on middle-aged people, sufferers of chronic pain, white Americans and those living in the eastern portion of the country. Naloxone’s elegant design saves lives by effectively competing for a position on an opioid biding receptor in the brain to almost instantly end an overdose and restore normal breathing. …

Friends Of The Poppy: An Ethical Exploration Of Opioid Addiction, Emma Goldblatt

Sound Decisions: An Undergraduate Bioethics Journal

Scientists and philosophers have been puzzling over the root of addiction for centuries. In the past, addiction was seen as a moral failing, a choice and an inevitability for certain people. Since then, science has shown us that social circumstance and physiological dependency are much better explanations for why addiction develops and persists. This has come into the conversation surrounding the current American opioid epidemic. It is spoken about in medical terms and is being addressed by the Centers for Disease Control and Prevention, both of which would not be possible without defining addiction as a disease. Addiction is more …

Prenatal Opioid Maintenance In The U.S. And Its Effect On Neonatal Abstinence Sysndrome: The Case Of West Virginia's Opioid Epidemic, Morgan Ruley

Theses, Dissertations and Capstones

Introduction: West Virginia’s opioid epidemic has been the cause of about 1,000 deaths each year. Opioid abuse has become an issue among pregnant mothers and has increased the effects of NAS in infants. The purpose of this research study was to evaluate the participation of prenatal opioid maintenance to determine if it has decreased the amount of treatment needed for NAS in infants in WV.

Methodology: The methodology for this study utilized a literature review and a semi-structured interview. It consisted of academic sources, five electronic databases, academic journals, and government websites. Thirty-seven sources were referenced for this literature …

Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies

Walden Dissertations and Doctoral Studies

Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …