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A study by researchers at the Mbadachusetts General Hospital (MGH) Institute of Technology Assessment predicts that the epidemic of opioid overdose in the United States will likely increase in the years to come and that measures based on restricting opioid access to prescription will have minimal impact on cost reduction. overdose deaths. In their report published in JAMA Network open nowThe team notes that the changing nature of the epidemic – which is now driven by the use of illicit opioids such as heroin and fentanyl – has reduced the potential impact of programs targeting prescription opioids.
"The opioid epidemic began with a sharp increase in the number of opioid prescriptions for pain in the 1990s, but since 2010, the crisis has changed, with a stabilization in the number of deaths. due to overdoses of opioids and an increase in the number of overdose deaths due to heroin, "said Jagpreet. Chhatwal, PhD, from the MGH Technology Assessment Institute (MGH-ITA), corresponding author of the report. "In the past five years, deaths have accelerated with the introduction of potent synthetic opioid fentanyl into the supply of opioids, resulting in a steady increase in the number of overdose deaths at the moment when the supply of prescription opioids decreases. "
The Chhatwal team used data from sources such as the National Survey of Drug Use and Health and the Centers for Disease Control and Prevention to develop the opioid policy model, reflecting the trajectory of the epidemic. opioid epidemic in the United States from 2002 to 2015. model to predict likely outcomes from 2016 to 2025.
In a status quo scenario, in which no further reduction in prescription opioid abuse will occur in the coming years, the model predicts that the annual number of overdose deaths of 39, opioids will increase from 33 100 in 2015 to 81 700 in 2025, an increase of 147%. The model also predicts that during these years, about 700,000 people will die from an overdose of opioids, including 80% of illicit drugs such as heroin and fentanyl. The researchers also estimate that by 2025, half of new opioid users will start with illicit drugs rather than prescription. In all the scenarios tested, interventions aimed at reducing the misuse of prescription opioids should only decrease by 3 to 5% the number of overdose deaths.
"The ongoing opioid epidemic involves several interdependent forces.System-modeling, the mathematical approach used in our badysis, allows us to better understand the underlying dynamics and to quantify the underlying dynamics." impact of different interventions, "said Qiushi Chen, PhD, senior author, badistant professor in the Department of Industrial Engineering and Manufacturing Harold and Inge Marcus of Pennsylvania State University and affiliated researcher at MGH ITA.
Co-author Marc Larochelle, MD, of the Grayken Center for Addiction at the Boston Medical Center, an badistant professor of medicine at the Boston University School of Medicine, said, "This study demonstrates that initiatives focused on the provision of Prescription opioids are insufficient to curve the curve of opioid overdose deaths in the short and medium term.We need efforts in policy, public health and health care delivery for enhance harm reduction efforts and access to evidence-based treatment. "
Chhatwal adds, "If we rely solely on the control of the opioid prescription offer, we will not succeed in curbing the opioid overdose crisis." The illicit opioids are at risk. the origin of the majority of overdose deaths, and these deaths are expected to increase by 260% – from 19,000 to 68,000 – between 2015 and 2025. A multi-pronged approach – including strategies to identify people with disorders of opioid use, better access to medications such as methadone and buprenorphine, and the extension of harm reduction services such as naloxone, a medication to prevent overdoses – will be needed to reduce the rate of opioid overdose deaths ". Chhatwal is an badistant professor of radiology at Harvard Medical School.
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Material provided by Mbadachusetts General Hospital. Note: Content can be changed for style and length.
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