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Article
Publication date: 22 September 2022

Brian C. Kelly and Mike Vuolo

The emergence of fentanyl has deepened concerns about the opioid crisis. The shift has created new distinctions in patterns of opioid use, which may be important for…

Abstract

Purpose

The emergence of fentanyl has deepened concerns about the opioid crisis. The shift has created new distinctions in patterns of opioid use, which may be important for prevention and intervention. This paper aims to examine sociodemographic correlates as well as health and substance use characteristics of different groups of opioid users.

Design/methodology/approach

This paper used the 2015–2019 National Survey on Drug Use and Health to examine distinctions between groups (n = 11,142) of individuals who misuse prescription opioids, use heroin but not fentanyl, misuse pharmaceutical fentanyl but not heroin and use both heroin and fentanyl. Multinomial and logistic regression models were used to identify these distinctions.

Findings

Few sociodemographic differences emerged between the prescription opioid group and pharmaceutical fentanyl misuse group. While those who misuse fentanyl have higher odds of using other drugs and experiencing certain mental health problems than those misusing prescription pills, both the heroin and fentanyl–heroin use groups reported considerably poorer health and substance use indicators relative to those who solely misuse fentanyl. It is also notable that both heroin use groups are more highly associated with cocaine and methamphetamine use than those misusing fentanyl alone.

Research limitations/implications

While this study identifies important distinctions between the opioid use groups studied, individuals using both heroin and pharmaceutical fentanyl report the poorest health and substance use characteristics. Important differences between the fentanyl-only group and the group who consume both drugs may have implications for prevention, intervention and clinical work amid shifting patterns of opioid use.

Practical implications

Important differences between the fentanyl-only group and the group who consume both drugs may have implications for prevention, intervention and clinical work amid shifting patterns of opioid use.

Originality/value

This study highlights distinctions between pharmaceutical fentanyl users, heroin users and users of both substances.

Details

Drugs, Habits and Social Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2752-6739

Keywords

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

Keywords

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

Keywords

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

Keywords

Article
Publication date: 20 June 2022

Ana M. Ning and Rick Csiernik

Critical analyses of health policies and practices may appear to lack practicality during unprecedented times that demand immediate solutions. This paper aims to use…

Abstract

Purpose

Critical analyses of health policies and practices may appear to lack practicality during unprecedented times that demand immediate solutions. This paper aims to use critical social science theories to help improve essential service delivery during a public health crisis.

Design/methodology/approach

This study is based on qualitative content analysis of government and scholarly sources between 2008 and 2021 to identify strengths and gaps underlying the Canadian Federal Government’s evidence-based solutions to the opioid death crisis. Key questions examined are: What constitutes best-evidence practices underlying the Canadian Drugs and Substances Strategy?, Is biomedical evidence the only legitimate framework to substantiate feasible interventions? and Because the opioid death crisis affects disproportionately vulnerable populations, what is the potential merit of considering diverse knowledges and practices as valid forms of intervention despite lacking biomedical evidence bases?

Findings

While overdose reversing drugs, drug replacement approaches, biologically focused harm reduction options and pharmacological regulatory and surveillance initiatives help reduce premature opioid-related morbidity and mortality across provinces, this study’s findings demonstrate that these individualizing, biomedical magic bullets are temporary solutions, not comprehensive plans to solve a societal problem. This study’s theoretically informed analysis shows that the Canadian Federal Government responses detract attention from issues of social justice, social inequities and the biomedical dominance of health care as broader forces of the opioid death crisis. To address these analytical omissions, broader evidence-based solutions must build upon meaningful intraventions, the insiders’ perspectives or voices of the afflicted communities alongside meaningful interventions – going beyond distal, clinical-based and proximal, home-based interventions.

Originality/value

By highlighting the biomedical and social embeddings of the opioid death crisis, this study underscores structural conditions rather than individuals’ physical bodies as the catalysts for change. A deeper theoretical understanding of why certain issues exists, as they do and how they occur, can provide the basis for prediction of their (re)occurrence and for informing meaningful intervention efforts.

Details

Drugs, Habits and Social Policy, vol. 23 no. 1
Type: Research Article
ISSN: 2752-6739

Keywords

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

Keywords

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. 15 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

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…

101

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.

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…

602

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

Keywords

Article
Publication date: 24 August 2022

Corinne A. Beaugard, Valerie Hruschak, Christina S. Lee, Jenifer Swab, Sheila Roth and Daniel Rosen

Emergency medical service (EMS) workers are at risk for burnout related to the opioid overdose crisis because they are frequently present during overdose events. The…

Abstract

Purpose

Emergency medical service (EMS) workers are at risk for burnout related to the opioid overdose crisis because they are frequently present during overdose events. The study’s aims were twofold: 1) to determine whether variables related to the opioid crisis were associated with burnout and 2) to explore the relationship between mental health, sleep, substance use, social support, and attitudes about working during the opioid overdose crisis with burnout.

Design/methodology/approach

In a cross-sectional web-based study, surveys were distributed by supervisors to EMS workers in Pennsylvania (winter 2018). Participants (n = 214) completed measures on burnout, social support, mental health, substance use, and sleep quality and reported their frequency of naloxone administration and their attitudes about working during the opioid overdose crisis. Bivariate and multivariable analyses were run to determine correlates of burnout.

Findings

The sample was 65.4% male, 91.5% white, and 43% were between 36–55 years old. In the regression model (n = 177), depression, anxiety, post-traumatic stress disorder (PTSD), sleep, attitudes about working during the opioid crisis, cannabis use, social support, age, hours worked each week, and frequency of naloxone administration were significantly correlated with burnout.

Originality/value

This study contributes to the emergent literature on burnout and EMS professionals during the opioid overdose crisis by finding that attitudes about working during the opioid overdose crisis are correlated with burnout. While the relationship should be explored in future research, the authors believe that interventions to prevent EMS burnout could incorporate training to improve attitudes about supporting individuals during overdose events.

Details

International Journal of Emergency Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2047-0894

Keywords

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