The Effect of Naloxone Access Laws on Fatal Synthetic Opioid Overdose Fatality Rates

Background: Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level. Methods: A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths. Results: The presence of an NAL had a significant (univariate P-value = .013; multivariable p-value = .010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P-value \u3c .001), MOUD (univariate P-value \u3c .001; multivariable P-value = .009), and Good Samaritan Law (univariate P-value = .033; multivariable P-value = .018). Conclusion: Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate

Reproducibility in the absence of selective reporting : An illustration from large-scale brain asymmetry research

Altres ajuts: Max Planck Society (Germany).The problem of poor reproducibility of scientific findings has received much attention over recent years, in a variety of fields including psychology and neuroscience. The problem has been partly attributed to publication bias and unwanted practices such as p-hacking. Low statistical power in individual studies is also understood to be an important factor. In a recent multisite collaborative study, we mapped brain anatomical left-right asymmetries for regional measures of surface area and cortical thickness, in 99 MRI datasets from around the world, for a total of over 17,000 participants. In the present study, we revisited these hemispheric effects from the perspective of reproducibility. Within each dataset, we considered that an effect had been reproduced when it matched the meta-analytic effect from the 98 other datasets, in terms of effect direction and significance threshold. In this sense, the results within each dataset were viewed as coming from separate studies in an "ideal publishing environment," that is, free from selective reporting and p hacking. We found an average reproducibility rate of 63.2% (SD = 22.9%, min = 22.2%, max = 97.0%). As expected, reproducibility was higher for larger effects and in larger datasets. Reproducibility was not obviously related to the age of participants, scanner field strength, FreeSurfer software version, cortical regional measurement reliability, or regional size. These findings constitute an empirical illustration of reproducibility in the absence of publication bias or p hacking, when assessing realistic biological effects in heterogeneous neuroscience data, and given typically-used sample sizes

Assessing the Social Service Needs of an Emerging Population of Recent Mexican Immigrants Living with, or at risk for, HIV/AIDS

Latinos have recently become the largest minority group in the United States. It is expected that Latino population growth will continue due to high fertility and high immigration rates. Latinos currently experience a health disparity in HIV rates compared to Caucasians. This disparity may be associated with health care access, which is compounded by the phenomenon of an emerging population with language and culture that differ from the health care system. This article then provides an example of the methodology developed to access and assess the needs of, individuals with HIV/AIDS who traditionally have not participated in needs assessments. Implications of the current research findings and recommendations for future research are discussed.Desde hace poco tiempo la población latina se ha convertido en el grupo minoritario más grande de los Estados Unidos. Se espera que el crecimiento de este sector poblacional continúe también en el futuro debido a una elevada tasa de fertilidad y de inmigración. Comparados con la población blanca, los latinos experimentan una disparidad en cuanto a las tasas de VIH que puede estar asociada con el acceso a servicios de salud el cual se agrava ya que se trata de una población emergente con lengua y cultura diferentes a los conocidos por el sistema de salud. En este artículo se ofrecen ejemplos de una metodología que fue desarrollada para conocer y evaluar las necesidades de individuos que padecen VIH/SIDA y que tradicionalmente no han participado en este tipo de evaluaciones. Sobre esta base se discuten las implicaciones de los resultados y se elaboran una serie de recomendaciones para investigaciones futuras

Meta-analysis of primary care delivered buprenorphine treatment retention outcomes

Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting. Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD. Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies. Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine. Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse.</p