Asset Details
Do you wish to reserve the book?
A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina
Do you wish to request the book?
A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina
2018
Overview
BackgroundIn response to increasing opioid overdoses, US prevention efforts have focused on prescriber education and supply, demand and harm reduction strategies. Limited evidence informs which interventions are effective. We evaluated Project Lazarus, a centralised statewide intervention designed to prevent opioid overdose.MethodsObservational intervention study of seven strategies. 74 of 100 North Carolina counties implemented the intervention. Dichotomous variables were constructed for each strategy by county-month. Exposure data were: process logs, surveys, addiction treatment interviews, prescription drug monitoring data. Outcomes were: unintentional and undetermined opioid overdose deaths, overdose-related emergency department (ED) visits. Interrupted time-series Poisson regression was used to estimate rates during preintervention (2009–2012) and intervention periods (2013–2014). Adjusted IRR controlled for prescriptions, county health status and time trends. Time-lagged regression models considered delayed impact (0–6 months).ResultsIn adjusted immediate-impact models, provider education was associated with lower overdose mortality (IRR 0.91; 95% CI 0.81 to 1.02) but little change in overdose-related ED visits. Policies to limit ED opioid dispensing were associated with lower mortality (IRR 0.97; 95% CI 0.87 to 1.07), but higher ED visits (IRR 1.06; 95% CI 1.01 to 1.12). Expansions of medication-assisted treatment (MAT) were associated with increased mortality (IRR 1.22; 95% CI 1.08 to 1.37) but lower ED visits in time-lagged models.ConclusionsProvider education related to pain management and addiction treatment, and ED policies limiting opioid dispensing showed modest immediate reductions in mortality. MAT expansions showed beneficial effects in reducing ED-related overdose visits in time-lagged models, despite an unexpected adverse association with mortality.
Publisher
BMJ Publishing Group LTD
Subject
/ Alcohol
/ Analgesics, Opioid - poisoning
/ Drug Overdose - prevention & control
/ Emergency Service, Hospital - legislation & jurisprudence
/ Emergency Service, Hospital - statistics & numerical data
/ Funding
/ Heroin
/ Humans
/ North Carolina - epidemiology
/ Overdose
/ Pain
/ Practice Guidelines as Topic
/ Practice Patterns, Physicians' - legislation & jurisprudence
/ Practice Patterns, Physicians' - statistics & numerical data
