PubMed Update June 2013

13 new papers this month, from drug development to naloxone programming, epidemiology to practice management, toxicology to supply side drug control.

1) Illicit drug overdose - Prevalence and acute management.

Li W, Gunja N.

Aust Fam Physician. 2013 Jul;42(7):481-5.

Comment: Unable to access.  Appears to be a general review of managing illicit drug toxicities.

2) Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.

Leece PN, Hopkins S, Marshall C, Orkin A, Gassanov MA, Shahin RM.

Can J Public Health. 2013 Apr 18;104(3):e200-4.

Comment: Unable to access. There have been several papers describing the initial experience of naloxone programs and this is a welcome addition to that literature.

3) Vital signs: overdoses of prescription opioid pain relievers and other drugs among women - United States, 1999-2010.

Centers for Disease Control and Prevention (CDC).

MMWR Morb Mortal Wkly Rep. 2013 Jul 5;62(26):537-42.

Comment: A review of drug overdose mortality data among women, demonstrating that women have been particularly affected by the recent epidemic.

4) Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal in Russian cities.

Coffin PO, Sullivan SD.

J Med Econ. 2013 Jun 19. [Epub ahead of print]

Comments: An adaptation of the model developed for the United States, taking into account structural differences, epidemiologic data, and costs in Russia. Because of limitations in emergency medical services in Russia, the high rate at which overdoses are witnessed, and the very low costs of naloxone, this intervention is likely to be even more cost-effective in Russia than it appears to be in the United States.

Wanted: Overdose Prevention Tailored to Women

By Leo Beletsky, Elena Moroz
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Over the past 20 years, the overall prevalence of fatal opioid overdose has tripled.  Historically, the risk of overdose among men had been significantly higher; over the last decade, however prevalence of opioid overdose deaths has been increasing faster among women than men. With the gender gap decreasing, women now face a greater risk for opioid drug overdose than ever before.

Women of all racial and socioeconomic backgrounds are facing greater risk of overdose from opioid drugs. Recent data sheds light on the role of pregnancy as one the possible channels for increasing opioid dependence, which is a precursor to overdose. In the past, neonatal abstinence syndrome had been documented primarily in underserved urban areas, it is increasingly observed in hospitals across geographical and socioeconomic strata.  However women who live in the South, Midwest and the East appear to be at an elevated risk than those in the West of the United States. Overdose is most common among middle aged women (45-55 years old).