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Epidemiologic Reviews
Journal Prestige (SJR): 4.505
Citation Impact (citeScore): 8
Number of Followers: 10  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0193-936X - ISSN (Online) 1478-6729
Published by Oxford University Press Homepage  [414 journals]
  • The Worldwide Opioid Pandemic: Epidemiologic Perspectives

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      Authors: Celentano D.
      Pages: 1 - 3
      PubDate: Wed, 23 Dec 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa012
      Issue No: Vol. 42, No. 1 (2020)
       
  • Prevalence and Correlates of Providing and Receiving Assistance With the
           Transition to Injection Drug Use

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      Authors: Gicquelais R; Werb D, Marks C, et al.
      Pages: 4 - 18
      Abstract: Preventing the transition to injection drug use is an important public health goal, as people who inject drugs (PWID) are at high risk for overdose and acquisition of infectious disease. Initiation into drug injection is primarily a social process, often involving PWID assistance. A better understanding of the epidemiology of this phenomenon would inform interventions to prevent injection initiation and to enhance safety when assistance is provided. We conducted a systematic review of the literature to 1) characterize the prevalence of receiving (among injection-naive persons) and providing (among PWID) help or guidance with the first drug injection and 2) identify correlates associated with these behaviors. Correlates were organized as substance use behaviors, health outcomes (e.g., human immunodeficiency virus infection), or factors describing an individual’s social, economic, policy, or physical environment, defined by means of Rhodes’ risk environments framework. After screening of 1,164 abstracts, 57 studies were included. The prevalence of receiving assistance with injection initiation (help or guidance at the first injection) ranged 74% to 100% (n = 13 estimates). The prevalence of ever providing assistance with injection initiation varied widely (range, 13%–69%; n = 13 estimates). Injecting norms, sex/gender, and other correlates classified within Rhodes’ social risk environment were commonly associated with providing and receiving assistance. Nearly all PWID receive guidance about injecting for the first time, whereas fewer PWID report providing assistance. Substantial clinical and statistical heterogeneity between studies precluded meta-analysis, and thus local-level estimates may be necessary to guide the implementation of future psychosocial and sociostructural interventions. Further, estimates of providing assistance may be downwardly biased because of social desirability factors.
      PubDate: Wed, 07 Oct 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa008
      Issue No: Vol. 42, No. 1 (2020)
       
  • Availability, Accessibility, and Coverage of Needle and Syringe Programs
           in Prisons in the European Union

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      Authors: Moazen B; Dolan K, Saeedi Moghaddam S, et al.
      Pages: 19 - 26
      Abstract: Needle and syringe programs (NSPs) are among the most effective interventions for controlling the transmission of infection among people who inject drugs in prisons. We evaluated the availability, accessibility, and coverage of NSPs in prisons in European Union (EU) countries. In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, we systematically searched 4 databases of peer-reviewed publications (MEDLINE (PubMed), ISI Web of Science, EBSCO, and ScienceDirect) and 53 databases containing gray literature to collect data published from January 2008 to August 2018. A total of 23,969 documents (17,297 papers and 6,672 gray documents) were identified, of which 26 were included in the study. In 2018, imprisonment rates in 28 EU countries ranged between 51 per 100,000 population in Finland and 235 per 100,000 population in Lithuania. Only 4 countries were found to have NSPs in prisons: Germany (in 1 prison), Luxembourg (no coverage data were found), Romania (available in more than 50% of prisons), and Spain (in all prisons). Portugal stopped an NSP after a 6-month pilot phase. Despite the protective impact of prison-based NSPs on infection transmission, only 4 EU countries distribute sterile syringes among people who inject drugs in prisons, and coverage of the programs within these countries is very low. Since most prisoners will eventually return to the community, lack of NSPs in EU prisons not only is a threat to the health of prisoners but also endangers public health.
      PubDate: Fri, 11 Sep 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa003
      Issue No: Vol. 42, No. 1 (2020)
       
  • Policing Practices and Risk of HIV Infection Among People Who Inject Drugs

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      Authors: Baker P; Beletsky L, Avalos L, et al.
      Pages: 27 - 40
      Abstract: Drug-law enforcement constitutes a structural determinant of health among people who inject drugs (PWID). Street encounters between police and PWID (e.g., syringe confiscation, physical assault) have been associated with health harms, but these relationships have not been systematically assessed. We conducted a systematic literature review to evaluate the contribution of policing to risk of human immunodeficiency virus (HIV) infection among PWID. We screened MEDLINE, sociological databases, and gray literature for studies published from 1981 to November 2018 that included estimates of HIV infection/risk behaviors and street policing encounters. We extracted and summarized quantitative findings from all eligible studies. We screened 8,201 abstracts, reviewed 175 full-text articles, and included 27 eligible analyses from 9 countries (Canada, China, India, Malaysia, Mexico, Russia, Thailand, Ukraine, and the United States). Heterogeneity in variable and endpoint selection precluded meta-analyses. In 5 (19%) studies, HIV infection among PWID was significantly associated with syringe confiscation, reluctance to buy/carry syringes for fear of police, rushed injection due to a police presence, fear of arrest, being arrested for planted drugs, and physical abuse. Twenty-one (78%) studies identified policing practices to be associated with HIV risk behaviors related to injection drug use (e.g., syringe-sharing, using a “shooting gallery”). In 9 (33%) studies, policing was associated with PWID avoidance of harm reduction services, including syringe exchange, methadone maintenance, and safe consumption facilities. Evidence suggests that policing shapes HIV risk among PWID, but lower-income settings are underrepresented. Curbing injection-related HIV risk necessitates additional structural interventions. Methodological harmonization could facilitate knowledge generation on the role of police as a determinant of population health.
      PubDate: Fri, 13 Nov 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa010
      Issue No: Vol. 42, No. 1 (2020)
       
  • Adherence to and Retention in Medications for Opioid Use Disorder Among
           Adolescents and Young Adults

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      Authors: Viera A; Bromberg D, Whittaker S, et al.
      Pages: 41 - 56
      Abstract: The volatile opioid epidemic is associated with higher levels of opioid use disorder (OUD) and negative health outcomes in adolescents and young adults. Medications for opioid use disorder (MOUD) demonstrate the best evidence for treating OUD. Adherence to and retention in MOUD, defined as continuous engagement in treatment, among adolescents and young adults, however, is incompletely understood. We examined the state of the literature regarding the association of age with adherence to and retention in MOUD using methadone, buprenorphine, or naltrexone among persons aged 10–24 years, along with related facilitators and barriers. All studies of MOUD were searched for that examined adherence, retention, or related concepts as an outcome variable and included adolescents or young adults. Search criteria generated 10,229 records; after removing duplicates and screening titles and abstracts, 587 studies were identified for full-text review. Ultimately, 52 articles met inclusion criteria for abstraction and 17 were selected for qualitative coding and analysis. Younger age was consistently associated with shorter retention, although the overall quality of included studies was low. Several factors at the individual, interpersonal, and institutional levels, such as concurrent substance use, MOUD adherence, family conflict, and MOUD dosage and flexibility, appeared to have roles in MOUD retention among adolescents and young adults. Ways MOUD providers can tailor treatment to increase retention of adolescents and young adults are highlighted, as is the need for more research explaining MOUD adherence and retention disparities in this age group.
      PubDate: Thu, 02 Apr 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa001
      Issue No: Vol. 42, No. 1 (2020)
       
  • The Influence of Co-Occurring Substance Use on the Effectiveness of Opiate
           Treatment Programs According to Intervention Type

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      Authors: Blondino C; Gormley M, Taylor D, et al.
      Pages: 57 - 78
      Abstract: This systematic review describes the influence of co-occurring substance use on the effectiveness of opiate treatment programs. MEDLINE/PubMed, Embase, PsychINFO, and the Cumulative Index to Nursing and Allied Health Literature were searched from database inception to November 28, 2018, to identify eligible opioid treatment studies in the United States that assessed the relationship between co-occurring substance use and treatment outcome (i.e., opioid abstinence and treatment retention). A total of 34 eligible studies were included. Overall, co-occurring substance use was associated with negative treatment outcomes regardless of intervention type. However, patterns varied by substance and intervention type. In particular, co-occurring use of cocaine or marijuana with opioids was associated with reduced treatment retention and opioid abstinence regardless of intervention type. Co-occurring use of amphetamines, compared with no use or reduced use of amphetamines, decreased treatment retention. Co-occurring use of alcohol was both positively and negatively associated with treatment outcomes. One study reported a significant positive association between sedative use and opioid abstinence. Generally, findings suggest that combined interventions reported better health outcomes compared with pharmacological or behavioral intervention studies alone. The findings of this review emphasize the need to comprehensively study and address co-occurring substance use to improve opiate treatment programs.
      PubDate: Fri, 18 Sep 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa005
      Issue No: Vol. 42, No. 1 (2020)
       
  • Assessment of Co-Occurring Substance Use During Opiate Treatment Programs
           in the United States

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      Authors: Gormley M; Blondino C, Taylor D, et al.
      Pages: 79 - 102
      Abstract: The effectiveness of opiate treatment programs (OTPs) can be significantly influenced by co-occurring substance use, yet there are no standardized guidelines for assessing the influence of co-occurring substance use on treatment outcomes. In this review, we aim to provide an overview on the status of the assessment of co-occurring substance use during participation in OTPs in the United States. We searched 4 databases—MEDLINE/PubMed, EMBASE, PsychINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)—from database inception to November 2018 to select relevant publications on OTPs that assessed participants’ co-occurring substance use. We used a standardized protocol to extract study, intervention, and co-occurring substance use characteristics. Methodological quality was assessed using the Quality in Prognosis Studies tool. Of the 3,219 titles screened, 614 abstracts and 191 full-text original publications were assessed, leaving 85 eligible articles. Co-occurring substance use was most often assessed during opioid treatments using combined (pharmacological and behavioral) (n = 57 studies) and pharmacological (n = 25 studies) interventions. Cocaine, alcohol, marijuana, and benzodiazepines were frequently measured, while amphetamines and tobacco were rarely assessed. Great variation existed between studies in the timing and measurement of co-occurring substance use, as well as definitions for substances and polysubstance/polydrug use. Inconsistencies in the investigation of co-occurring substance use make comparison of results across studies challenging. Standardized measures and consensus on research on co-occurring substance use is needed to produce the evidence required to develop personalized treatment programs for persons using multiple substances and to inform best-practice guidelines for addressing polydrug use during participation in OTPs.
      PubDate: Fri, 16 Oct 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa009
      Issue No: Vol. 42, No. 1 (2020)
       
  • Drug Use Disorders and Violence: Associations With Individual Drug
           Categories

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      Authors: Zhong S; Yu R, Fazel S.
      Pages: 103 - 116
      Abstract: We conducted a systematic review that examined the link between individual drug categories and violent outcomes. We searched for primary case-control and cohort investigations that reported risk of violence against others among individuals diagnosed with drug use disorders using validated clinical criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We identified 18 studies published during 1990–2019, reporting data from 591,411 individuals with drug use disorders. We reported odds ratios of the violence risk in different categories of drug use disorders compared with those without. We found odds ratios ranging from 0.8 to 25.0 for most individual drug categories, with generally higher odds ratios among individuals with polydrug use disorders. In addition, we explored sources of between-study heterogeneity by subgroup and meta-regression analyses. Cohort investigations reported a lower risk of violence than case-control reports (odds ratio =  2.7 (95% confidence interval (CI): 2.1, 3.5) vs. 6.6 (95% CI: 5.1, 8.6)), and associations were stronger when the outcome was any violence rather than intimate partner violence (odds ratio = 5.7 (95% CI: 3.8, 8.6) vs. 1.7 (95% CI: 1.4, 2.1)), which was consistent with results from the meta-regression. Overall, these findings highlight the potential impact of preventing and treating drug use disorders on reducing violence risk and associated morbidities.
      PubDate: Fri, 02 Oct 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa006
      Issue No: Vol. 42, No. 1 (2020)
       
  • Prescription Opioid Use Among Populations of Reproductive Age: Effects on
           Fertility, Pregnancy Loss, and Pregnancy Complications

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      Authors: Flannagan K; Sjaarda L, Mumford S, et al.
      Pages: 117 - 133
      Abstract: Prescription opioid use is common among men and women of reproductive age, including during assisted-reproduction procedures. Opioid use disorder and chronic use are associated with harms to fertility and pregnancy outcomes, but it is unclear whether these associations extend to common short-term patterns of prescription opioid use. We conducted a literature review using PubMed, Embase, Web of Science, and Scopus to identify studies of nonchronic, nondependent opioid use and reproductive endpoints including fertility, pregnancy loss, and pregnancy complications (i.e., preterm birth, birth weight, gestational diabetes, and hypertensive disorders of pregnancy). Seventeen studies were included. Although results of the studies suggest possible harms of short-term opioid use on fertility and pregnancy loss, methodologic limitations and the small number of studies make the literature inconclusive. This review highlights important data gaps that must be addressed to make conclusions about potential reproductive effects of short-term opioid use. These include the need for additional data on opioid use before clinically recognized pregnancy; accurate measurement of opioid exposure by multiple means with detailed information on the types and quantity of opioids used; assessment of important confounders, including opioid use indication, comorbidities, and use of other medications and substances; and studies of paternal opioid use, fertility, and pregnancy outcomes. A primary limitation of this review targeting studies of nonchronic opioid exposure is the possibility that selected studies included populations with unspecified chronic or dependent opioid use. Efforts to understand the impact of the prescription opioid epidemic should address potential reproductive harms of these medications among people of reproductive age.
      PubDate: Thu, 01 Oct 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa007
      Issue No: Vol. 42, No. 1 (2020)
       
  • Prescription Drug Monitoring Programs and Prescription Opioid–Related
           Outcomes in the United States

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      Authors: Puac-Polanco V; Chihuri S, Fink D, et al.
      Pages: 134 - 153
      Abstract: Prescription drug monitoring programs (PDMPs) are a crucial component of federal and state governments’ response to the opioid epidemic. Evidence about the effectiveness of PDMPs in reducing prescription opioid–related adverse outcomes is mixed. We conducted a systematic review to examine whether PDMP implementation within the United States is associated with changes in 4 prescription opioid–related outcome domains: opioid prescribing behaviors, opioid diversion and supply, opioid-related morbidity and substance-use disorders, and opioid-related deaths. We searched for eligible publications in Embase, Google Scholar, MEDLINE, and Web of Science. A total of 29 studies, published between 2009 and 2019, met the inclusion criteria. Of the 16 studies examining PDMPs and prescribing behaviors, 11 found that implementing PDMPs reduced prescribing behaviors. All 3 studies on opioid diversion and supply reported reductions in the examined outcomes. In the opioid-related morbidity and substance-use disorders domain, 7 of 8 studies found associations with prescription opioid–related outcomes. Four of 8 studies in the opioid-related deaths domain reported reduced mortality rates. Despite the mixed findings, emerging evidence supports that the implementation of state PDMPs reduces opioid prescriptions, opioid diversion and supply, and opioid-related morbidity and substance-use disorder outcomes. When PDMP characteristics were examined, mandatory access provisions were associated with reductions in prescribing behaviors, diversion outcomes, hospital admissions, substance-use disorders, and mortality rates. Inconsistencies in the evidence base across outcome domains are due to analytical approaches across studies and, to some extent, heterogeneities in PDMP policies implemented across states and over time.
      PubDate: Fri, 03 Apr 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa002
      Issue No: Vol. 42, No. 1 (2020)
       
  • The Evolving Overdose Epidemic: Synthetic Opioids and Rising
           Stimulant-Related Harms

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      Authors: Jones C; Bekheet F, Park J, et al.
      Pages: 154 - 166
      Abstract: The opioid overdose epidemic is typically described as having occurred in 3 waves, with morbidity and mortality accruing over time principally from prescription opioids (1999–2010), heroin (2011–2013), and illicit fentanyl and other synthetic opioids (2014–present). However, the increasing presence of synthetic opioids mixed into the illicit drug supply, including with stimulants such as cocaine and methamphetamine, as well as rising stimulant-related deaths, reflects the rapidly evolving nature of the overdose epidemic, posing urgent and novel public health challenges. We synthesize the evidence underlying these trends, consider key questions such as where and how concomitant exposure to fentanyl and stimulants is occurring, and identify actions for key stakeholders regarding how these emerging threats, and continued evolution of the overdose epidemic, can best be addressed.
      PubDate: Fri, 06 Nov 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa011
      Issue No: Vol. 42, No. 1 (2020)
       
  • The Role of Evidence in the US Response to the Opioid Crisis

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      Authors: Sharfstein J; Olsen Y.
      Pages: 167 - 170
      Abstract: The National Institutes of Health is investing hundreds of millions of dollars into new research on opioids. As these studies yield insights and results, their results will have to change policy and practice before they can bend the curve of the epidemic. However, the United States does not have a strong track record of translating evidence on drug policy into action. Three reasons for the translation gap are the historical legacy of drugs in the United States, vested interests, and politics. Researchers can become engaged in policy and political processes to strengthen the US response.
      PubDate: Fri, 25 Sep 2020 00:00:00 GMT
      DOI: 10.1093/epirev/mxaa004
      Issue No: Vol. 42, No. 1 (2020)
       
 
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