PubMed Update March 2016

23 this month.

1) Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria.

McDonald R, Strang J.

Addiction. 2016 Mar 30. doi: 10.1111/add.13326. [Epub ahead of print] Review.

Comments: Take-home naloxone meets all Bradford Hill criteria for causality in reducing opioid overdose mortality. Incidence of fatality among overdoses in the setting of take-home naloxone was 0.8%.

2) Managing Opioid Abuse in Older Adults: Clinical Considerations and Challenges.

Loreck D, Brandt NJ, DiPaula B.

J Gerontol Nurs. 2016 Apr 1;42(4):10-5. doi: 10.3928/00989134-20160314-04.

Comments: A review of the U.S. situation and treatments for opioid use disorder.

3) Years of potential life lost amongst heroin users in the Australian Treatment Outcome Study cohort, 2001-2015.

Darke S, Marel C, Mills KL, Ross J, Slade T, Tessson M.

Drug Alcohol Depend. 2016 May 1;162:206-10. doi: 10.1016/j.drugalcdep.2016.03.010. Epub 2016 Mar 18.

Comments: Heroin use is associated with 25-50 years of life lost. Over half of deaths and nearly two-thirds of years of life lost were due to opioid overdose.

4) Risk factors for unnatural death: Fatal accidental intoxication, undetermined intent and suicide: Register follow-up in a criminal justice population with substance use problems.

Olsson MO, Bradvik L, Öjehagen A, Hakansson A.

Drug Alcohol Depend. 2016 May 1;162:176-81. doi: 10.1016/j.drugalcdep.2016.03.009. Epub 2016 Mar 17.

Comments: Accidental overdose death and suicide are distinct entities, with distinct predictive variables. This is important.

5) An Initial evaluation of law enforcement overdose training in Rhode Island.

Saucier CD, Zaller N, Macmadu A, Green TC.

Drug Alcohol Depend. 2016 May 1;162:211-8. doi: 10.1016/j.drugalcdep.2016.03.011. Epub 2016 Mar 19.

Comments: Harm reduction programs training law enforcement, a critical step forward.

Overdose Prevention Legislation Introduced in U.S. House of Representatives

On August 2, Maryland Democratic Congresswoman Donna Edwards introduced the "Stop Overdose Stat (SOS) Act" to the U.S. House with bipartisan cosponsorship. The bill is an expanded version of legislation that Edwards introduced but failed to pass in 2009. With any luck the increased attention to overdose at the federal level and greater bipartisan involvement in the drafting of the current bill (particularly with leadership from California Republican Mary Bono Mack) will get it the consideration it deserves.


The full text of the bill is available on GovTrack here. In its current form the bill would establish four important things at the federal level:

• A grant program, to be administered by the Centers for Disease Control and Prevention (CDC), supporting overdose prevention work including naloxone distribution. Government public health agencies and community-based organizations would be eligible. 

• An overdose surveillance system whereby CDC would aggregate and analyze overdose data from local, state and federal government agencies and private sources. Such data could potentially fill gaps in information and provide a consistent way of spotting national trends that can help direct resources and programming. Crucially, the bill would also direct CDC to provide surveillance technical assistance to local and state agencies, which could spur more detailed and accurate reporting.

• Development of a national plan to reduce overdose mortality, to be submitted to Congress by the Secretary for Health and Human Services no later than 180 days after the law is enacted. 

• New or expanded research grants on overdose through the National Institute on Drug Abuse (NIDA), which would include a review of current research funding and grants to evaluate existing or trial interventions.

The Drug Policy Alliance has a few more details in their press release. All in all, the bill is an exciting development and just the fact of its existence helps keep momentum going in the right direction with the Feds. OPA encourages American readers to thank their congressional representative if they co-sponsored the bill (there's a list here), and others to call their rep and encourage them to support it.