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2.
JAMA Netw Open ; 2(6): e195388, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-31173125

RESUMO

Importance: Despite the increasingly important role of pharmacies in the implementation of naloxone access laws, there is limited information on the impact of such laws at the local level. Objective: To evaluate the availability (with or without a prescription) and cost of naloxone nasal spray at pharmacies in Philadelphia, Pennsylvania, following a statewide standing order enacted in Pennsylvania in August 2015 to allow pharmacies to dispense naloxone without a prescription. Design, Setting, and Participants: A survey study was conducted by telephone of all pharmacies in Philadelphia between February and August 2017. Pharmacies were geocoded and linked with the American Community Survey (2011-2015) to obtain information on the demographic characteristics of census tracts and the Medical Examiner's Office of the Philadelphia Department of Public Health to derive information on the number of opioid overdose deaths per 100 000 people for each planning district. Data were analyzed from March 2018 to February 2019. Main Outcomes and Measures: Availability and out-of-pocket cost of naloxone nasal spray (with or without a prescription) at Philadelphia pharmacies overall and by pharmacy and neighborhood characteristics. Results: Of 454 eligible pharmacies, 418 were surveyed (92.1% response rate). One in 3 pharmacies (34.2%) had naloxone nasal spray in stock; of these, 61.5% indicated it was available without a prescription. There were significant differences in the availability of naloxone by pharmacy type and neighborhood characteristics. Naloxone was both more likely to be in stock (45.9% vs 27.8%; difference, 18.0%; 95% CI, 8.3%-27.8%; P < .001) and available without a prescription (80.6% vs 42.2%; difference, 38.4%; 95% CI, 23.0%-53.8%; P < .001) in chain stores than in independent stores. Naloxone was also less likely to be available in planning districts with very elevated rates of opioid overdose death (≥50 per 100 000 people) compared with those with lower rates (31.1% vs 38.5%). The median (interquartile range) out-of-pocket cost among pharmacies offering naloxone without a prescription was $145 ($119-$150); costs were greatest in independent pharmacies and planning districts with elevated rates of opioid overdose death. Conclusions and Relevance: Despite the implementation of a statewide standing order in Pennsylvania more than 3 years prior to this study, only one-third of Philadelphia pharmacies carried naloxone nasal spray and many also required a physician's prescription. Efforts to strengthen the implementation of naloxone access laws and better ensure naloxone supply at local pharmacies are warranted, especially in localities with the highest rates of overdose death.


Assuntos
Naloxona/administração & dosagem , Antagonistas de Entorpecentes/administração & dosagem , Farmácias/estatística & dados numéricos , Administração por Inalação , Honorários Farmacêuticos , Gastos em Saúde/estatística & dados numéricos , Humanos , Naloxona/economia , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/economia , Antagonistas de Entorpecentes/provisão & distribução , Sprays Nasais , Medicamentos sem Prescrição/administração & dosagem , Medicamentos sem Prescrição/economia , Medicamentos sem Prescrição/provisão & distribução , Transtornos Relacionados ao Uso de Opioides/economia , Transtornos Relacionados ao Uso de Opioides/reabilitação , Farmácias/economia , Philadelphia , Medicamentos sob Prescrição/administração & dosagem , Medicamentos sob Prescrição/economia , Medicamentos sob Prescrição/provisão & distribução
3.
J Pharm Pract ; 32(4): 412-421, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29478362

RESUMO

BACKGROUND: The Centers for Disease Control and Prevention (CDC) reports a 200% escalation in the rate of opioid overdose deaths in the United States. Unfortunately, Ohio has been deemed the epicenter of the nation's opioid epidemic. In 2015, Ohio passed a bill that permits a pharmacist to distribute naloxone without a prescription. OBJECTIVES: This survey was aimed to discover pharmacists' knowledge of naloxone and Ohio law, perceived barriers that may prohibit naloxone dispensing, and Ohio pharmacists' general confidence, comfort, perception, and experience dispensing naloxone per physician protocol. METHODS: Pharmacists' knowledge of naloxone and Ohio law pertaining to dispensing naloxone; perceived barriers to naloxone distribution; and overall experience, willingness, comfort, and perceptions of personally supplying naloxone were assessed using multiple-choice and Likert-type scale questions through an e-mail survey. RESULTS: Overall, Ohio pharmacists were knowledgeable about naloxone and displayed confidence in their training and ability to provide patient education on naloxone. Pharmacists were less certain about Ohio law pertaining to naloxone distribution, especially those who have been in practice longer. Pharmacists indicated several barriers to dispensing naloxone and the need for more training. Younger pharmacists were more likely to report a concern with clientele who would frequent their pharmacy and moral and ethical concerns as barriers to dispensing naloxone. CONCLUSION: Additional educational programs should be delivered to Ohio pharmacists to inform them of the state law and policies. Continuing education programs that review substance abuse and attempt to reduce social stigma may assist with increasing naloxone distribution to those in need, especially, if directed toward younger pharmacists in Ohio.


Assuntos
Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Adulto , Fatores Etários , Idoso , Overdose de Drogas/tratamento farmacológico , Prescrições de Medicamentos , Controle de Medicamentos e Entorpecentes , Feminino , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Educação de Pacientes como Assunto , Farmacêuticos/estatística & dados numéricos
7.
JAAPA ; 31(10): 47-52, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30252764

RESUMO

The treatment of patients with acute and chronic pain not attributed to cancer or end-of-life conditions is a challenge for many clinicians. Although CDC guidelines that focus on the primary care setting have provided critical recommendations, evidence-based guidance is lacking on optimal duration of opioid treatment for postoperative and acute care in specialty settings. Over the last 2 decades, the liberal use of opioids has resulted in many unintended consequences, including dependence and abuse, illicit distribution of legally and illegally prescribed opioid medication, progression to IV heroin and an epidemic of overdoses, and most recently an increase in the incidence of HIV among patients sharing syringes, frequently in communities with historically low HIV rates. This article analyzes these complex issues and proposes strategies to help clinicians improve patient care through education and responsible prescribing.


Assuntos
Epidemias/legislação & jurisprudência , Epidemias/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Prática de Saúde Pública , Política de Saúde , Humanos , Naloxona/provisão & distribução , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/provisão & distribução , Antagonistas de Entorpecentes/uso terapêutico , Assistentes Médicos , Estados Unidos
8.
J Addict Nurs ; 29(3): 157-162, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30180000

RESUMO

PROBLEM: In 2014, there were approximately 200,000 incidents of an unintentional opioid overdose nationwide. The 2016 Centers for Disease Control and Prevention opioid prescription guidelines identified a knowledge deficit regarding opioid prescribing among primary care providers as a contributing factor to this epidemic. PURPOSE: The purpose of this quality assurance project was to provide education on opioid overdose and distribution of naloxone kits through a presentation to primary care providers at Veterans Administration facilities in the southeast region of the United States. METHODS: A convenience sampling strategy was utilized for this project. Primary care providers who prescribe opioids or care for patients at risk of an opioid-related event or death were invited to participate. A Likert scale survey was used to determine the effectiveness of the presentation. RESULTS: The results of the survey showed a potential for improving medical providers' perceptions and comfort with prescribing naloxone kits. The mean score at pretest was 32 of 50 (64%) in contrast to 42 of 50 (84%) after attending the presentation. Attending this quality assurance presentation was related to an increased awareness of naloxone kit availability and Centers for Disease Control and Prevention recommendations regarding the safe administration of opioids. CONCLUSION: This educational presentation can assist providers in identifying patients who are prescribed opioids and at risk for accidental overdose and death.


Assuntos
Analgésicos Opioides/envenenamento , Overdose de Drogas/prevenção & controle , Educação Continuada/organização & administração , Hospitais de Veteranos/organização & administração , Naloxona/administração & dosagem , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/administração & dosagem , Antagonistas de Entorpecentes/provisão & distribução , Atenção Primária à Saúde/organização & administração , Garantia da Qualidade dos Cuidados de Saúde , Conscientização , Overdose de Drogas/epidemiologia , Overdose de Drogas/enfermagem , Prescrições de Medicamentos , Educação Continuada/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Fatores de Risco , Sudeste dos Estados Unidos/epidemiologia , Estados Unidos
9.
Int J Drug Policy ; 59: 94-97, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30075401

RESUMO

BACKGROUND: Despite promising findings of opioid overdose education and naloxone distribution (OEND) programs, overdose continues to be a major cause of mortality. The "cascade of care" is a tool for identifying steps involved in achieving optimal health outcomes. We applied the cascade concept to identify gaps in naloxone use. METHODS: Data came from a cross-sectional survey of 353 individuals aged 18 and older who self-reported lifetime history of heroin use. RESULTS: The sample was majority male (65%) and reported use of heroin (74%) and injection (57%) in the past 6 months. Ninety percent had ever witnessed an overdose and of these 59% were in the prior year. Awareness of naloxone (90%) was high. Of those aware, over two-thirds reported having ever received (e.g. access) (69%) or been trained to use naloxone (60%). Of those who had ever received naloxone (n = 218) over one-third reported possession never (36%) or rarely/sometimes carrying naloxone (38%), while 26% reported always carrying. Nearly half of those who had ever received naloxone reported ever use to reverse an opiate overdose (45%). Among individuals who had ever received naloxone, possession often/always compared to never was associated with being female (RRR = 2.88, 95%CI = 1.31-6.27) and ever used naloxone during an overdose (RRR = 4.68, 95%CI = 2.00-11.0). CONCLUSIONS: This study identifies that consistent possession is a gap in the naloxone cascade. Future research is needed to understand reasons for not always carrying naloxone.


Assuntos
Overdose de Drogas/tratamento farmacológico , Overdose de Drogas/prevenção & controle , Naloxona/administração & dosagem , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/administração & dosagem , Antagonistas de Entorpecentes/provisão & distribução , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Adolescente , Adulto , Idoso , Conscientização , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde , Heroína/envenenamento , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
J Law Med Ethics ; 46(2): 367-381, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30146989

RESUMO

This paper focuses on the most common state policy responses to the opioid crisis, dividing them into six broad categories. Within each category we highlight the rationale behind the group of policies within it, discuss the details and support for individual policies, and explore the research base behind them. The objective is to better understand the most prevalent state responses to the opioid crisis.


Assuntos
Transtornos Relacionados ao Uso de Opioides/terapia , Política Pública , Governo Estadual , Analgésicos Opioides/administração & dosagem , Prescrições de Medicamentos , Tráfico de Drogas/legislação & jurisprudência , Educação Médica Continuada , Educação em Saúde , Humanos , Legislação de Medicamentos , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Programas de Troca de Agulhas , Tratamento de Substituição de Opiáceos , Manejo da Dor , Médicos/legislação & jurisprudência , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Programas de Monitoramento de Prescrição de Medicamentos , Estados Unidos
11.
J Law Med Ethics ; 46(2): 472-484, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-30146993

RESUMO

The rising cost of the opioid antagonist and overdose reversal agent naloxone is an urgent public health problem. The recent and dramatic price increase of Evzio, a naloxone auto-injector produced by Kaléo, shows how pharmaceutical manufacturers entering the naloxone marketplace rely on market exclusivity guaranteed by the patent system to charge prices at what the market can bear, which can restrict access to life-saving medication. We argue that 28 U.S.C. § 1498, a section of the federal code that allows the government to use patent-protected products for its own purposes in exchange for reasonable compensation, could be used to procure generic naloxone auto-injectors, or at least bring Kaléo to the negotiating table. Precedent exists for the use of § 1498 to procure pharmaceuticals, and it could give meaning to the federal government's recent declaration of a public health emergency around the opioid epidemic, discourage new market entrants from charging exorbitant prices, and yield important public health benefits.


Assuntos
Acesso aos Serviços de Saúde/legislação & jurisprudência , Naloxona/economia , Antagonistas de Entorpecentes/economia , Patentes como Assunto/legislação & jurisprudência , Analgésicos Opioides/efeitos adversos , Overdose de Drogas/tratamento farmacológico , Humanos , Naloxona/provisão & distribução , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/provisão & distribução , Antagonistas de Entorpecentes/uso terapêutico , Transtornos Relacionados ao Uso de Opioides , Saúde Pública , Estados Unidos
12.
J Law Med Ethics ; 46(2): 422-436, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30146999

RESUMO

The national opioid epidemic is severely impacting Indian Country. In this article, we draw upon data from the Centers for Disease Control and Prevention to describe the contours of this crisis among Native Americans. While these data are subject to significant limitations, we show that Native American opioid overdose mortality rates have grown substantially over the last seventeen years. We further find that this increase appears to at least parallel increases seen among non-Hispanic whites, who are often thought to be uniquely affected by this crisis. We then profile tribal medical and legal responses to the opioid epidemic, ranging from tribally-operated medication-assisted therapy to drug diversion courts rooted in traditional tribal cultures.


Assuntos
Índios Norte-Americanos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/etnologia , Transtornos Relacionados ao Uso de Opioides/terapia , Analgésicos Opioides/efeitos adversos , Indústria Farmacêutica/legislação & jurisprudência , Overdose de Drogas/mortalidade , Redução do Dano , Acesso aos Serviços de Saúde , Humanos , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Tratamento de Substituição de Opiáceos , Punição , Apoio Social , Centros de Tratamento de Abuso de Substâncias , Estados Unidos/epidemiologia , United States Indian Health Service
13.
J Law Med Ethics ; 46(2): 272-278, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30147002

RESUMO

Buprenorphine is a form of opioid agonist treatment that has been demonstrated to be an effective medication for opioid addiction. It is available in different formulations and marketed under various trade names, including commonly as a buprenorphine/naloxone combination. This paper provides an overview of existing literature on the supply of buprenorphine treatment, the ability of people to access treatment with buprenorphine, and the quality of treatment received. We argue that better data for each of these aspects of treatment could inform policy to expand effective treatment with buprenorphine, and we suggest steps to obtain and act on such data.


Assuntos
Buprenorfina/provisão & distribução , Acesso aos Serviços de Saúde , Antagonistas de Entorpecentes/provisão & distribução , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Buprenorfina/uso terapêutico , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Humanos , Antagonistas de Entorpecentes/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Indicadores de Qualidade em Assistência à Saúde , Estados Unidos
14.
Am J Public Health ; 108(10): 1394-1400, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30138057

RESUMO

OBJECTIVES: To estimate health outcomes of policies to mitigate the opioid epidemic. METHODS: We used dynamic compartmental modeling of US adults, in various pain, opioid use, and opioid addiction health states, to project addiction-related deaths, life years, and quality-adjusted life years from 2016 to 2025 for 11 policy responses to the opioid epidemic. RESULTS: Over 5 years, increasing naloxone availability, promoting needle exchange, expanding medication-assisted addiction treatment, and increasing psychosocial treatment increased life years and quality-adjusted life years and reduced deaths. Other policies reduced opioid prescription supply and related deaths but led some addicted prescription users to switch to heroin use, which increased heroin-related deaths. Over a longer horizon, some such policies may avert enough new addiction to outweigh the harms. No single policy is likely to substantially reduce deaths over 5 to 10 years. CONCLUSIONS: Policies focused on services for addicted people improve population health without harming any groups. Policies that reduce the prescription opioid supply may increase heroin use and reduce quality of life in the short term, but in the long term could generate positive health benefits. A portfolio of interventions will be needed for eventual mitigation.


Assuntos
Redução do Dano , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Política Pública , Overdose de Drogas/mortalidade , Dependência de Heroína/epidemiologia , Dependência de Heroína/mortalidade , Dependência de Heroína/prevenção & controle , Humanos , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Programas de Troca de Agulhas , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/mortalidade , Anos de Vida Ajustados por Qualidade de Vida , Estados Unidos/epidemiologia
15.
J Subst Abuse Treat ; 93: 19-25, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30126537

RESUMO

BACKGROUND: Buprenorphine is an effective medication for the treatment of opioid addiction, but current barriers to buprenorphine access limit treatment availability for many patients. We identify and characterize regions within the United States (US) with poor buprenorphine access relative to the observed burden of overdose deaths. METHODS: This cross sectional study includes US county-level data on the number of available buprenorphine providers (Substance Abuse and Mental Health Services Administration Buprenorphine Treatment Practitioner Locator) and the number of opioid-related overdose deaths between 2013 and 2015 (Centers for Disease Control and Prevention WONDER Database). Counties with fewer than 10 deaths during this time period were excluded to maintain patient privacy. Population-adjusted county death rates and provider availability were compared to identify locations with high disease burdens and limited buprenorphine access. The presence of significant clustering across the dataset was evaluated using Global Moran's I and zones of significant spatial clusters and anomalies were identified using Local Indicator of Spatial Autocorrelation. RESULTS: County data were available for 846 counties from 49 states and the District of Columbia, comprising 83% of the US population. The median number of opioid overdose deaths per county was 20.0 deaths per 100,000 residents (interquartile range 13.4-29.9, range 2.9 to 108.8). The number of buprenorphine providers per 100,000 county residents ranged from 0 to 45, with a median of 5.9 (interquartile range 3.2 to 9.5). Global Moran's I analysis yielded significant clustering in the distribution of both providers and deaths, with notable significant clusters of higher than average providers and deaths in the Northeast, and scattered mismatched regions of lower-than-average providers and higher-than-average deaths across the Southern, Midwestern, and Western US. Graphical analysis of buprenorphine provider availability and overdose burden reveals limited treatment access relative to overdose deaths throughout much of the Midwestern and Southern US. CONCLUSIONS: Substantial county-level imbalances between the availability of buprenorphine providers and the burden of opioid overdose deaths are present within the US.


Assuntos
Buprenorfina/administração & dosagem , Overdose de Drogas/prevenção & controle , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/reabilitação , Buprenorfina/provisão & distribução , Estudos Transversais , Overdose de Drogas/epidemiologia , Overdose de Drogas/mortalidade , Acesso aos Serviços de Saúde , Humanos , Antagonistas de Entorpecentes/administração & dosagem , Antagonistas de Entorpecentes/provisão & distribução , Transtornos Relacionados ao Uso de Opioides/complicações , Médicos/estatística & dados numéricos , Estados Unidos
17.
Am J Public Health ; 108(9): 1191-1196, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30024793

RESUMO

OBJECTIVES: To improve public health surveillance and response by using spatial optimization. METHODS: We identified cases of suspected nonfatal opioid overdose events in which naloxone was administered from April 2013 through December 2016 treated by the city of Pittsburgh, Pennsylvania, Bureau of Emergency Medical Services. We used spatial modeling to identify areas hardest hit to spatially optimize naloxone distribution among pharmacies in Pittsburgh. RESULTS: We identified 3182 opioid overdose events with our classification approach, which generated spatial patterns of opioid overdoses within Pittsburgh. We then used overdose location to spatially optimize accessibility to naloxone via pharmacies in the city. Only 24 pharmacies offered naloxone at the time, and only 3 matched with our optimized solution. CONCLUSIONS: Our methodology rapidly identified communities hardest hit by the opioid epidemic with standard public health data. Naloxone accessibility can be optimized with established location-allocation approaches. Public Health Implications. Our methodology can be easily implemented by public health departments for automated surveillance of the opioid epidemic and has the flexibility to optimize a variety of intervention strategies.


Assuntos
Transtornos Relacionados ao Uso de Opioides/epidemiologia , Vigilância da População , Melhoria de Qualidade , Alocação de Recursos/normas , Serviços Comunitários de Farmácia/provisão & distribução , Overdose de Drogas/tratamento farmacológico , Epidemias , Humanos , Auditoria Médica , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Entorpecentes/administração & dosagem , Pennsylvania/epidemiologia , População Urbana
18.
Addict Behav ; 86: 86-89, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29914719

RESUMO

Anecdotal evidence indicates that naloxone prices have risen in recent years, but limited research has examined the magnitude of these increases and potential causes. We contribute nationally representative evidence to help answer each of these questions, including wholesale pricing data from a proprietary drug sales database spanning January 2006 to February 2017. We find that all formulations of naloxone increased in price since 2006 except for Narcan Nasal Spray. These cumulative increases totaled 2281% for the 0.4 MG single-dose products, 244% for the 2 MG single-dose products, 3797% for the 4 MG multi-dose products, and 469% for the 0.4 MG Evzio auto-injector. We believe that increased demand for naloxone from the opioid epidemic may explain the more gradual price increases for the 0.4 MG single-dose and 4 MG multi-dose products prior to 2012. On the other hand, we believe that the sudden, sustained prices increases occurring for all of the products since 2012 may be the result of a drug shortage for the 0.4 MG single-dose products and the fact that each naloxone product has historically been sold by only a single competitor.


Assuntos
Comércio/tendências , Custos de Medicamentos/tendências , Naloxona/economia , Antagonistas de Entorpecentes/economia , Custos e Análise de Custo/tendências , Indústria Farmacêutica/tendências , Humanos , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Estados Unidos
19.
Health Promot Chronic Dis Prev Can ; 38(6): 224-233, 2018 Jun.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-29911818

RESUMO

INTRODUCTION: This review provides a national summary of what is currently known about the Canadian opioid crisis with respect to opioid-related deaths and harms and potential risk factors as of December 2017. METHODS: We reviewed all public-facing opioid-related surveillance or epidemiological reports published by provincial and territorial ministries of health and chief coroners' or medical examiners' offices. In addition, we reviewed publications from federal partners and reports and articles published prior to December 2017. We synthesized the evidence by comparing provincial and territorial opioid-related mortality and morbidity rates with the national rates to look for regional trends. RESULTS: The opioid crisis has affected every region of the country, although some jurisdictions have been impacted more than others. As of 2016, apparent opioid-related deaths and hospitalization rates were highest in the western provinces of British Columbia and Alberta and in both Yukon and the Northwest Territories. Nationally, most apparent opioid-related deaths occurred among males; individuals between 30 and 39 years of age accounted for the greatest proportion. Current evidence suggests regional age and sex differences with respect to health outcomes, especially when synthetic opioids are involved. However, differences between data collection methods and reporting requirements may impact the interpretation and comparability of reported data. CONCLUSION: This report identifies gaps in evidence and areas for further investigation to improve our understanding of the national opioid crisis. The Public Health Agency of Canada will continue to work closely with the provinces, territories and national partners to further refine and standardize national data collection, conduct special studies and expand information-sharing to improve the evidence needed to inform public health action and prevent opioid-related deaths and harms.


Assuntos
Overdose de Drogas/epidemiologia , Serviços Médicos de Emergência/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Fatores Etários , Canadá/epidemiologia , Overdose de Drogas/mortalidade , Fentanila/envenenamento , Hospitalização/estatística & dados numéricos , Humanos , Naloxona/provisão & distribução , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/provisão & distribução , Antagonistas de Entorpecentes/uso terapêutico , Entorpecentes/envenenamento , Transtornos Relacionados ao Uso de Opioides/mortalidade , Medicamentos sob Prescrição/envenenamento , Fatores de Risco , Fatores Sexuais , Populações Vulneráveis/estatística & dados numéricos
20.
Health Promot Chronic Dis Prev Can ; 38(6): 252-255, 2018 Jun.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-29911822

RESUMO

The Government of Manitoba launched the provincial Take-Home Naloxone Program in January 2017. By the end of September 2017, there were over 60 sites operating in Manitoba. These sites distributed 765 kits to people at risk of opioid overdose, and 93 of these kits were replacement kits used in overdose events. Most of these events occurred among males (60.2%) and in a private residence (72.0%). Fentanyl and carfentanil were the most common substances reported during overdose events. Take-Home Naloxone Program data provide important information about the unique context of the opioid crisis in Manitoba.


Assuntos
Overdose de Drogas/tratamento farmacológico , Naloxona/provisão & distribução , Antagonistas de Entorpecentes/provisão & distribução , Adolescente , Adulto , Analgésicos Opioides/envenenamento , Criança , Feminino , Fentanila/análogos & derivados , Fentanila/envenenamento , Humanos , Masculino , Manitoba , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Avaliação de Programas e Projetos de Saúde , Recidiva , Fatores Sexuais , Adulto Jovem
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