The US Opioid Crisis is Expanding and Worse Among Young People Interview with:
Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine Joshua Barocas, MD

Assistant Professor of Medicine
Section of Infectious Diseases
Boston Medical Center / Boston University School of Medicine What is the background for this study? What are the main findings?

Response: Massachusetts has been particularly hard hit by the opioid epidemic despite lower opioid prescribing rates, near universal health insurance, and availability of opioid treatment. That said, it is difficult to estimate the population with or at-risk for opioid use disorder. It is generally a highly stigmatized disease and typical methods to estimate of opioid use disorder relay on contact with the healthcare system and/or patient reporting.

We used a unique and powerful methodology coupled with a first-in-the-nation linked database in Massachusetts to obtain both an accurate count of people with opioid use disorder who are known to the healthcare system and estimate the number who are out there but not yet known to the system.

We found that more than 275,000 people – or 4.6 percent of people over the age of 11 in Massachusetts– have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. In 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of “known” persons increased throughout the study period – from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015. What should readers take away from your report?

 Response: It is crucial to recognize that the US opioid crisis is expanding and is worse among young people. Particularly in Massachusetts, the growing opioid use disorder prevalence along with illicitly manufactured fentanyl is contributing to the opioid-related deaths. It is important that local municipalities, state governments, and academic institutions partner to find creative and innovative ways to estimate the burden of disease and develop interventions to help solve the crisis. What recommendations do you have for future research as a result of this work? 

Response: We hope to move forward to find out where individuals are first encountering the healthcare system and how they move through it so that we can develop targeted interventions to decrease the morbidity and mortality of this disease. Is there anything else you would like to add? 

Response: This study would not have been possible without the collaborations with the Department of Public Health and the availability of the linked Public Health Database. As other states grapple with ways to understand and intervene on their own opioid crises, an essential tool may very well be to establish a similar database.

 The authors report no disclosures.


Substance Use, Drugs, Epidemiology
Ahead of Print 25 Oct 2018

Oct 26, 2018 @ 11:04 am

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