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Article
Publication date: 3 September 2021

Alan David Smith

The purpose of this study is to highlight the overshadowing of the opioid crisis due to Covid-19 pandemic. Opioids are affecting increasing numbers as the current opioid

Abstract

Purpose

The purpose of this study is to highlight the overshadowing of the opioid crisis due to Covid-19 pandemic. Opioids are affecting increasing numbers as the current opioid overdose death rate is increasing to 209 per day. While there appears light shining on the end of the Covid-19 pandemic with the advent of a fourth vaccine, there is no such light for the opioid epidemic. Based on a sample of 603 relatively educated adults in NE Ohio, the health harm caused by both crises, prescribing physician blaming, high levels of income loss and physical and emotional burdens shared by the respondents were obvious and striking.

Design/methodology/approach

Using Bertram et al. (2014) theory of the blame model, the number of results concerning gender and personally involvement of friends and family members, including men empathy increased with greater knowledge of numbers of addicted opioid users in their personal contracts.

Findings

Unfortunately, many women had to remain home taking care of children and elderly loved ones at greater percentages than their male counterparts may account for less empathy as such addicted users have become a burden to economically impaired families. This tendency for placing blame for circumstances with twin crises appears to follow a relatively predictable path as modeled by Bertram et al. (2014) (i.e. denial, justification and excuse).

Originality/value

These are few studies that are studying the amplification effects of the Covid-19 pandemic context on the current opioid crisis.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

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Book part
Publication date: 25 November 2019

Loren E. Wilbers

In this chapter, I explore connections between institutional and personal narratives of treating chronic pain with prescription opioids.

Abstract

Purpose

In this chapter, I explore connections between institutional and personal narratives of treating chronic pain with prescription opioids.

Methods/Approach

I explore how stories told in a Food and Drug Administration public hearing construct moral boundaries around different kinds of pain patients and justify a label change intended to reduce prescribing of opioids to people with chronic pain. I then examine how personal narratives, acquired through interviews with chronic pain patients who rely on opioids, both conform to and challenge the institutional narratives told in the hearing and work as subversive stories. Additionally, I consider how institutional and personal narratives of chronic pain shed light on intersections and conflicts between the medical and social models of disability.

Findings

The “invisible disability” experience of chronic pain highlights the complex entanglement between the struggles associated with impairment emphasized by the medical model, and those stemming from cultural and structural barriers emphasized by the social model.

Implications/Value

I conclude with a discussion of the methodological value of examining narratives such as those of chronic pain and disability at multiple levels of social life. This study contributes to efforts to broaden disability discourse to include experiences such as chronic pain that are poorly represented in disability scholarship.

Details

New Narratives of Disability
Type: Book
ISBN: 978-1-83909-144-5

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Article
Publication date: 6 April 2021

Susan Glose, Tamatha Arms and Noell Rowan

The purpose of this study is to explore the knowledge, beliefs and attitudes surrounding prescription opioid medications of community living older adults in southeast…

Abstract

Purpose

The purpose of this study is to explore the knowledge, beliefs and attitudes surrounding prescription opioid medications of community living older adults in southeast North Carolina.

Design/methodology/approach

A cross-sectional, descriptive, anonymous survey design of participants aged 55 or over was used.

Findings

Study participants (N = 119) reported bias in their attitudes and beliefs about the use and misuse of prescription opioid medications. Multiple regression analyses revealed that gender, age, work, marital status and education level all had significant results in explaining variance in the statistical models. Even though study participants demonstrated high levels of education and understanding of the potential of addiction to opiates, there were a number of misconceptions about prescription pain medications revealed.

Originality/value

There is a dearth of studies looking at older adults’ knowledge, beliefs and attitudes about prescription pain medications. This urges the necessity of increased awareness via further research, presentations and creative discourse to assist in the understanding of precursors of addiction and ways to deal with pain that do not automatically depend on prescription opioid medicines. Implications include outreach to a larger and more diverse sample to address knowledge, beliefs and attitudes surrounding prescription opioid medications of community living older adults in southeast North Carolina and beyond.

Details

Advances in Dual Diagnosis, vol. 14 no. 2
Type: Research Article
ISSN: 1757-0972

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Book part
Publication date: 30 November 2020

Bharat Mehra and Baheya S. Jaber

The acceleration of Opioid deaths over the last decade has made it a serious national public health crisis. Alabama has not been immune to this epidemic, with dramatically…

Abstract

The acceleration of Opioid deaths over the last decade has made it a serious national public health crisis. Alabama has not been immune to this epidemic, with dramatically increased age-adjusted drug overdose death rates. These increases have occurred in a state with limited resources for Opioid health prevention, treatment, and recovery services. This chapter introduces the term “o-CHIL” in order to better understand the multi-factorial layers of intertwining health injustices (in the plural) experienced in Alabama’s communities and their embedded public libraries. It highlights the complexities in Opioid consumer health information literacies, the culturally situated dimensions of the Opioid crisis in Alabama, and the uniquely relevant consumer health literacies in its public libraries. Findings are based on an empirical assessment of representative information support services identified in February 2020 on the websites of the 230 public libraries listed as members of the Alabama Public Library Service. The exploratory study applies website content analysis to identify seven examples of information offerings and to class offerings into three categories: (1) information sources (collections, resources); (2) information policy and planning (assigned Opioid-related role, strategic representation); and (3) connections (internal, external, news and events). The discussion potentially provides new directions, approaches, and opportunities to build collaborations of sharing within Alabama’s network of public libraries and beyond for them to better serve their local and regional communities impacted by the Opioid crisis.

Details

Roles and Responsibilities of Libraries in Increasing Consumer Health Literacy and Reducing Health Disparities
Type: Book
ISBN: 978-1-83909-341-8

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Book part
Publication date: 11 July 2019

Janet Currie, Jonas Jin and Molly Schnell

This chapter uses quarterly county-level data from 2006 to 2014 to examine the direction of causality in the relationship between per capita opioid prescription rates and…

Abstract

This chapter uses quarterly county-level data from 2006 to 2014 to examine the direction of causality in the relationship between per capita opioid prescription rates and employment-to-population ratios. We first estimate models of the effect of per capita opioid prescription rates on employment-to-population ratios, instrumenting opioid prescriptions for younger ages using opioid prescriptions to the elderly. We find that the estimated effect of opioids on employment-to-population ratios is positive but small for women, while there is no relationship for men. We then estimate models of the effect of employment-to-population ratios on opioid prescription rates using a shift-share instrument and find ambiguous results. Overall, our findings suggest that there is no simple causal relationship between economic conditions and the abuse of opioids. Therefore, while improving economic conditions in depressed areas is desirable for many reasons, it is unlikely on its own to curb the opioid epidemic.

Details

Health and Labor Markets
Type: Book
ISBN: 978-1-78973-861-2

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Article
Publication date: 10 July 2020

Sabir Zaman, Shahid Irfan, Basharat Hussain, Muhammad Tahir Nawaz and Shazia Khalid

There is increased social discussion of the emerging issues of opioid use, health and well-being of young adults within contemporary Asian society. The purpose of this…

Abstract

Purpose

There is increased social discussion of the emerging issues of opioid use, health and well-being of young adults within contemporary Asian society. The purpose of this study is to contribute new knowledge of opioid-using young adults through ethnographic perspectives of the five main cultures of Pakistan. Furthermore, it tried to explore the values of opioid users.

Design/methodology/approach

It is a qualitative study. Semi-structured interview and observation techniques were used to gain the participants’ information, in a non-judgmental environment. Observation and life focus history interview methodology were used for data collection. The sample consisted of 18 male opioid users (approximately three from each area including: Punjab, Khyber Pakhtoon Khah, Balochistan, Sindh, Gilgit Baltistan and Azad Jammu and Kashmir). An interview script was used in interviews after written informed consent. After the detailed interview and observation of non-verbal behaviours, the researchers analysed the data by using the content analysis of qualitative method.

Findings

The result showed that poor relationships, conflicts over property, lack of social support and family problems increased with the use of opioids by individuals. The individual’s mental health, such as hopelessness, curiosity, mistrust and lack of interest in social activities, was the major cause of opioid addiction. Moreover, peer influences and friends may also have played contributing roles in opioids use among men.

Research limitations/implications

The current study added to the understanding of the relationship of different environmental, behavioural and social factors involved in developing opioid use among young individuals. The homogeneity of the sample may have weakened the generalisability of the findings of the study as all participants in the study were male.

Practical implications

Clinicians and allied professionals have shown a great interest in early intervention with opioid users. At the same time, there is a lack of qualitative studies exploring the lived experiences of young opioid users. That is why this study was done, to empower counsellors.

Social implications

Opioids, including heroin, have strong addictive tendencies. They are easily available, particularly in unplanned urban areas of Pakistan. The present study tried to understand the lived experiences and beliefs of opioid users belonging to different cultures of Pakistan.

Originality/value

At the same time, there is a lack of qualitative studies exploring the lived experiences of adult opioid users. Therefore, this study presented 18 interview-based facts from the opioid users belonging to different areas of Pakistan residing in capital of Pakistan. The content of these vignettes was examined in the context of an ethnographic perspective, as it has a strong connection and contribution to drug abuse.

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Article
Publication date: 11 September 2018

Jennifer Fuhrmann-Berger

The purpose of this paper is to aid employers and HR professionals in addressing the opioid epidemic, by examining the economic burden of addiction and its impact on the…

Abstract

Purpose

The purpose of this paper is to aid employers and HR professionals in addressing the opioid epidemic, by examining the economic burden of addiction and its impact on the workplace, and it presents solutions based on a clinical approach to treatment and prevention of substance abuse.

Design/methodology/approach

The paper undertakes a review of current opioid addiction statistics provided by various professional organizations and the US government to assess the scope of opioid addiction and its effects on the US economy. Solutions to the growing issue of addiction are based on the author’s clinical experience within the pharmacy benefits space.

Findings

Opioid addiction costs employers an estimated $18bn annually and incurred $1tn in expenses overall in the US between the years 2001 and 2017. These figures account for factors such as medical expenses, lost productivity and loss of life. The opioid crisis has led to a significant decline in workforce participation (20 per cent among men and 25 per cent among women), making it difficult for employers to find and keep qualified workers.

Originality/value

In this article, the author discusses means by which employers and HR professionals can protect and retain employees in the face of a national epidemic of addiction to prescription opioids. Solutions encompass not only how to identify and address existing substance abuse, but how to prevent addiction through employee education and close clinical coordination with partners such as an organization’s pharmacy benefits manager.

Details

Strategic HR Review, vol. 17 no. 4
Type: Research Article
ISSN: 1475-4398

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Article
Publication date: 3 September 2021

Dalia Chowdhury

Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This…

Abstract

Purpose

Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This study aims to present an integrated, trauma-informed, behavioral workforce development initiative in a midwestern rural setting in the USA.

Design/methodology/approach

This is a mixed method, two-phased study: the first phase tracked and analyzed two focus group conferences involving experts (n = 6) and professionals (n = 8) to develop a training protocol; the second phase provided a training (n = 101), based on the protocol to future professionals and compared competencies before and after the implementation of the training.

Findings

There is a need of a trauma integrated approach in providing interprofessional training connecting health-care workers in rural communities to address the current opioid crisis to bring about cohesion among integrated and interdisciplinary teams. Workforce building will need to implement best practices not only among medical providers but among community mental health practitioners in rural areas.

Originality/value

This is a unique trauma-informed workforce development initiative in a rural community. Such studies are extremely limited and almost non-existent. Further initiatives need to be taken in this field to identify unique differences within communities that may hinder implementation.

Details

The Journal of Mental Health Training, Education and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 19 August 2021

Faiqa Naz, Kanwar Hamza Shuja, Muhammad Aqeel, Saima Ehsan, Atqa Noor, Dua Butt, Hajra Gul, Ushba Rafaqat, Amna Khan and Shafaq Gulzamir

There is an ever-increasing number of patients suffering from various forms of acute and chronic pain and getting treatment for such ailments is a basic human right. Opioid

Abstract

Purpose

There is an ever-increasing number of patients suffering from various forms of acute and chronic pain and getting treatment for such ailments is a basic human right. Opioid analgesics remain one way of managing and attending to such patients. However, due to the prevalence of opiophobia, many doctors avoid prescribing opioid-based medicines, even at the cost of patients suffering leading to a hindrance in providing optimal health care. Up till now, there has been no reliable and valid instrument to measure the severity of opiophobia in doctors. For this reason, the purpose of this study is to represent the construction of a precise and reliable instrument for measuring opiophobia along with its validation for doctors in Pakistan.

Design/methodology/approach

Interviews and theoretical knowledge relating to opiophobia were used as the basis for the purpose of generating an item pool. The generated item pool was evaluated by subject matter experts for content validity and inter-rater reliability, followed by Velicer’s minimum average partial method and maximum likelihood factor analysis for establishing the factorial structure of the scale. As opiophobia in doctors prevails the most and causes a lower ratio of prescription of opioid analgesics. The present sample selected for the study was that of n = 100 doctors (men = 50; women = 50) from various hospitals, treating patients with chronic pain, in Rawalpindi and Islamabad.

Findings

A two-factor structure was suggested by Velicer’s minimum average partial method and maximum likelihood factor analysis, which were labeled as fear of opioid analgesics and justified acceptance of opioids. The developed opiophobia questionnaire along with its subscales displayed appropriate levels of reliability α = 0.733, α = 0.760 and α = 0.725, respectively, suggesting the scale to be reliable.

Research limitations/implications

Like any other study, this study also tried to address every essential aspect, but still lacked at some places which should be considered and catered for in future studies. In the first place the sample size was very limited which was due to the fact, the study was conducted during a pandemic and physically going for data collection was unavailable, thus leading to consequent sample size. It is recommended a correspondent study can be conducted with larger sample size, so they can get more reliable results with greater precision and power. Then, they will have the advantage of a small margin of error. The second limitation was the study involved only doctors as that was the main focus of the present study. However, other hospital staff such as nurses should also be incorporated to assess their level of opiophobia. The current scale suggests the severity of opiophobia with higher scores though no cutoff point has been suggested. Future studies should try and incorporate a cutoff point to assess the difference between doctors who have conventional levels of reservations against opioids and those suffering from opiophobia. Another limitation was that the present scale did not establish additional validities such as convergent and divergent validity. Future studies should collect data from a larger sample to establish these validities to further refine the scale.

Practical implications

This instrument can be immensely effective in identifying doctors who have concerns and fears about prescribing opioids to patients with chronic pain. The findings acquired on such a scale can help in developing appropriate academic and psychological interventions which can help such doctors to overcome their opiophobia. This can enable more doctors to prescribe appropriate medicine to their patients instead of letting them suffer from pain. Additionally, researchers can equally benefit from the instrument as it can enable them to investigate opiophobia with other possible variables.

Social implications

Developing such a scale about the fear faced by doctors while treating patients would be very useful as it is not possible to take such fear when it comes to a patient’s life. This fear is also common among patients where they have a fear about the undesirable effects, addiction of drugs and fear of dying. Better awareness should be given to them which will be helpful for successful and less painful treatment in hospitals.

Originality/value

This scale is an original work with the aim of accessing opiophobia among doctors toward (chronic) patients with severe pain. There was a lot of research work that has been done on opiophobia in developed countries and few Pakistani researchers have also worked on opiophobia and its impact on pain management but still, no scale has been developed to measure the extent or tendency of opiophobia among doctors or patients. This scale can be used globally on both men and women doctors to access the tendency of opiophobia among them.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

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Book part
Publication date: 29 July 2009

Susan W. Hinze, Noah J. Webster, Heidi T. Chirayath and Joshua H. Tamayo-Sarver

Do physician perceptions of patient “deservingness” factor into the decision to prescribe opioid analgesics? Using a data set of 398 physicians randomly selected from the…

Abstract

Do physician perceptions of patient “deservingness” factor into the decision to prescribe opioid analgesics? Using a data set of 398 physicians randomly selected from the American College of Emergency Physicians (ACEP) membership list, we explore how a range of patient social context variables influence a physician's decision to prescribe opioids for three conditions: ankle fracture, back pain, and migraine headache. Being hurt running from the police, former and current drug or alcohol use, and frequent emergency room (ER) visits reduce the likelihood of opioid prescription. Having a reliable relationship with a primary care provider and being injured in a ladder fall or intramural collegiate basketball game increase the likelihood of opioid prescription. Factor analyses for each of the three conditions reveal two scales: socially stigmatizing characteristics and socially accepted characteristics. Discussion centers on what places people at risk for inadequate pain control. Our work contributes to the expanding literature on social conditions as a fundamental cause of illness.

Details

Social Sources of Disparities in Health and Health Care and Linkages to Policy, Population Concerns and Providers of Care
Type: Book
ISBN: 978-1-84855-835-9

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