Record Linkage Approaches Using Prescription Drug Monitoring Program and Mortality Data for Public Health Analyses and Epidemiologic Studies
Background: The use of Prescription Drug Monitoring Program (PDMP) data has greatly increased in recent years as these data have accumulated as part of the response to the opioid epidemic in the United States. We evaluated the accuracy of record linkage approaches using the Controlled Substance Monitoring Database (Tennessee’s [TN] PDMP, 2012–2016) and mortality data on all drug overdose decedents in Tennessee (2013–2016). Methods: We compared total, missed, and false positive (FP) matches (with manual verification of all FPs) across approaches that included a variety of data cleaning and matching methods (probabilistic/fuzzy vs. deterministic) for patient and death linkages, and prescription history. We evaluated the influence of linkage approaches on key prescription measures used in public health analyses. We evaluated characteristics (e.g., age, education, sex) of missed matches and incorrect matches to consider potential bias. Results: The most accurate probabilistic/fuzzy matching approach identified 4,714 overdose deaths (vs. the deterministic approach, n = 4,572), with a low FP linkage error (
The United States continues to face a public heatlh crisis of epic proportion, with over 500,000 deaths from opioid overdoses since 2000. Medications for opioid use disorder, like buprenorphine, offer patients an effective approach to cessation. Unfortunately many barriers to use of medications for opioid use disorder exist, including insufficient number of programs offering medications for opioid use disorder, inadequate number of addiction specialists to provide these medications, and stigma surrouding patients with opioid use disorders and the medications used to treat them.
ConclusionOpioid overdose identified by receiving out-of-hospital naloxone with clinical improvement carries a 13-fold increase in mortality compared to the general population. This suggests that this is a high-risk population that deserves attention from public health officials, policymakers, and health care providers in regard to the development of long-term solutions.
John Kapoor, CEO of Insys Therapeutics, was sentenced yesterday to 5 1/2 years in prison. That's a pretty stiff sentence, right?Well let's see now. What did he do exactly?His company sold fentanyl under the brand name Subsys. As you probably know, fentanyl is an extremely powerful synthetic opioid that is responsible for a high percentage of the overdose deaths in the current epidemic of opioid addiction. As a prescription drug, it was approved by the FDA only for so-called breakthrough pain in cancer patients. But Insys literally bribed doctors to prescribe it inappropriately, resulting in8,000 known deathsand countless m...
Doctors have been increasingly prescibing benzodiazepines, also known as "benzos," a new study finds.
Abstract The United States is in the midst of an opioid epidemic claiming more than 130 lives per day. The annual economic burden of prescription opioid misuse is estimated at $78.5 billion. The opioid epidemic has far exceeded the resources traditionally available for those with opioid use disorder (OUD). Medication for opioid use disorder (MOUD), specifically buprenorphine, has been shown to decrease mortality, reduce overdoses, and increase treatment retention. PMID: 31958179 [PubMed - as supplied by publisher]
ConclusionsPrescribing patterns alone may not be sufficient to identify patients who are at high risk for opioid overdose, especially for those using illicit opioids. Interventions aimed at reducing opioid overdoses should take into account different patterns of opioid prescribing associated with illicit and prescription opioid overdose deaths and be designed around the local characteristics of the opioid overdose epidemic.
Methamphetamine is a central nervous system stimulant initially synthesized from ephedrine in 1893 by the Japanese chemist Nagai Nagayoshi. It was utilized in World War II by Allied and Axis forces for their effects on performance enhancement.1 Because of rising abuse, methamphetamines became a schedule II controlled substance in the United States in 1971.2 Over the past 50 years, there has been a gradual increase in the incidence of methamphetamine abuse followed by a recent rapid rise. Although methamphetamine abuse was dramatized in the popular TV series Breaking Bad, the epidemic has largely been overshadowed by overdo...
Death certificates used in federal counts of drug deaths don't capture those who die due to drug use, but didn't overdose, creating an undercount, according to U Penn and Georgetown researchers.
This report from a clinical decision support (CDS) working group convened by the NIDA Center for the Clinical Trials Network aims to converge electronic technology in the EHR with the urgent need to improve screening, identification, and treatment of OUD in primary care settings through the development of a CDS algorithm that could be implemented as a tool in the EHR. This aim is consistent with federal, state and local government and private sector efforts to improve access and quality of MOUD treatment for OUD, existing clinical quality and HEDIS measures for OUD or drug and alcohol use disorders, and with a recent draft...
Nonmedical use of prescription opioids (NUPO) among adolescents is decreasing. However, given the evolving epidemiology of the drug overdose epidemic as well as the association between NUPO and heroin use, NUPO in adolescents is still an important issue. Understanding interrelationships between NUPO and illicit opioid use in adolescents can inform prevention efforts. The purpose of this study is to present the magnitude of the drug overdose problem in adolescents and understand heroin use and injection drug use (IDU) in the context of NUPO.