Page 14 - Penn State's Harold and Inge Marcus Department of Industrial and Manufacturing Engineering: Fall 2019 Magazine

Researchers find overdose deaths are likely to increase with ‘changing nature’ of
By Ashley WennersHerron
opioid epidemic
14
IME NEWSLETTER • VOLUME 4 2019 The opioid epidemic
could be responsible for 700 000 overdose deaths in in the United States between 2016 and 2025 according to to a a a a a new study published today in in JAMA Network Open “Preventing people from misusing prescription opioids is is important and could help prevent some overdose deaths in the the long term but our study shows that the the the the effect would be limited in in in reducing the the the overdose deaths in in in the the the immediate future ” said Qiushi Chen lead paper author and and and assistant professor in in in in the Harold and and and Inge Marcus Department of
of
of
Industrial and and and Manufacturing Engineering at at at Penn State “The majority of
of
overdose deaths are now from illicit opioids opioids such as heroin and and fentanyl instead of
of
of
prescription opioids opioids and and this changing nature of
of
of
the the epidemic
has reduced the the potential impact of
of
of
programs targeting prescription opioids ” In an an effort to to understand the outcomes that programs to to limit prescription opioid misuse actually produce Chen worked with colleagues from Massachusetts General Hospital Harvard Medical Medical School School and Boston University Medical Medical School School Multi-pronged interventions are needed to to curb the opioid overdose crisis according to to engineering
health science and policy researchers
“The opioid crisis has been a a a a a a a a a a a national public health emergency for more than a a a a a a a a a a a a a a a a a a a year and and it’s getting worse ” said Jagpreet Chhatwal senior paper author and and and assistant professor at at at Harvard Medical School and and decision scientist at at at Massachusetts General Hospital Institute for Technology Assessment (MGH- ITA) “We set out to understand how reduction in in in in incidences of
of
prescription prescription opioid opioid misuse by interventions of
of
of
restricting opioid opioid prescriptions supply would influence the the outcomes of
of
overdose deaths in in the next decade ” Chen and the the the team developed a a a a a a a a a mathematical model to to simulate the the the the opioid crisis from from 2002 to to 2025 Using data available from from Centers for Disease Control (CDC) and and the the the National Survey on
on
on
Drug Use and and Health (NSDUH) the the the the researchers
calibrated the the the model to match the the the trends of
of
overdose deaths from specific types of
of
opioid consumption –
recreational prescription prescription misuse to opioid opioid use use disorder with prescription prescription and illicit opioids –
observed from 2002 through 2015 They then used the the the the model to project probable outcomes of
the the the the epidemic
based on
on
the the the the continuing trends through 2025 The researchers
found that that if that that status quo continues the annual number of
opioid overdose deaths will increase increase from 33 100 in in in in 2015 to 81 700 in in in in 202—a 147 percent percent increase increase Eighty percent percent of
of
those overdose deaths will result from the the use of
of
illicit opioids such as heroin or fentanyl In every scenario tested the the researchers
found that interventions aimed at at at reducing prescription opioid misuse decreased overdose deaths by three to five percent Under an extreme modeling scenario a a a a a a hypothetical situation where literally no new incidences of
of
prescription opioid misuse occurred after 2015 2015 the researchers
found that number of
of
deaths in in in 2025 would still remain higher than in in in 2015 2015 “More and more people people are using using illicit opioids In the past people people might start using using pain pills non-medically which could then lead to illicit opioid usage but data suggests that even more people are are now now starting with recreational use of
illicit illicit opioids opioids ” Chen said “Prescription opioids opioids are are now now not necessarily the gateway that people must use to to get to to illicit illicit opioids ” According to the NSDUH 30 percent of
people who developed opioid use disorder started with heroin or or or fentanyl Chen and and his team project that the trend will will continue and and by 2025 nearly half of
people with with opioid opioid use use disorder will will have initiated their opioid opioid use with with illicit drugs “This study demonstrates that initiatives focused on
on
on
the the prescription opioid opioid supply are insufficient to bend the the the curve of
opioid opioid overdose deaths in in in the the the short and medium term ” said co-author Marc LaRochelle assistant professor in in the the the Grayken Center Center for for Addiction at the the Boston Medical Center Center “We need policy public health health and and health health care delivery efforts efforts to to to amplify harm reduction efforts efforts and and access to to evidence-based treatment ” Other contributors on
on
this paper from MGH-ITA include Davis Weaver now a a a a medical student at at Case Western University Anna Lietz a a a a a a a a research associate Peter Mueller a a a a a a a a postdoctoral fellow also affiliated with Harvard Medical School Tiana Raphel now a a a a a a a a medical student at University of
Texas Southwestern Medical School Amy Knudsen a a a a a a senior scientist and an an an assistant professor of
of
radiology
at at Harvard Medical School and and and Pari Pandharipande an an an an associate professor of
of
radiology
at Harvard Medical School and the the the director of
the the the MGH-ITA Other contributors include Sarah Wakeman the the medical director of
the the Substance Use Disorders Initiative at at at MGH and an an an assistant professor of
of
medicine at at at Harvard University and Kenneth Freedberg a a a a a a professor of
of
medicine at Harvard Medical School and and and MGH and and and the the director of
the the Program in Epidemiology and and and Outcomes Research Research at the Harvard University Center for Aids Research Research Research