Understanding the Relationship Between Drug Overdose Death Rates and Socioeconomic Factors

Drug-overdose deaths increased rapidly recently. What are the causes? We believe socioeconomical factors play critical roles. Secondary data analyses are done on the US population, using mortality-data files from the National Vital Statistics System. Deaths are grouped by race, age, sex, education and marital status. We believe that the percentage-of-total-death (PoTD) value, which equals to the number-of-overdose-deaths divided by the total-number-of-deaths in the corresponding group, more accurately reflect the severity of overdose-deaths. Analysis of 2017 data reveals that among all age groups, PoTD is highest in the age 25-34 group, with dramatic differences between white (PoTD 24%) and black (PoTD 9%) populations, and between single (22%) and married (13%) populations. PoTD is generally higher for males than females; however, for the 15-24 age group, the PoTD for females (13%) is higher than males (10%), suggesting the need of special attention to young females in overdose prevention. PoTD is higher (~3%) for population with less-than-college education than college-or-higher education (~1%). However, the population with middle-school or less education has very low PoTD (0.6%). The PoTD vs. education relationship is similar between white and black populations. We also investigate dependencies of PoTD on factors such as day-of-week, and variations in PoTD over the past 15 years. In conclusion, large differences were revealed in the severity of overdose deaths among different socioeconomical groups by examining the PoTD values. We believe that PoTD values of individual groups should be given more considerations when developing health policies in response to the drug overdose crisis

E-cigarette use among women of reproductive age: Impulsivity, cigarette smoking status, and other risk factors.

INTRODUCTION: The study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant. METHOD: Survey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24-44years from the US. Half (n=400) reported current, daily smoking and half (n=400) reported smokingsociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression. RESULTS: Daily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products. CONCLUSIONS: E-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs

Patterns in Change of Opioid Overdose Death Rate with the Day of the Week and Their Implications

The objective of this study was to investigate the dependencies of opioid overdose death rates on the day of the week and understand the implications of the dependencies Understanding and presenting the dependencies is useful for first responders and for health care system resource planning It can provide additional insights in the opioid epidemic and should be considered in prevention effortshttps://jdc.jefferson.edu/phbposters/1002/thumbnail.jp

Effects of Using Different Death Rate Metrics on the Analysis of Drug-Overdose Death Rates and Socioeconomical Factors

Age-adjusted death rate (AADR) and raw death rate (RDD) used in drugoverdose studies typically involves death-record data and populationsurvey data. Difference can exist between the two data sources, leading to the so-called dual data-source error. Proportionate mortality avoids the error; however, no studies have been done comparing the conclusions drawn using the different metrics. The objective of this study is to evaluate the differences and merits of using different death-rate metrics in overdose analysis.https://jdc.jefferson.edu/phbposters/1003/thumbnail.jp

The European Federation of Organisations for Medical Physics policy statement no 14 : the role of the medical physicist in the management of safety within the magnetic resonance imaging environment : EFOMP recommendations

This European Federation of Organisations for Medical Physics (EFOMP) Policy Statement outlines the way in which a Safety Management System can be developed for MRI units. The Policy Statement can help eliminate or at least minimize accidents or incidents in the magnetic resonance environment and is recommended as a step towards harmonisation of safety of workers, patients, and the general public regarding the use of magnetic resonance imaging systems in diagnostic and interventional procedures.peer-reviewe

Treatments for opioid use disorder among pregnant and reproductive-aged women.

The increased prevalence of opioid use disorder and access to medical insurance is subsequently increasing the likelihood that medical professionals will encounter individuals with opioid use disorder. Sharp increases in opioid use disorder among women mean that obstetricians, gynecologists, and other reproductive medicine providers may be especially likely to encounter such patients. Medical professionals\u27 understanding of treatment for opioid use disorder and their roles in their patients\u27 treatment may increase referrals to treatment, reduce stigma, and improve the quality of medical care. Treatment for opioid use disorder falls into four overlapping domains: medication management, medical care, behavioral/mental health care, and psychosocial support. In this review, we discuss these domains with an emphasis on pregnant women and women of reproductive age. Treatment for opioid use disorder is most effective when all providers coordinate care in an informed, nonjudgmental, patient-centered approach

Pregnant Smokers Receiving Opioid Agonist Therapy Have an Elevated Nicotine Metabolite Ratio: A Replication Study.

INTRODUCTION: Pregnant women exposed chronically to opioids smoked more cigarettes per day (CPD) and had a higher nicotine metabolite ratio (NMR), 3-hydroxycotinine/cotinine, a biomarker of nicotine metabolism and clearance, than those not receiving opioids. We examined CPD and NMR in a group of pregnant smokers, a quarter of whom were receiving opioid agonist therapy (OAT). AIMS AND METHODS: Pregnant smokers recruited to participate in a placebo-controlled trial of bupropion for smoking cessation provided a blood sample for measurement of NMR. RESULTS: Half (52.4%) of the 124 women with NMR data were African American. OAT-treated women (n = 34, 27.4%; 27 receiving methadone and 7 buprenorphine) were more likely to be white (79% vs. 30%, p \u3c .001) and to have a lower mean PHQ-9 total score (2.91 [SD = 2.83] vs. 4.83 [SD = 3.82], p = .007). OAT-treated women reported smoking more CPD (9.50 [SD = 5.26] vs. 7.20 [SD = 3.65], p = .005) and had higher NMR (0.78 [SD = 0.36] vs. 0.56 [SD = 0.25], p = .001) than the non-OAT-treated group. In a linear regression analysis adjusting for race, depression severity, and CPD, NMR was greater in the OAT group (p = .025), among whom the daily methadone-equivalent dosage correlated with NMR (Spearman\u27s ρ = 0.49, p = .003). CONCLUSIONS: Consistent with the findings of Oncken et al. (2019), we found that OAT smokers smoked more and had higher NMR than non-OAT smokers. As higher NMR is associated with a reduced likelihood of smoking cessation, the effects on NMR of both pregnancy and OAT could contribute to a lower smoking cessation rate in pregnant smokers receiving chronic opioid therapy. IMPLICATIONS: We replicated the finding that the NMR is significantly greater among pregnant smokers receiving OAT than those not receiving this treatment for opioid use disorder. Furthermore, we found that the dosage of the OAT was significantly associated with the NMR level. These findings may contribute to a poorer response to smoking cessation treatment in pregnant women treated with OAT, particularly those receiving high-dose therapy, and raise the question of whether novel approaches are needed to treat smoking in this subgroup of pregnant smokers

Health Status and Preventive Health Services Among Reproductive-Aged Women in Treatment for Opioid Use Disorder

OBJECTIVE: To assess the utilization of preventive health services and the prevalence of chronic health conditions among a cohort of women in treatment for opioid use disorder (OUD). METHODS: Ninety-seven women who were receiving treatment for OUD from a single urban treatment program completed a self-administered anonymous online questionnaire that asked about demographics, health, receipt of preventive health services, and utilization of health care. Descriptive statistics were used to describe data. RESULTS: More than one-third of respondents reported that their health was fair or poor, whereas one-quarter were very concerned with their health. Most participants (59%) reported at least one chronic health condition; nearly 1 in 5 reported two or more conditions. Less than half of respondents had received a routine medical examination in the past year. Vaccine uptake was low; 56% received the coronavirus disease 2019 vaccine and 36% received the annual influenza vaccine. CONCLUSIONS: Women in treatment for OUD could benefit from enhanced health care to address the high rates of chronic diseases and risk factors and underutilization of recommended preventive health services. Interventions and models of care that aim to enhance utilization of such services, and ultimately improve the health of this vulnerable population, may be worth exploring

The Child Healthcare at MATER Pediatric Study (CHAMPS): A 2-Arm Cluster Randomized Control Trial of Group Well Child Care For Mothers in Treatment for Opioid Use Disorder and Their Children

BACKGROUND: Studies suggest that group-based well child care-a shared medical appointment where families come together as a group to receive pediatric primary care-increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children. METHODS: CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother-child dyads will be enrolled into the study. Twenty-six clusters of approximately 4 mother-infant dyads each will be randomized 1:1 to one of two study arms (intervention or control). Clustering will be based on child\u27s month of birth. In the intervention arm, group well child care will be provided on-site at a maternal substance use disorder treatment program. Mother-child dyads in the control arm will receive individual well child care from one nearby pediatric primary care clinic. Dyads in both study arms will be followed prospectively for 18 months, and data will be compared between the two study arms. Primary outcomes include well child care quality and utilization, child health knowledge, and parenting quality. DISCUSSION: The CHAMPS trial will provide evidence to determine if a group well child care offered on-site at an opioid treatment program for pregnant and parenting women is beneficial over individual well child care for families impacted by maternal opioid use disorder. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05488379. Registered on Aug. 04, 2022