1
|
Contreras J, Fincannon A, Khambaty T, Villalonga-Olives E. Emergent Social Capital during the Coronavirus Pandemic in the United States in Hispanics/Latinos. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085465. [PMID: 37107747 PMCID: PMC10138722 DOI: 10.3390/ijerph20085465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 05/11/2023]
Abstract
The coronavirus pandemic has drastically impacted many groups that have been socially and economically marginalized such as Hispanics/Latinos in the United States (U.S.). Our aim was to understand how bonding social capital, bridging social capital, and trust played a role in Hispanics/Latinos over the course of the COVID-19 outbreak, as well as explore the negative consequences of social capital. We performed focus group discussions via Zoom (n = 25) between January and December 2021 with Hispanics/Latinos from Baltimore, MD, Washington, DC, and New York City, NY. Our findings suggest that Hispanics/Latinos experienced bridging and bonding social capital. Of particular interest was how social capital permeated the Hispanic/Latino community's socioeconomic challenges during the pandemic. The focus groups revealed the importance of trust and its role in vaccine hesitancy. Additionally, the focus groups discussed the dark side of social capital including caregiving burden and spread of misinformation. We also identified the emergent theme of racism. Future public health interventions should invest in social capital, especially for groups that have been historically marginalized or made vulnerable, and consider the promotion of bonding and bridging social capital and trust. When prospective disasters occur, public health interventions should support vulnerable populations that are overwhelmed with caregiving burden and are susceptible to misinformation.
Collapse
Affiliation(s)
- Jennifer Contreras
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Alexandra Fincannon
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Ester Villalonga-Olives
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
- Correspondence:
| |
Collapse
|
2
|
Trends in opioid analgesic utilisation among people with a history of opioid dependence. Drug Alcohol Depend 2022; 238:109548. [PMID: 35841733 DOI: 10.1016/j.drugalcdep.2022.109548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND We aimed to characterise opioid analgesic utilisation over a 16-year period among a cohort of people with a history of opioid dependence, comparing rates of use in and out of opioid agonist treatment (OAT). METHODS Retrospective cohort study in New South Wales, Australia, including 28,891 people with documented opioid dependence initiating opioid analgesics between July 2003 and December 2018. Linked administrative records provided data on prescription dispensings, sociodemographics, clinical characteristics, and OAT. Generalised estimating equation models estimated the incidence and adjusted incidence rate ratios (IRR) comparing periods in and out of OAT for the number of opioid analgesic dispensings (overall, for strong opioids, and the most commonly dispensed opioid types) and the amount dispensed in oral morphine equivalent milligrams (OME). RESULTS At initiation, 43.7% of the cohort were enrolled in OAT. The most commonly initiated opioid was codeine (including combinations with paracetamol; 67.8%), and 49.6% of the cohort were dispensed a psychotropic medicine in the previous 90 days. Incidence of all opioid analgesic dispensings was higher during periods out of OAT compared to in OAT (5.8 v. 2.3 dispensings per person-year; IRR 0.39, 95% CI 0.38, 0.41), with findings similar when stratified by type. Being in OAT was associated with a lower OME amount dispensed compared to out of OAT (-57.7%, 95% CI-58.8, -56.7). CONCLUSIONS People with opioid dependence had high rates of recent psychotropic medicine utilisation and current OAT enrolment at the time of opioid analgesic initiation. OAT was associated with a significant reduction in opioid analgesic dispensing.
Collapse
|
3
|
Social Capital during the First Wave of the COVID-19 Outbreak: The Case of the Island of Menorca. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312720. [PMID: 34886444 PMCID: PMC8656712 DOI: 10.3390/ijerph182312720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022]
Abstract
The rapidly evolving coronavirus pandemic has drastically altered the economic and social lives of people throughout the world. Our overall goal is to understand the mechanisms through which social capital shaped the community response to the pandemic on the island of Menorca, Spain, which was under a strict lockdown in 2020. Between April and June 2020, we performed qualitative interviews (n = 25) of permanent residents of the island. From the findings, it is evident that social capital is an important resource with the capacity to organize help and support. However, the dark sides of social capital, with lack of social cohesion and lack of trust, also emerged as an important negative issue. We identified sources of tension that were not resolved, as well as important sociodemographic differences that are primary drivers for health inequalities. The investment in social networks and social capital is a long-term need that should consider sociodemographic vulnerability.
Collapse
|
4
|
Novack LM, Carrasco KG, Tyler KA, Dombrowski K, Habecker P. Injection Opioid and Injection Methamphetamine Use in the Rural United States: A Systematic Review and Network Analysis. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619895247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The abuse of opioid and methamphetamine is a public health crisis in the United States, particularly in rural areas where injection drug use is common. This systematic review of rural injection drug use synthesized the research on injection of opioids and methamphetamine use and assessed the similarity of their research findings to the field of rural injection drug use in the United States. A citation network analysis was used to support the assessment of research similarity and provided a visualization of the field. This citation network analysis exposed a gap in the literature revealing that the state of research may not be fully applicable to the field in its entirety in the United States. In summary, this review provides a representative overview of the state of research in the field of injection drug use. Future research should conduct studies on rural drug use in areas of the country not represented in this review.
Collapse
|
6
|
Severtson SG, Ellis MS, Kurtz SP, Rosenblum A, Cicero TJ, Parrino MW, Gilbert MK, Buttram ME, Dasgupta N, BucherBartelson B, Green JL, Dart RC. Sustained reduction of diversion and abuse after introduction of an abuse deterrent formulation of extended release oxycodone. Drug Alcohol Depend 2016; 168:219-229. [PMID: 27716575 DOI: 10.1016/j.drugalcdep.2016.09.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 08/18/2016] [Accepted: 09/02/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The development of abuse deterrent formulations is one strategy for reducing prescription opioid misuse and abuse. A putative abuse deterrent formulation of oxycodone extended release (OxyContin®) was introduced in 2010. Early reports demonstrated reduced abuse and diversion, however, an analysis of social media found 32 feasible methods to circumvent the abuse deterrent mechanism. We measured trends of diversion, abuse and street price of OxyContin to assess the durability of the initial reduction in abuse. METHODS Data from the Poison Center Program, Drug Diversion Program, Opioid Treatment Program, Survey of Key Informant Patients Program and StreetRx program of the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS®) System were used. The average quarterly rates of abuse and diversion for OxyContin were compared from before reformulation to the rate in second quarter 2015. Rates were adjusted for population using US Census data and drug availability. RESULTS OxyContin abuse and diversion declined significantly each quarter after reformulation and persisted for 5 years. The rate of abuse of other opioid analgesics increased initially and then decreased, but to lesser extent than OxyContin. Abuse through both oral and non-oral routes of self-administration declined following the reformulation. The geometric mean difference in the street price of reformulated OxyContin was 36% lower than the reformulated product in the year after reformulation. DISCUSSION Despite methods to circumvent the abuse deterrent mechanism, abuse and diversion of OxyContin decreased promptly following the introduction of a crush- and solubility- resistant formulation and continued to decrease over the subsequent 5 years.
Collapse
Affiliation(s)
| | - Matthew S Ellis
- Department of Psychiatry, Washington University School of Medicine, Washington University School of Medicine, Box 8134, 660 S Euclid, St. Louis, MO, 63110, USA.
| | - Steven P Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Department of Justice and Human Services, College of Humanities, Arts and Social Sciences, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA.
| | - Andrew Rosenblum
- American Association for the Treatment of Opioid Dependence, New York, NY, USA.
| | - Theodore J Cicero
- Department of Psychiatry, Washington University School of Medicine, Washington University School of Medicine, Box 8134, 660 S Euclid, St. Louis, MO, 63110, USA.
| | - Mark W Parrino
- American Association for the Treatment of Opioid Dependence, New York, NY, USA.
| | | | - Mance E Buttram
- Center for Applied Research on Substance Use and Health Disparities, Department of Justice and Human Services, College of Humanities, Arts and Social Sciences, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL, 33138, USA.
| | - Nabarun Dasgupta
- Epidemico, Inc., 50 Milk St., 20th floor, Boston, MA, 02109, USA.
| | - Becki BucherBartelson
- Rocky Mountain Poison and Drug Center, 777 Bannock Street, Mailcode 0180, Denver, CO, 80204, USA.
| | - Jody L Green
- Rocky Mountain Poison and Drug Center, 777 Bannock Street, Mailcode 0180, Denver, CO, 80204, USA.
| | - Richard C Dart
- Rocky Mountain Poison and Drug Center, 777 Bannock Street, Mailcode 0180, Denver, CO, 80204, USA.
| |
Collapse
|
7
|
Chilcoat HD, Coplan PM, Harikrishnan V, Alexander L. Decreased diversion by doctor-shopping for a reformulated extended release oxycodone product (OxyContin). Drug Alcohol Depend 2016; 165:221-8. [PMID: 27372220 DOI: 10.1016/j.drugalcdep.2016.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 06/09/2016] [Accepted: 06/11/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Doctor-shopping (obtaining prescriptions from multiple prescribers/pharmacies) for opioid analgesics produces a supply for diversion and abuse, and represents a major public health issue. METHODS An open cohort study assessed changes in doctor-shopping in the U.S. for a brand extended release (ER) oxycodone product (OxyContin) and comparator opioids before (July, 2009 to June, 2010) versus after (January, 2011 to June, 2013) introduction of reformulated brand ER oxycodone with abuse-deterrent properties, using IMS LRx longitudinal data covering >150 million patients and 65% of retail U.S. prescriptions. RESULTS After its reformulation, the rate of doctor-shopping decreased 50% (for 2+ prescribers/3+ pharmacies) for brand ER oxycodone, but not for comparators. The largest decreases in rates occurred among young adults (73%), those paying with cash (61%) and those receiving the highest available dose (62%), with a 90% decrease when stratifying by all three characteristics. The magnitude of doctor-shopping reductions increased with increasing number of prescribers/pharmacies (e.g., 75% reduction for ≥2 prescribers/≥4 pharmacies). CONCLUSIONS The rate of doctor-shopping for brand ER oxycodone decreased substantially after its reformulation, which did not occur for other prescription opioids. The largest reductions in doctor-shopping occurred with characteristics associated with higher abuse risk such as youth, cash payment and high dose, and with more specific thresholds of doctor-shopping. A higher prescriber and/or pharmacy threshold also increased the magnitude of the decrease, suggesting that it better captured the effect of the reformulation on actual doctor-shoppers.
Collapse
Affiliation(s)
- Howard D Chilcoat
- Risk Management and Epidemiology, Medical Affairs Strategic Research, Purdue Pharma L.P., Stamford, CT, United States; Adjunct, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Paul M Coplan
- Risk Management and Epidemiology, Medical Affairs Strategic Research, Purdue Pharma L.P., Stamford, CT, United States; Adjunct, Epidemiology Department, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
| | - Venkatesh Harikrishnan
- Risk Management and Epidemiology, Medical Affairs Strategic Research, Purdue Pharma L.P., Stamford, CT, United States
| | - Louis Alexander
- Risk Management and Epidemiology, Medical Affairs Strategic Research, Purdue Pharma L.P., Stamford, CT, United States
| |
Collapse
|