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نتیجه جستجو - Opioid overdose

تعداد مقالات یافته شده: 5
ردیف عنوان نوع
1 A Scoping Review of Barriers and Facilitators to Implementation of Medications for Treatment of Opioid Use Disorder within the Criminal Justice System
مروری گسترده از موانع و تسهیل کننده های اجرای داروها برای درمان اختلال استفاده از مواد افیونی در سیستم عدالت کیفری-2020
Background: Policies aimed at addressing the high rates of opioid overdose have prioritized increasing access to medications for treatment of opioid use disorder (MOUD). Numerous barriers exist to providing MOUD within the criminal justice system and/or to justice-involved populations. The aim of this study was to conduct a scoping review of the peer-reviewed literature on implementation of MOUD within criminal justice settings and with justice-involved populations. Methods: A systematic search process identified 53 papers that addressed issues pertaining to implementation barriers or facilitators of MOUD within correctional settings or with justice-involved populations; these were coded and qualitatively analyzed for common themes. Results: Over half of the papers were published outside of the U.S. (n = 28); the most common study designs were surveys or structured interviews (n = 20) and qualitative interviews/focus groups (n = 18) conducted with correctional or treatment staff and with incarcerated individuals. Four categories of barriers and facilitators were identified: institutional, programmatic, attitudinal, and systemic. Institutional barriers typically limited capacity to provide MOUD to justice-involved individuals, which led to programmatic practices in which MOUD was not implemented following clinical guidelines, often resulting in forcible withdrawal or inadequate treatment. These programmatic practices commonly led to aversive experiences among justice-involved individuals, who consequently espoused negative attitudes about MOUD and were reluctant to seek treatment with MOUD following their release to the community. Facilitators of MOUD implementation included increased knowledge and information from training interventions and favorable prior experiences with individuals being treated with MOUD among correctional and treatment staff. Few systemic facilitators to implementing MOUD with justiceinvolved individuals were evident in the literature. Conclusion: Barriers to implementing MOUD in criminal justice settings and/or with justice-involved populations are pervasive, multi-leveled, and inter-dependent. More work is needed on facilitators of MOUD implementation.
Keywords: opioid use disorder | medication | criminal justice system | implementation | barriers | facilitators
مقاله انگلیسی
2 The effectiveness of drug-related Good Samaritan laws: A review of the literature
اثربخشی قوانین سامری خوب مربوط به مواد مخدر: مروری بر ادبیات-2020
Background: The United States (US) and Canada are in the midst of an opioid overdose epidemic. Many people who use illicit drugs (PWUD) do not call an emergency number 911 at the scene of an overdose due to fear of arrest. In the US and Canada, when an individual calls 911, both emergency medical services (EMS) and police are notified to attend the overdose event. In response, many settings in North America have introduced drugrelated ‘Good Samaritan’ laws (GSLs) that aim to encourage PWUD to call 911 by providing legal immunity (mainly protections from drugs possessed for personal use) to those at the scene of the overdose. However, little is known about the effectiveness of these laws in increasing calls to 911. Methods: We conducted a literature review of the published literature between 2005 and 2019 to examine the effectiveness of GSLs. Searches were referenced using keywords that included: “good samaritan”, “overdose”, “emergency services”, and “drug use”. Results: Among 68 articles identified, after eligibility screening, 12 publications were deemed to meet the inclusion criteria. These publications were largely quantitative observational studies (9/12), with a minority (3/ 12) being qualitative in design. Two major themes emerged: “knowledge of GSLs and calling EMS” and “overdose- related hospital admissions and mortality assessment”. Conclusion: At this time, the current body of evidence regarding the effectiveness of GSLs in increasing calls to EMS and reducing drug-related harms is limited and mixed. Studies show that PWUD have low levels of knowledge regarding GSLs while some evidence suggests their effectiveness in increasing calls to EMS at the scene of an overdose. Given the current overdose crisis, further investigation is warranted to establish the effectiveness of these laws in reducing drug-related harms.
Keywords: Overdose | good samaritan | drug policy | emergency services | illicit drugs
مقاله انگلیسی
3 Opioid overdose death following criminal justice involvement: Linking statewide corrections and hospital databases to detect individuals at highest risk
مرگ با یش از حد مصرف مواد مخدر به دنبال درگیری عدالت کیفری: پیوند دادن به اصلاحات سراسر کشور و پایگاه داده های بیمارستان برای شناسایی افراد در معرض خطر-2020
Background: Persons who interact with criminal justice and hospital systems are particularly vulnerable to negative health outcomes, including overdose. However, the relationship between justice involvement, healthcare utilization and overdose risk is not well-understood. This data linkage study seeks to improve our understanding of the link between different types of justice involvement as well as hospital interaction and risk of fatal opioid overdose among persons with incarcerations, arrests and parole/probation records for drug and property crimes in Maryland. Methods: Maryland statewide criminal justice records were obtained for 2013–2016. Data were linked at the person-level to an all-payer hospitalization database and overdose death records for the same years. Logistic regression was performed to determine which criminal justice and hospital characteristics were associated with greatest risk of overdose death. Results: 89,591 adults had criminal-justice records and were included in the study. During the 2013–2016 study period, 4108 (4.59 %) were hospitalized for a non-fatal opioid overdose, and 519 (0.58 %) died of opioid overdose. Strongest risk factors for death included being older, being white, having had an inpatient or emergency hospitalization, having had more arrests, having been arrested for a drug charge (vs. property charge), having a misdemeanor drug charge (vs. a felony charge), and having been released from incarceration during the study period. Conclusion: Linking corrections and healthcare information can help advance understanding of risk and target overdose prevention interventions directed at justice-involved individuals with greatest need.
Keywords: Opioid overdose | Criminal justice | Hospitalization | Data linkage
مقاله انگلیسی
4 Machine learning for phenotyping opioid overdose events
یادگیری ماشین برای فنوتیپ وقایع مصرف بیش از حد مواد افیونی-2019
Objective: To develop machine learning models for classifying the severity of opioid overdose events from clinical data. Materials and methods: Opioid overdoses were identified by diagnoses codes from the Marshfield Clinic population and assigned a severity score via chart review to form a gold standard set of labels. Three primary feature sets were constructed from disparate data sources surrounding each event and used to train machine learning models for phenotyping. Results: Random forest and penalized logistic regression models gave the best performance with cross-validated mean areas under the ROC curves (AUCs) for all severity classes of 0.893 and 0.882 respectively. Features derived from a common data model outperformed features collected from disparate data sources for the same cohort of patients (AUCs 0.893 versus 0.837, p value=0.002). The addition of features extracted from free text to machine learning models also increased AUCs from 0.827 to 0.893 (p value < 0.0001). Key word features extracted using natural language processing (NLP) such as ‘Narcan’ and ‘Endotracheal Tube’ are important for classifying overdose event severity. Conclusion: Random forest models using features derived from a common data model and free text can be effective for classifying opioid overdose events.
Keywords: Machine learning | Opioid | Phenotype | Overdose | Electronic health record
مقاله انگلیسی
5 The use of cannabis in response to the opioid crisis: A review of the literature
استفاده از شاهدانه در پاسخ به بحران مواد مخدر:مروری بر ادبیات-2018
Background: A staggering number of Americans are dying from overdoses attrib uted to prescription opioid medications (POMs). In response, states are creating policies related to POM harm reduction strategies, overdose prevention, and al ternative therapies for pain management, such as cannabis (medical marijuana). However, little is known about how the use of cannabis for pain management may be associated with POM use. Purpose: The purpose of this article is to examine state medical cannabis (MC) use laws and policies and their potential association with POM use and related harms. Methods: A systematic literature review was conducted to explore United States policies related to MC use and the association with POM use and related harms. Medline, PubMed, CINAHL, and Cochrane databases were searched to identify peer reviewed articles published between 2010 and 2017. Using the search criteria, 11,513 records were identified, with 789 abstracts reviewed, and then 134 full-text ar ticles screened for eligibility. Findings: Of 134 articles, 10 articles met inclusion criteria. Four articles were cross sectional online survey studies of MC substitution for POM, six were secondary data analyses exploring state-level POM overdose fatalities, hospitalizations related to MC or POM harms, opioid use disorder admissions, motor vehicle fatalities, and Medicare and Medicaid prescription cost analyses. The literature suggests MC laws could be associated with decreased POM use, fewer POM-related hos pitalizations, lower rates of opioid overdose, and reduced national health care expenditures related to POM overdose and misuse. However, available literature on the topic is sparse and has notable limitations. Conclusions: Review of the current literature suggests states that implement MC policies could reduce POM-associated mortality, improve pain management, and significantly reduce health care costs. However, MC research is constrained by federal policy restrictions, and more research related to MC as a potential alter native to POM for pain management, MC harms, and its impact on POM-related harms and health care costs should be a priority of public health, medical, and nursing research.
Keywords: Opioid ، Opioid use disorder ، Medical marijuana ، Medical cannabis ، Chronic pain ، Integrative pain management
مقاله انگلیسی
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