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Responding to the Opioid Crisis


June 2023

Responding to the Opioid Crisis

The opioid epidemic in the United States is a public health crisis. Opioid overdoses have increased significantly in the past 20 years, quintupling since 1999. In the past 2 years (2021 and 2022), there have been over 100,000 deaths annually attributed to overdose in the United States; a majority (75%–80%) of these deaths involved opioids. With the latest wave of opioid overdose deaths, most are now attributable to synthetic opioids, with a significant rise in illicit fentanyl use. San Francisco, for example, saw 625 deaths from overdose in 2021, 76% of which were related to fentanyl. The harm of this public health crisis falls disproportionately on people of color, with over 300 of the 625 overdose deaths in San Francisco being among Black/African American individuals. This Editor’s Choice Collection highlights the public health response to this national crisis. Articles in this collection describe harm reduction policies, such as safe consumption sites and syringe access programs, models of low-barrier access to treatment, and the clinical challenges posed by fentanyl. They include a critical focus on the contribution of social determinants of health and racial and ethnic health disparities in the opioid epidemic.

Veronica Losso, M.D., Carrie Cunningham, M.D., M.P.H., Lisa B. Dixon, M.D., M.P.H.

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POLICY CONSIDERATIONS

Conceptualizing the COVID-19, Opioid Use, and Racism Syndemic and Its Associations With Traumatic Stress
Denise Nguyen Hien, Ph.D., Alexandria G. Bauer, Ph.D., Liza Franklin, Tanya Lalwani, Kierra Pean
2022, Volume 73, Issue 3, pp 353–356

COVID-19 Could Change the Way We Respond to the Opioid Crisis—for the Better
Yuhua Bao, Ph.D., Arthur Robin Williams, M.D., Bruce R. Schackman, Ph.D.
2020, Volume 71, Issue 12, pp 1214–1215

Fentanyl and the Evolving Opioid Epidemic: What Strategies Should Policy Makers Consider?
Colleen L. Barry, Ph.D., M.P.P.
2018, Volume 69, Issue 1, pp 100–103

Establishing Sanctioned Safe Consumption Sites in the United States: Five Jurisdictions Moving the Policy Agenda Forward
Alene Kennedy-Hendricks, Ph.D., Jenna Bluestein, B.A., Alex H. Kral, Ph.D., Colleen L. Barry, Ph.D., M.P.P., Susan G. Sherman, Ph.D., M.P.H.
2019, Volume 70, Issue 4, pp 294–301

Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy
Emma McGinty, Ph.D., M.S., Bernice Pescosolido, Ph.D., Alene Kennedy-Hendricks, Ph.D., Colleen L. Barry, Ph.D., M.P.P.
2018, Volume 69, Issue 2, pp 136–146

Spillover of Medicaid Expansion to Prescribing of Opioid Use Disorder Medications in Medicare Part D
Amanda J. Abraham, Ph.D., Emily C. Lawler, Ph.D., Samantha J. Harris, Ph.D., Grace Bagwell Adams, Ph.D., W. David Bradford, Ph.D.
2022, Volume 73, Issue 4, pp 418–424

How Physician Workforce Shortages Are Hampering the Response to the Opioid Crisis
Jennifer McNeely, M.D., M.S., Daniel Schatz, M.D., M.S., Mark Olfson, M.D., M.P.H., Noa Appleton, M.P.H., Arthur Robin Williams, M.D., M.B.E.
2022, Volume 73, Issue 5, pp 547–554

Rural-Urban Differences in Physician Bias Toward Patients With Opioid Use Disorder
Berkeley Franz, Ph.D., M.A., Lindsay Y. Dhanani, Ph.D., William C. Miller, M.D., Ph.D.
2021, Volume 72, Issue 8, pp 874–879

ADAPTING SERVICE MODELS

Low-Barrier Buprenorphine Treatment for People Experiencing Homelessness
Claire L. Gibson, M.D., M.S.C.R., Emma Lo, M.D.
2023, Volume 74, Issue 1, pp 104–104

A Mobile Buprenorphine Treatment Program for Homeless Patients With Opioid Use Disorder
Colin Buzza, M.D., M.P.H., Andrea Elser, B.A., Jeffrey Seal, M.D.
2019, Volume 70, Issue 7, pp 635–636

CLINICAL INTERVENTIONS

Guidance for Handling the Increasing Prevalence of Drugs Adulterated or Laced With Fentanyl
Craig Allen, M.D., Christina Arredondo, M.D., Rochelle Dunham, M.D., Marc Fishman, M.D., Leonard Lev, M.D., Shannon Mace, J.D., M.P.H., Joseph Parks, M.D., Daniel Rosa, M.D., Sosunmolu Shoyinka, M.D., DeJuan White, M.D., Aaron Williams, M.A.
2023, PS in Advance

Moving Beyond the Medication or Psychosocial Treatment Dichotomy to Address the Opioid Epidemic
Matthew A. Stimmel, Ph.D., David Smelson, Psy.D., Andrea K. Finlay, Ph.D.
2022, Volume 73, Issue 12, pp 1320–1321

Enhancing Use of Medications for Opioid Use Disorder Through External Coaching
Todd Molfenter, Ph.D., Hanna Kim, M.A., M.S., Jee-Seon Kim, Ph.D., Abby Kisicki, B.S., Hannah K. Knudsen, Ph.D., Julie Horst, M.B.A., Randy Brown, M.D., Ph.D., Lynn M. Madden, Ph.D., M.P.A., Alex Toy, M.S., Eric Haram, B.S., L.A.D.C., Nora Jacobson, Ph.D.
2023, Volume 74, Issue 3, pp 265–271

Use of Predictive Analytics to Identify Unhealthy Opioid Use and Guide Intervention
Elise G. Valdes, Ph.D., Christopher Reist, M.D., Rola Aamar, Ph.D., Barbara Hallisey, B.S., Elizabeth Shirley Stanton, M.D., Leah Williams, Dr. H., Ross Andel, Ph.D., Jack Gorman, M.D.
2022, PS in Advance

Opioid Use Disorder Among Clients of Community Mental Health Clinics: Prevalence, Characteristics, and Treatment Willingness
Allison J. Ober, M.S.W., Ph.D., Sarah B. Hunter, Ph.D., Colleen M. McCullough, M.P.A., Isabel Leamon, B.A., Michael McCreary, M.P.P., Ivan Beas B.S., Alanna Montero, B.S., Derjung M. Tarn, M.D., Ph.D., Elizabeth Bromley, M.D., Ph.D., Brian Hurley, M.D., M.B.A., John Sheehe, M.S.W., Jeremy Martinez, M.D., Katherine E. Watkins, M.D., M.S.H.S.
2022, Volume 73, Issue 3, pp 271–279

Concurrent Opioid and Benzodiazepine Utilization Patterns and Predictors Among Community-Dwelling Adults in the United States
Nina Vadiei, Pharm.D., B.C.P.P., and Sandipan Bhattacharjee, M.S., Ph.D.
2020, Volume 71, Issue 10, pp 1011–1019

Sex Differences in Comorbid Mental and Substance Use Disorders Among Primary Care Patients With Opioid Use Disorder
Jordan M. Braciszewski, Ph.D., Abisola E. Idu, M.P.H., M.S., Bobbi Jo H. Yarborough, Psy.D., Scott P. Stumbo, M.A., Jennifer F. Bobb, Ph.D., Katharine A. Bradley, M.D., M.P.H., Rebecca C. Rossom, M.D., M.S., Mark T. Murphy, M.D., Ingrid A. Binswanger, M.D., M.P.H., Cynthia I. Campbell, Ph.D., P.H., Joseph E. Glass, Ph.D., M.S.W., Theresa E. Matson, M.P.H., Gwen T. Lapham, Ph.D., M.P.H., Amy M. Loree, Ph.D., Celestina Barbosa-Leiker, Ph.D., Ma A. Hatch, Ph.D., Judith I. Tsui, M.D., M.P.H., Julia H. Arnsten, M.D., M.P.H., Angela Stotts, Ph.D., Viviana Horigian, M.D., M.H.A., Rebecca Hutcheson, S.W., Gavin Bart, M.D., Ph.D., Andrew J. Saxon, M.D., Manu Thakral, Ph.D., R.N., Deborah Ling Grant, Ph.D., M.B.A., Chaya Mangel Pflugeisen, M.S., M.Ed. Ingrid Usaga, M.S.W., Lawrence T. Madziwa, M.S., Angela Silva, D.B.A., M.A.O.L., Denise M. Boudreau, Ph.D.
2022, Volume 73, Issue 12, pp 1330–1337

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