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> Disorders > Mental or Behavioral Dysfunction > Opioid Misuse

Opioid Misuse

Opioid Misuse refers to the inappropriate or recreational use of opioid medications, which can lead to addiction, overdose, and other adverse health consequences.
This term encompasses the misuse of prescription opioids, as well as the use of illicit opioids, such as heroin.
Opioid misuse is a significant public health concern, and research into effective prevention and treatment strategies is crucial.
Leveraging AI-driven comparisons to locate the best protocols from literature, pre-prints, and patents can enhance the research process and identify the most effective solutions to address this critical issue.

Most cited protocols related to «Opioid Misuse»

1
Opioid Substitution Treatment Mortality Meta-Analysis
Cited 18 times
Two investigators independently reviewed the titles and abstracts identified in the search and retrieved articles to determine eligibility and to extract study data. Disagreements or uncertainties were resolved by consensus with an additional investigator.
For each eligible study, we retrieved information on baseline population characteristics, including study location, sex and age distribution, primary opioid of misuse, and prevalence of opioid injection, non-opioid drug use, HIV infection, and psychiatric and medical comorbidity; number of cohort participants entering opioid substitution treatment during the study period (untreated participants and those under other types of treatment were excluded); treatment features, including drug type (methadone or buprenorphine), average daily dose, induction method (inpatient or ambulatory), and provider (addiction medicine specialist or general practitioner); and main follow-up characteristics, including calendar period, average length of follow-up from the start of maintenance treatment (excluding any previous detoxification period), loss to follow-up, and mortality outcomes. We also registered detailed information on the number of deaths, person years at risk, and mortality rates from all causes and overdose during follow-up periods in and out of treatment and, whenever possible, during specific time intervals since treatment initiation and cessation. Finally, we registered information on first and subsequent treatment episodes (table A in appendix 2) and on completeness of treatment (table B in appendix 2).
We specifically designed a quality assessment form based on standardised and extensively used instruments: the methodology checklist for cohort studies developed by the Scottish Intercollegiate Guidelines Network14 and the checklist for drug related studies developed by the National Drug and Alcohol Research Centre, Australia.15 The design process, based on a thorough review of the above sources, included the development of different proposals, discussion of their appropriateness, and final agreement among the authors. The final version comprised separate sections according to the study design and was based on a “star system” score approach,16 including a general appraisal of external and internal validity and of the biases relevant to cohort studies, plus an ad hoc assessment of reporting for studies on mortality during and after opioid substitution treatment (appendix 3).
Sordo L., Barrio G., Bravo M.J., Indave B.I., Degenhardt L., Wiessing L., Ferri M, & Pastor-Barriuso R. (2017). Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. The BMJ, 357, j1550.
Publication 2017
Buprenorphine Drug Overdose Eligibility Determination Ethanol HIV Infections Inpatient Metabolic Detoxication, Drug Methadone Opiate Substitution Treatment Opioid Misuse Opioids Pharmaceutical Preparations
2
Community Engagement for Opioid Harm Reduction
Cited 9 times

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Publication 2020
Concept Formation Continuity of Patient Care Drug Abuse Drug Overdose Mental Health Opiate Overdose Opioid Misuse Opioids Pseudohyperkalemia Cardiff Safety Substance Abuse Substance Use Substance Use Disorders Vertebral Column Wound Healing
3
Opioid Misuse and Treatment Utilities
Cited 9 times
We measured utilities for 6 of opioid misuse and treatment states, selected to represent a spectrum of states that would be useful for future cost-effectiveness analyses: active injection opioid misuse (“active injection misuse”); active prescription opioid misuse (“active prescription misuse”); methadone maintenance therapy at the initiation stage (“initiation methadone”), and when the user is considered stabilized in treatment (“stabilized methadone”); and buprenorphine therapy at the initiation stage (“initiation buprenorphine”), and when the user is considered stabilized in treatment (“stabilized buprenorphine”). Utilities are defined on a scale of 0-1.0, where zero=the value of being dead and 1.0=the value of being in perfect health, and all health states are valued relative to these endpoints. Utility is thus a universal metric that allows comparisons across diseases.
Utilities can be measured in a variety of ways: the “direct” method is to describe a health condition to someone in the general population – with or without personal experience with it--and have him/her assign it a number between 0 and 1.0. The “indirect” method is to have a person who has a condition report on his/her symptoms, health status, and functioning using a structured questionnaire (a “generic” utility instrument), and then to assign a utility value to this report using a pre-existing set of values collected from the general population.18 Broadly speaking, direct methods are considered theoretically superior but more administratively burdensome to implement than indirect methods; indirect methods are more convenient and can easily be integrated into clinical trials, but have practical limitations in their sensitivity to effects.19 (link),20 (link) Both methods produce theoretically equivalent results, although in practice differences across methods have been observed.21 (link)We used a direct method in this study, the “standard gamble” (SG).18 The SG asks a respondent to consider the risk of death s/he would be willing to take in order to avoid living in a particular health state, and assigns value to health on the 0-1.0 scale described above.18 For example, if someone would take 10% risk of death to avoid living with diabetes, the SG for diabetes would be 0.90, or 90% of the value of perfect health. The SG is considered the theoretically optimal method for estimating utilities for societal-perspective economic evaluation.6
Wittenberg E., Bray J.W., Aden B., Gebremariam A., Nosyk B, & Schackman B.R. (2015). Measuring benefits of opioid misuse treatment for economic evaluation: health related quality of life of opioid dependent individuals and their spouses as assessed by a sample of the US population. Addiction (Abingdon, England), 111(4), 675-684.
Publication 2015
Buprenorphine Diabetes Mellitus Generic Drugs Hypersensitivity Methadone Opioid Misuse Prescription Opioid Misuse
4
Evaluating Opioid Craving Dynamics
Cited 8 times

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Publication 2012
Genetic Heterogeneity Opioid Misuse Patients Physicians Population at Risk Severity, Pain Urine
5
Assessing Opioid Misuse Behaviors
Cited 6 times
Each patient's physician was asked to complete the POTQ. This 11-item scale, adapted from the Physician Questionnaire of Aberrant Drug Behavior,19 (link) was completed by the treating clinician to assess misuse of opioids. The items reflect the behaviors outlined by Chabal and colleagues20 (link) that were indicative of substance abuse. The participant patient's chart was made available to the treating physician to facilitate accurate recall of information. Providers answered yes or no to eleven questions indicative of misuse of opioids, including multiple unsanctioned dose escalations, episodes of lost or stolen prescriptions, frequent unscheduled visits to the pain center or emergency room, excessive phone calls, and inflexibility around treatment options. The POTQ has been found to be significantly correlated with the PDUQ and abnormal urine screens (p<0.01) as an external measure of its validity.21 (link) Patients’ ratings of craving opioid medication has also been found to be significantly correlated with physicians ratings on the POTQ.21 (link) Patients who were positively rated on two or more of the items met criteria for prescription opioid misuse, as indicated in previous investigations.22 (link)-23 (link)
Butler S.F., Budman S.H., Fanciullo G.J, & Jamison R.N. (2010). Cross Validation of the Current Opioid Misuse Measure (COMM) to Monitor Chronic Pain Patients on Opioid Therapy. The Clinical journal of pain, 26(9), 770-776.
Publication 2010
Mental Recall Opioid Misuse Opioids Patients Pharmaceutical Preparations Physicians Prescription Opioid Misuse Prescriptions Substance Abuse Urine

Most recents protocols related to «Opioid Misuse»

1
Multisite CTN Trials for Opioid Use Disorder
The source (or study) population for our analyses was the pooled study sample of participants in two multisite CTN treatment trials: 0051 (X:BOT [10 (link)]; 2014–2017) and 0067 (CHOICES [34 (link)]; 2018–2019). Information on each study, including inclusion/exclusion criteria and recruitment and enrollment data are presented in Additional file 1: Table S1. Briefly, X:BOT randomized participants to XR-NTX vs. sublingual buprenorphine in inpatient, medically monitored opioid treatment facilities. CHOICES randomized to XR-NTX vs. treatment as usual in outpatient HIV clinics. However, 93% of treatment-as-usual participants who initiated treatment received buprenorphine; to create a more homogeneous pooled source population, eight CHOICES participants receiving methadone and three receiving only oral naltrexone were excluded. All X:BOT participants were included (corresponding to the original intent-to-treat sample). In both studies, participants provided urine drug screen (UDS) and harmonized questionnaire, and clinical, pharmacy, or laboratory data weekly (X:BOT) or every 4 weeks (CHOICES) for 24 weeks.
We defined three target populations for our analyses. The first is a nationally-representative sample of civilian, housed, noninstitutionalized adults with OUD identifying the need for treatment, as characterized by the NSDUH household 2018 and 2019 survey years [35 ]. Among all NSDUH respondents, we included those who had OUD, were age 18 or older, and (1) received treatment in the past year, but used nonprescribed opioids in the past month or (2) identified the need for, but had not received, treatment. The second target population was people receiving or planning to receive MOUD treatment, as captured in the 2018 TEDS admissions dataset [36 ]. Treatment episodes were included if the individual entering treatment met diagnostic criteria for OUD based off the Diagnostic and Statistical Manual of Mental Disorder—5th edition (DSM-5), used heroin or other illicit opioids in the past month, was 18 or older, and had MOUD as part of their intended treatment plan. The third target population was people who inject drugs or misuse opioids in rural areas of the U.S. as characterized by eight sites participating in the ROI [37 (link)]. Briefly, the ROI is a consortium of harmonized studies of people who use drugs in rural counties with high overdose rates covering ten states (Illinois, Kentucky, North Carolina, New England [Massachusetts, New Hampshire, Vermont], Ohio, Oregon, West Virginia, Wisconsin). Inclusion criteria varied slightly by study site, but generally, people were eligible for the ROI cohort if they reported IDU or use of opioids to “get high” in the past month. ROI participants were included in this analysis if they were 18 or older and used opioids to get high in the past month. In order to meet positivity assumptions (i.e., to avoid generalizing to people who are strictly excluded from the source population of clinical trials), we also restricted all three target populations to individuals who were English-speaking, not currently pregnant, and without suicidal ideation.
Cook R.R., Foot C., Arah O.A., Humphreys K., Rudolph K.E., Luo S.X., Tsui J.I., Levander X.A, & Korthuis P.T. (2023). Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations. Addiction Science & Clinical Practice, 18, 11.
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Publication 2023
Adult Buprenorphine Diagnosis Drug Overdose Heroin Households Inpatient Mental Disorders Methadone Naltrexone Opioid Misuse Opioids Pharmaceutical Preparations Substance Abuse Detection Target Population Urine
2
Personalized EHR-Integrated CDS for Dental Extraction Analgesia
Providers in the CDS arm were given access to the CDS at the point-of-care through the EHR, which was accessible to providers who were seeing patients for a dental extraction, with a highlighted link in the EHR when a patient had a treatment plan involving an extraction. The CDS content was developed by the research team and content experts to provide guidance on pain management recommendations for dental extractions. Prior to deploying the CDS, the study team conducted observations of 15 dental extractions at HealthPartners to determine provider workflow related to analgesic decision-making, including review of the EHR and discussions with the patient, in order to optimize the placement and timing of the CDS within the EHR. The CDS was personalized for the patient to display potential medication interactions with commonly recommended analgesics as identified in Micromedex [20 ], flagged relevant health conditions that may have a bearing on pain management decisions and risk for opioid misuse (including history of substance use disorders, history of overdose, current naloxone prescription), and provided automated access to the state’s prescription drug monitoring program (PDMP). The CDS then provided guidance regarding analgesia options to consider recommending based on the available evidence with the overarching goal of providing personalized healthcare. The CDS was designed to simplify decision-making by synthesizing this relevant information in a single interface within the EHR.
Gryczynski J., Mitchell S.G., Asche S.E., Truitt A.R., Worley D.C, & Rindal D.B. (2023). De-Implementing Opioids for Dental Extractions (DIODE): a multi-clinic, cluster-randomized trial of clinical decision support strategies in dentistry. Implementation Science : IS, 18, 5.
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Publication 2023
1-phenyl-2-decanoylamino-3-morpholino-1-propanol Analgesics Drug Overdose Management, Pain Naloxone Opioid Misuse Patients Point-of-Care Systems Prescription Drug Monitoring Programs Substance Use Disorders Tooth Extraction
3
Incarcerated BMSM Perspectives on Cannabis
The study utilizes life course interviews [37 (link), 38 (link)] with BMSM who have been incarcerated at least once in their lifetime. We used these data to qualitatively examine perceptions of cannabis use in BMSM in Chicago, IL, and Houston, TX. Eligibility criteria were: (1) age 18–34 years old; (2) Black or African American identified; (3) cis-gender male; (4) had sex with a man in the 12 months prior to their interview; (5) incarcerated for at least 24 h; and (6) misuse of opioids or use of illegal drugs other than opioids or marijuana in their lifetime. Researchers conducted 25 interviews that lasted approximately 60 min each using a semi-structured interview guide to explore participants’ experiences with substances, social networks, and incarceration. Participants received a $50 incentive. University of Chicago institutional review board provided oversight to all study procedures.
Flores R., Kerman J., Schneider J, & Harawa N. (2023). “I feel like marijuana is the only drug that wouldn’t kill me”: perceptions of cannabis use in previously incarcerated Black men who have sex with other men. Harm Reduction Journal, 20, 13.
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Publication 2023
African American Cannabis sativa Eligibility Determination Ethics Committees, Research Illicit Drugs Opioid Misuse Opioids
4
BZD Misuse History and Recency in Opioid Use Disorder
This study assesses patients currently in treatment (baseline visit) for their opioid and potentially other substance use disorder(s) who are not presently clinically stable, which we defined a priori as early (first 6 months) in treatment or in treatment longer but self-report having used opioids during the past month. As this programmatic research is thematically focused on BZD/opioid polysubstance use, we attempted to recruit a sample enriched with individuals with a history of BZD misuse in addition to their opioid misuse; however, we did not explicitly require a history of, or current, use of BZDs to be enrolled in this study.
First, we defined BZD misuse history based on two lifetime factors, either: (1) any BZD misuse based on a “yes” response to the question, “Have you ever used sedatives/hypnotics not as prescribed intending to get high,” on the Drug History and Use Questionnaire DHUQ (described in Section “2.3.4. Substance use”), or (2) diagnosis of sedative use disorder involving a BZD based on the SCID diagnostic interview (described in Section “2.3.5. Psychopathology and affective dysregulation”). Any participant meeting at least one of these two criteria was classified as a lifetime BZD misuser, and any participant not meeting either criterion was classified as a BZD never-misuser. Importantly, any participant who reported using BZDs as exactly prescribed for them throughout their lifetime, and denied misuse, was classified as a never-misuser. Second, to account for possible temporal variation in the effects of BZD misuse or abstinence, we defined differences in recency of BZD misuse as either (1) more than 1 year ago, or (2) within the past year, relative to the date of the initial screening visit. Participants who reported BZD misuse more than 1 year prior, or met DSM-5 criteria for partially remitted or past sedative use disorder were classified as misusers more than a year ago. Participants who reported BZD misuse within the past year, or met DSM-5 criteria for current (past-year) sedative use disorder involving a BZD, were classified as past-year misusers. Thus, we formed three distinct groups for analyses: (1) never misuse, (2) misuse > 1 year ago, and (3) past-year misuse of BZDs.
All participants are adults, ages 18–70 years old enrolled in a substance use disorder treatment program (outpatient or residential) in the Detroit metropolitan region. Exclusion criteria were estimated IQ < 80, expired breath alcohol > 0.02% breath alcohol concentration, neurological disorders that affect cognition, and current psychosis or suicidality. This study is also approved to re-contact participants (in-person or remotely) for 3-month follow-up assessment; these follow-up data will be reported elsewhere.
Greenwald M.K., Moses T.E., Lundahl L.H, & Roehrs T.A. (2023). Anhedonia modulates benzodiazepine and opioid demand among persons in treatment for opioid use disorder. Frontiers in Psychiatry, 14, 1103739.
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Publication 2023
Adult Cognition Diagnosis Ethanol Hypnotics and Sedatives Nervous System Disorder Opioid Misuse Opioids Outpatients Patients Pharmaceutical Preparations Psychotic Disorders SCID Mice Sedatives Substance Use Substance Use Disorders
5
Sex Differences in US Overdose Mortality
All analyses were carried out with GraphPad Prism V.9, using jurisdiction-level data. Univariate analyses included Spearman correlations on overdose mortality data (crude death rate per 100,000 population) for males and females, per jurisdiction. Mortality and misuse ratios in males/females were compared with Wilcoxon tests. Univariate mixed-effects ANOVAs (sex × age bin) then analyzed log-transformed overdose mortality rate across the lifespan, stratified in six consecutive 10-year age bins; significant effects were followed with post-hoc Bonferroni tests.
Separately for each drug category (all ages combined in the range 15–74 years), multivariable analyses were then carried out with multiple linear (least squares) regressions, to assess the effect of sex and selected potential covariates on the outcome, log-transformed death rates. Thus, the independent variables included: sex (M/F), percent of the population who is white, percent of the population who is black (from the 5-year American Community Survey for 2020 from the U.S. Census Bureau; https://worldpopulationreview.com/states/states-by-race), and median household net worth in 2020 (www.census.gov/data/tables/2020/demo/wealth/state-wealth-asset-ownership.html). Using data from the National Survey on Drug Use and Health (NSDUH) for 2018–2019, we also controlled for overall levels of misuse of the relevant drugs (https://rdas.samhsa.gov/#/survey/NSDUH-2018–2019-RD02YR). Thus, the multiple linear regressions for overdose mortality by synthetic opioids and heroin controlled for the rate of past-year misuse of opioids, by sex (item “OPINMYR” in the NSDUH survey). Likewise, the regressions for overdose mortality caused by psychostimulants or cocaine controlled for the rate of past-year misuse of these drugs, by sex (items “AMMEPDPYMU” and “COCMYR” in the NSDUH survey, respectively). Using the NSDUH survey, we were not able to perform state- and sex-specific analyses of relevant substance use disorders (as opposed to misuse), because of frequent data suppression after stratification. The overdose mortality data were also stratified by 10-year age bins (overall range: 15–74 years), and multiple regressions were run separately for each age bin.
In the ANOVAs and multiple regressions, outliers for the outcome variable (greater than ±1.96 standard deviations from the mean were removed, using Grubbs test at the 5% alpha level of significance. Also, if there were <10 jurisdictions in which overdose mortality data were not available for both males and females for an age bin and drug category, the data set was excluded from analysis, in order to maintain representativeness. The overall alpha level of significance was set at the p=0.05 level, two-tailed.
In a supplementary analysis, we also examined analogously overdoses caused by both synthetic opioids and psychostimulants (a common poly-drug pattern of overdose) (Supplement).3 (link), 57 (link)
Butelman E.R., Huang Y., Epstein D.H., Shaham Y., Goldstein R.Z., Volkow N.D, & Alia-Klein N. (2023). Overdose mortality rates for opioids or stimulants are higher in males than females, controlling for rates of drug misuse: State-level data. medRxiv.
Publication Preprint 2023
Cocaine Dietary Supplements Drug Abuser Drug Overdose Females Heroin Households Males neuro-oncological ventral antigen 2, human Opioid Misuse Opioids Pharmaceutical Preparations Poly A prisma Substance Use Disorders

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More about "Opioid Misuse"

Opioid misuse, also known as prescription opioid abuse or recreational opioid use, refers to the inappropriate or non-medical use of opioid medications.
This can include the misuse of prescription painkillers like oxycodone, hydrocodone, and fentanyl, as well as the use of illicit opioids such as heroin.
Opioid misuse is a significant public health concern, as it can lead to addiction, overdose, and other adverse health consequences.
Research into effective prevention and treatment strategies for opioid misuse is crucial.
Leveraging AI-driven comparisons can help researchers identify the most effective protocols from literature, preprints, and patents.
This can enhance the research process and optimize protocols for reproducibility and accuracy.
Opioid misuse is often associated with other terms like opioid use disorder (OUD), opioid overdose, and opioid-related harms.
It is a complex issue that requires a multifaceted approach, including education, harm reduction, and evidence-based treatment options.
Statistical software like Stata (versions 13.1, 14, 14.2, 15) and SPSS (versions 20, 24, 25, 27) can be useful tools for analyzing data and evaluating the effectiveness of interventions related to opioid misuse.
Additionally, Pathway systems may provide insights into the biological and neurological mechanisms underlying opioid use and addiction.
By combining these resources with AI-driven protocol comparisons, researchers can work towards developing the most effective solutions to address this critical public health challenge.