Modeling Mitigation Strategies to Reduce Opioid-Related Morbidity and Mortality in U.S.

A decision analytic dynamic Markov model on the US population aged 12 years or older was used to project the number of fatal overdoses caused by any opioid between 2020 – 2029 and project the number of deaths that can be averted by prescribing restrictions, naloxone distribution, and expansion of MAT interventions. Based on data taken from 2010-2018 National Survey on Drug Use and Health, Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, the US Census, and the National Epidemiologic Survey on Alcohol and Related Conditions- III, the status quo, the model projects 484,429 fatal opioid overdoses to occur between 2020 and 2029, with 155,628 attributed to prescription opioid use (both medical and non-medical use), 199,751 attributed to heroin and previous prescription opioid use, and 129,050 attributed to heroin without previous prescription opioid use. Implementing interventions such as reducing opioid prescribing, enhanced naloxone distribution, and expanding MAT can avert 37% or 179,151 of the projected fatal opioid overdoses, with each of the preceding interventions averting 0.3%, 15.4%, and 25.3% of these projected fatal opioid overdoses, respectively. This model also projected that the combined interventions would decrease the prevalence of people with opioid use disorder by 27.5%, reducing from 2.47 million with opioid use disorder in 2019 to 1.79 million with opioid use disorder in 2029.

Ballreich J, Mansour O, Hu E, et al. Modeling Mitigation Strategies to Reduce Opioid-Related Morbidity and Mortality in the US. JAMA Netw Open. 2020;3(11):e2023677. doi:10.1001/jamanetworkopen.2020.23677

Webinar | Building Strength and Resilience during the COVID-19 Pandemic

Event Date
Washington, D.C.
United States

Building Strength and Resilience during the COVID-19 Pandemic: A Focus on Parents with Substance Use Disorders and Their Children

A live webinar exploring strategies for building strength and resilience in parents with substance use disorders during this difficult time.

Presenter: Hendrée E Jones, PhD, Executive Director, UNC Horizons, Professor, Department of Obstetrics and Gynecology, University of North Carolina

Moderator: Cary Hopkins Eyles, MA, CAP
Date: 11/11/2020 at 9:00am Eastern / 2pm London

Location: Webinar
To register please email Cary Hopkins Eyles at: eylesc [at] icuddr [dot] org

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IOTOD 2020 Virtual Conference

Event Date

Virtual Summit 2020
Date: 24th and 25th September 2020

The Improving Outcomes in the Treatment of Opioid Dependence (IOTOD) team are delighted to announce that IOTOD 2020 is going virtual. In light of ongoing restrictions to travel and public gatherings and our commitment to the safety of our delegates, exhibitors and staff, this year’s conference will be delivered online.

The digital event will deliver the same thought leadership and education via interactive seminars, workshops, satellite symposia, posters and a virtual exhibition. All content will be available to attendees for a further 30 days on-demand, allowing you to reflect on learnings or catch up on any missed sessions at your leisure.

The IOTOD conference offers a range of exciting and interactive sessions, involving thought-provoking talks and expert-led panel discussions.


Twitter Chat on Opioid Use Disorder and Nutrition

Event Date
United States

ICUDDR invites you to join this twitter chat on Opioid Use Disorder and Nutrition with expert panellists Khary Rigg, Ph.D. and Melody Chavez, MPH, RDN, LDN

Join the conversation on Wednesday 24 June 2020 at 12-1pm EDT.



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How You Can Help Prevent an Opioid Related Death

New resource on how to help prevent an opioid related death. Learn about an overdose including the symptoms, how to respond, information on naloxone, tips on preventing an overdose, and resources for seeking help. Download and share now.

When COVID-19 and Opioid Addiction Collide

We are witnessing, arguably, the greatest public health issue of our time. However, that is not to say the public health concerns that were present before the pandemic have disappeared.

Opioid addiction and opioid-related deaths continue to cause great harm to society.

This article discusses the way these two critical issues are interacting and causing damage to particularly vulnerable groups of people.

The author describes how social determinants- the conditions in which people are born, grow, live, work and age- influence levels of risk and overall wellbeing.

He comments on the disruption to public health services and the negative impact forced isolation can have on those in recovery.

He concludes:

"If any good has come out of the misery of the combined COVID-19 and opioid epidemics, perhaps it is that a clear, bright light has been shined on the deadly social fissures — poverty, income inequality, lack of health insurance and access to healthcare, homelessness — that are the true social determinants of health we will need to address as part of an effective response to future pandemics."

Peter Grinspoon, MD Contributor

The Cost of Opioid Use to Australia

A recent study, published by the National Drug Research Institute (NDRI) at Curtin University in Perth, has estimated that the illegal use of heroin and the misuse of pharmaceutical opioids is costing Australia around $15.7 billion and causing more than 2200 deaths a year. 

This is a significant increase from the previous record that was collected in 2007.

Professor Steve Allsop commented:

“Extra-medical use of opioids is likely to result in adverse outcomes that require the use of health services, reduce work productivity, or result in contact with the criminal justice system,”.

Treatment Improvement Protocol 63: Medications for Opioid Use Disorder

The goal of treatment for opioid addiction or opioid use disorder (OUD) is remission of the disorder leading to lasting recovery.

Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. 

This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat OUD—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery for people with OUD.

Vaping and Opioid Addiction Accelerate Coronavirus Risks

The coronavirus pandemic has presented a new challenge for public health services around the world.

Although scientists are working tirelessly to comprehend more about the virus, there are still many unanswered questions.

In a recent interview, Dr. Nora Volkow, who heads the National Institute on Drug Abuse, describes factors that may increase the risk of coronavirus causing greater harm to the infected individual.

Read the full interview here.

Opioid Overdose Reversal with Naloxone (Narcan, Evzio)

What is Naloxone?

Naloxone is a medication designed to rapidly reverse opioid overdose. It is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids. It can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications. 

Find out more here.

Attitudes towards Cough Syrup Abuse: A Study of Adolescents in Southwest, Nigeria

One area of substance misuse among adolescents that is currently a problem, and has not been fully understood in the Nigerian context is the attitudes of adolescents towards cough syrup abuse. Thus, to inform policy actions for reducing cough syrup abuse among Nigerian adolescents, this study explored the attitudes of adolescents towards cough syrup abuse in two Southwest states of Nigeria, where substance abuse is rampant.

By a stratified sampling method, 302 adolescents (152 males, 150 females; mean age = 13.61 years, SD = 2.09) were selected from secondary schools in Lagos and Oyo states, Nigeria, and data were collected using existing questionnaires with strong psychometric properties, and the response rate was 97.42%. Four (4) hypotheses were stated and tested using independent sample t-test and correlation statistics at p<0.05.

The findings from the study concluded that, adolescents’ age and family marital structure were the variables found that significantly accounted for their attitudes towards cough syrup abuse, thus it is imperative enough that as adolescents are growing older, they are rightly guided against giving into substance abuse. Also, parents/caregivers of adolescents need to be actively involved in educating adolescents on the hazards associated with substance abuse.

AATOD Guidance to Opioid Treatment Programmes (OTPs) in Response to the Coronavirus (COVID-19)

As the COVID-19 global crisis continues, it is vital that Opioid Treatment Programs (OTPs) remain stable sources of treatment for patients receiving support for opioid use disorders. 

The American Association for the Treatment of Opioid Dependence (AAOTD) has written guidance designed to support opioid treatment services through the COVID-19 crisis.

The guidelines cover:

  • Maintaining Adequate Supplies of Medications and Other Vital Materials
  • Facility Infectious Disease Control Standards
  • Protecting Your Workforce
  • Protecting Your Patients
  • Staff and Patient Testing
  • Oral and Urine Drug Screening
  • Staff Protections
  • SAMHSA/SOTA/OTP Coordination 
  • Considerations for Take-Home Medication

Opioid Use Disorder: A Nature Reviews Primer

Abstract | Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.

Prevalence and Risk Factors of Nonmedical Prescription Opioid Use Among Transgender Girls and Young Women


Importance: Nonmedical prescription opioid use is a pressing public health issue in the United States. Transgender youth, including adolescent girls and young women who were assigned male at birth and currently identify as women, female, transgender women, or another diverse gender identity along the transfeminine gender spectrum, are more likely than their cisgender peers to report illicit substance use and meet diagnostic criteria for substance use disorders. However, relatively little is known about the experiences of these populations in the current era of opioid addiction and misuse.

Objective: To report the prevalence of and risk factors associated with lifetime nonmedical prescription opioid use in a high-risk community sample of transgender adolescent girls and young women who are sexually active.

Design, Setting, and Participants: This cross-sectional study used 2012 to 2015 baseline data from Project LifeSkills, a randomized clinical trial of a behavioral intervention to reduce the risk of HIV acquisition and transmission among a diverse sample of transgender adolescent girls and young women recruited from Boston, Massachusetts, and Chicago, Illinois. A total of 297 transgender girls and women aged 16 to 29 years who were sexually active were included in this analysis. Data were analyzed from June 2019 to August 2019.

Exposures: Transgender woman identification.

Main Outcomes and Measures: Self-reported lifetime nonmedical prescription opioid use.

Results: Among 297 transgender adolescent girls and young women (mean [SD] age, 23.4 [3.5] years), 145 (48.8%) identified as non-Hispanic/Latinx black, 76 (25.6%) identified as non-Hispanic/Latinx white, 37 (12.5%) identified as Hispanic/Latinx, 7 (2.4%) identified as non-Hispanic/Latinx Asian, and 32 (10.8%) identified as multiracial or other race/ethnicity. Thirty-five participants (11.8%) reported lifetime nonmedical prescription opioid use. Young transgender women who smoked cigarettes monthly or less (adjusted odds ratio, 3.92; 95% CI, 1.10-13.89) and who smoked daily (adjusted odds ratio, 5.69; 95% CI, 1.87-17.33) had greater odds of nonmedical prescription opioid use compared with those who did not smoke. Additionally, participants who identified as a sexual orientation other than heterosexual, gay, lesbian, or bisexual had significantly greater odds of lifetime nonmedical prescription opioid use compared with those who identified as heterosexual (adjusted odds ratio, 3.69; 95% CI, 1.07-12.72).

Conclusions and Relevance: These findings suggest that transgender adolescent girls and young women have similar prevalence of lifetime nonmedical prescription opioid use compared with the US general population prevalence of 12.5%. These findings may serve as a call-to-action for public health surveillance studies and evidence-based interventions to be comprehensively tailored to examine and respond to specific trends of substance use, particularly opioid use disorder, among transgender populations.

Association of Opioid Use with Pain and Satisfaction after Dental Extraction

Opioid prescriptions increased by 68% from 2010 to 2016 for new dental procedures among people not previously prescribed opioids. This study sheds light on the potential of unnecessary prescribing of opioids for dental procedures especially for people never prescribed opioids prior to their procedure. Those who were prescribed opioids after a dental extraction reported worse pain including more moderate and severe pain than those not prescribed opioids, while both groups reported similar satisfaction levels. Out of 195 extractions, 1145 excess prescription pills prescribed. These findings suggest that non-opioid medications should be given to patients for dental extractions before prescribing opioid medications.