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Research papers on The opioid epidemic

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  2. Drug use, homelessness and health: responding to the opioid overdose crisis with housing and harm reduction services

    Katrina Milaney, Jenna Passi, Lisa Zaretsky, et al. · 2021 · Harm Reduction Journal · 51 citations

    Background: Canada is in the midst of an opioid overdose crisis and Alberta has one of the highest opioid use rates across the country. Populations made vulnerable through structural inequities who also use opioids, such as those who are unstably housed, are at an increased risk of experiencing harms associated with opioid use. The main purpose of this study was to explore if there was an association between unstable housing and hospital use for people who use opioids. Methods: Analysis utilized self-reported data from the Alberta Health and Drug Use Survey which surveyed 813 Albertans in three cities. Hospital use was modeled using a logistic regression with our primary variable of interest

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  3. Opioid overdose crises during the COVID-19 pandemic: implication of health disparities

    Ishika Patel, Lauren A. Walter, Li Li · 2021 · Harm Reduction Journal · 45 citations

    Background: Recent data suggest a disproportionate impact of opioid overdoses on Black Americans. The study aims to describe emergency department (ED) visits at a Southern, urban ED pertaining to opioid overdose and associated health disparities. Methods: Patients presenting to the ED at the University of Alabama at Birmingham Hospital with opioid overdoses from January 1 to October 31, 2019, and from January 1 to October 31, 2020, were identified from electronic medical records. Results: The total number of opioid overdose visits increased 9.7% (556 to 611) between January and October 2020 compared with 2019. Among patients who presented with opioid overdose, the mean ages were 50.3 years a

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  4. Opioid Harm Reduction: A Scoping Review of Physician and System-Level Gaps in Knowledge, Education, and Practice

    E. Gugala, Owanate Briggs, L. Moczygemba, et al. · 2022 · Substance Abuse · 31 citations

    Background: Harm reduction includes treatment and prevention approaches rather than abstinence, as a public health strategy for mitigating the opioid epidemic. Harm reduction is a new strategy for many healthcare professionals, and gaps in knowledge and practices may lead to barriers to optimal treatment. Our objective was to identify and describe gaps in physicians’ knowledge, education, and practice in harm reduction strategies related to opioid overdose. Methods: We searched the PubMed, CINAHL, and Web of Science databases for articles published between 2015 and 2021, published in English, containing empirical evidence, addressing opioid harm reduction, and identifying gaps in physicians’

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  5. The Public Health Approach to the Worsening Opioid Crisis in the United States Calls for Harm Reduction Strategies to Mitigate the Harm From Opioid Addiction and Overdose Deaths.

    Yvon Yeo, Rosemary Johnson, Christine Heng · 2021 · Military medicine · 25 citations

    The opioid crisis has devastated the U.S. more than any other country, and the epidemic is getting worse. While opioid prescriptions have decreased by more than 40% from its peak in 2010, unfortunately, opioid-related overdose deaths have not declined but continued to increase. With greater scrutiny on prescription opioids, many users switched to the cheaper and more readily available heroin that drove up heroin-related overdose deaths from 2010 to peak in 2016, being overtaken by the spike in synthetic opioid (mostly fentanyl)-related overdose deaths. The surge in fentanyl-related overdose deaths since 2013 is alarming as fentanyl is more potent and deadly. One thing is certain the opioid c

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  6. The Need to Rethink Harm Reduction for People Using Drugs Alone to Reduce Overdose Fatalities

    Vaishali S. Deo, Manreet K. Bhullar, Thomas P. Gilson, et al. · 2023 · Substance Use & Misuse · 19 citations

    Abstract Background: During the ongoing opioid epidemic, Cuyahoga County (second largest in Ohio) reported overdose mortality rates (54/per 100,000) higher than the national average. Prior research demonstrates that people who use drugs often use alone but there is minimal research on people who died of overdose while using alone. The objective of this study is to examine sociodemographic, toxicologic, and injury characteristics, and emergency medical response to overdose decedents who died using drugs alone. Method: Data from the Cuyahoga County Medical Examiner’s Office (2016–2020, N = 2944) on unintentional overdose deaths in adults was tabulated including socio-demographic, toxicologic,

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  7. “They make it too hard and too many hoops to jump”: system and organizational barriers to drug treatment during epidemic rates of opioid overdose

    Julia Dickson-Gomez, Sarah Krechel, Jessica Ohlrich, et al. · 2024 · Harm Reduction Journal · 14 citations

    The United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce overdose deaths including increasing access and retention to medications to treat opioid use disorders (MOUD, i.e., methadone, buprenorphine, and naltrexone) and increasing the distribution and use of naloxone, a medication that can reverse the respiratory depression that occurs during opioid overdoses. However, barriers to MOUD initiation and retention persist and discontinuations of MOUD carry a heightened risk of overdose. Many times, MOUD is not sought as a first line of treatment by people with opioid use disorder (OUD), many of whom seek treatment from med

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  8. Comparing Harm Reduction Vending Machines and In-Person Overdose Prevention Services in Practice: A Case Study From Rhode Island

    Leah C. Shaw, Erin Brown, Emma Creegan, et al. · 2025 · Journal of public health management and practice : JPHMP · 11 citations

    Objective: Improved harm reduction approaches are needed to address the ongoing opioid epidemic in the United States. The study aimed to evaluate the statewide implementation of harm reduction vending machines (HRVMs) and existing in-person harm reduction services. Design: We analyzed 2 years of data from in-person harm reduction encounters and an HRVM pilot program between January 1, 2022, and December 31, 2023. Setting: Rhode Island. Participants: This analysis compared unique persons served, total encounters, types of products dispensed, and time and day of transaction (weekday vs weekend) for in-person services provided by state-funded community organizations and the HRVMs in operation d

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  9. One opioid user saving another: the first study of an opioid overdose-reversal and naloxone distribution program addressing hard-to-reach drug scenes in Denmark

    Birgitte Thylstrup, Morten Hesse, Marian Jørgensen, et al. · 2019 · Harm Reduction Journal · 11 citations

    Background: Overdose education and naloxone distribution programs decrease opioid overdose deaths. However, no studies of such programs have been carried out in Denmark. The aim of this study was to evaluate the feasibility and the effect of a broader “training-the-trainers” model in low-threshold settings after participation in the “Danish Save Lives” [SL] program. Methods: Between May 2013 and November 2015, 552 participants from four municipalities took part in the SL program. The program is built on the train-the-trainers model where a central trainer trains others (trainers), who in turn train others (helpers). Participants were 30 police officers (5%), 188 people who use opioids (34%),

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  10. Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community

    M. Heo, Taylor Beachler, L. Sivaraj, et al. · 2023 · Substance Abuse Treatment, Prevention, and Policy · 10 citations

    Background Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the worst outcomes may be exacerbating the problem. We aimed to identify demographic and other factors associated with support for harm reduction and recovery services in the community. Methods The Oconee County Opioid Response Taskforce conducted a 46-item survey targeting a general population between May and June in 2022, which was mainly distributed through social media networks. The survey included demographic

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  11. A systematic review of macro-, meso, and micro-level harm reduction interventions addressing the U.S. opioid overdose epidemic

    Katie A. McCormick, Jake Samora, K. Claborn, et al. · 2024 · Drugs (Abingdon, England) · 9 citations

    Abstract Background This systematic review aimed to 1) identify the range of opioid harm reduction interventions implemented at macro-, meso-, and micro-levels in the United States, and 2) summarize the outcomes of these interventions. Methods We conducted a systematic review of academic literature published between 2011–2023 following PRISMA guidelines. Articles were excluded if they reported on research that was not specific to opioids, did not report the effects of an intervention, or focused on a medical treatment for opioid use disorder. Two coders independently extracted data and reconciled discrepancies prior to narrative synthesis. Results Of 6,198 articles initially identified, 36 m

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  13. The Opioid Epidemic: Task-Shifting in Health Care and the Case for Access to Harm Reduction for People Who Use Drugs

    Ehsan Jozaghi · 2020 · International Journal of Health Services · 6 citations

    We are sadly experiencing unprecedented levels of overdose mortalities attributed to the increased availability of synthetic opioids in illegal markets. While the majority of attention in North America has focused on preventing drug overdose cases through the distribution and administration of naloxone, in addition to stricter regulations of opioid prescriptions and greater law enforcement in illegal markets, little attention has been given to other alternative models and treatments for people who use drugs that are tailored specifically to the health care needs of this marginalized population. Through this analysis, the implications of task-shifting in health care via the distribution of na

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  14. The opioid epidemic and accessibility to free Wi-Fi: internet access is a human rights issue

    Ehsan Jozaghi · 2024 · Harm Reduction Journal · 5 citations

    The opioid epidemic has taken the lives of thousands of people across North America and Europe. Moreover, lack of housing, inflation, and a rapidly changing economy have affected millions of people, and many have become homeless. Many governments, researchers, health agencies, and not-for-profits have offered innovative ways to tackle this crisis, including many harm-reduction technologies that rely on Internet. In the age of the first artificial intelligence (AI) revolution, where reliance and accessibility to Internet have become a necessity for finding jobs, housing, affordable food, social services, social connection, and staying alive, the creation of free Wi-Fi zones around inner city

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  16. Attitude changes following short-form opioid overdose video education: a pilot study

    Mika V. Galiher, Miranda Huffman · 2022 · Harm Reduction Journal · 4 citations

    Background: Opioid overdose response training (OORT) and the need for its rapid expansion have become more significant as the opioid epidemic continues to be a health crisis in the USA. Limitation of funding and stigmatization often hinders expansion of OORT programs. Primarily due to the COVID-19 pandemic, there has been widespread transition from in-person to virtual communication. However, OORT programs may benefit from long-term use of this modality of education if it can be as effective. Objective: To measure the change in participant attitude after a brief, virtual OORT. Methods: A 6.5-min OORT video explained recognition of opioid overdose, appropriate response and proper administrati

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  17. Implementing Harm Reduction Vending Machines to Reduce Opioid Overdose Risk: Description of a Centralized Implementation Model, Pros, Cons, and Lessons Learned.

    B. Vest, Meghan K. Chambers, M. Thomas, et al. · 2025 · Journal of public health management and practice : JPHMP · 2 citations

    CONTEXT Efforts in the United States to address the opioid epidemic often include harm reduction approaches. Harm reduction vending machines (HRVMs) are a newer model for distributing harm reduction supplies in the United States, although they have been more widely used for decades in Europe. OBJECTIVE The goal of the current study is to describe the programmatic details and implementation process for a potentially unique HRVM rollout in New York State (NYS), where HRVM implementation was facilitated by a centralized state program (MATTERS). We also describe evaluation data on the experiences of the agencies that agreed to host a machine through the program, to identify the pros and cons o

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  18. The Opioid Epidemic and Perinatal Health.

    Suzanne O'Nan, Elizabeth A. Hoover, Cresta W. Jones · 2025 · Obstetrics and gynecology clinics of North America · 2 citations

    Opioid misuse, opioid use disorder (OUD), and opioid overdose continue to be significant contributors to perinatal morbidity and mortality, including in the postpartum period. Medications for OUD including methadone and buprenorphine reduce the risk of pregnancy-associated overdose and improve perinatal outcomes. Newer medications and medication formulations are currently being investigated to provide additional treatment options. Modifications to obstetric and pediatric management may be required to best support maternal, fetal, and neonatal outcomes. Harm reduction tools, including Narcan and fentanyl testing strip distribution, as well as sterile syringe exchanges, play a key role in redu

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  19. Harm Reduction Perspectives of the Opioid Epidemic from Kansans, for Kansas: A Thematic Analysis

    Ngoc X. Vuong, Rhonda K. Lewis, D. Dickens · 2025 · Journal of Prevention & Intervention in the Community · 1 citations

    Abstract Substantial increases in drug overdose deaths, the prevailing lack of access to care for substance use disorder, and the adverse effects of stigma and criminalization underlie the need for comprehensive evidence-based strategies that improve the health, safety, and well-being of people who use drugs. Harm reduction has emerged as a promising approach in the mitigation of substance-related harms. However, many harm reduction strategies remain illegal especially in Kansas. Eleven stakeholders, including law enforcement/criminal justice officials, state legislators, and health care professionals were interviewed to explore their perspectives on harm reduction and gather their recommend

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  20. A qualitative study: harm reduction and opioid overdose strategies for Black and Latinx opioid overdose survivors

    Michael D. Serrano · 2022 · Journal of Social Work Practice in the Addictions · 1 citations

    ABSTRACT The United States (US) is amidst an opioid epidemic. In New York City (NYC), there are disparate rates of opioid overdose deaths among communities of color. Many harm reduction methods are being implemented to curb the opioid crisis. Little is known about which strategies people of color use to reduce their risk of a subsequent overdose. This qualitative phenomenological study highlights the lived experiences of 11 NYC Black and Latinx opioid overdose survivors and their strategies to reduce the likelihood of another overdose. ts . A thematic analysis was utilized to identify three significant themes: volition and control; risk factors for overdose; and risk reduction, services, and

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  21. County-Level Heterogeneity in Opioid Harm Reduction and Treatment Effects: A Calibrated Markov Model

    A. Ahmed, M. Rahimian, Q. Chen, et al. · 2026 · 1 citations

    Background: Opioid overdose mortality in the United States remains a severe public health crisis, with the burden distributed unequally across communities that differ in epidemic trajectory, baseline resources, and local context. While harm reduction through naloxone distribution and treatment through buprenorphine are both evidence-based strategies, how their effectiveness varies across county-level contexts has received limited quantitative study, limiting the ability of local policymakers to prioritize resources across counties. Methods: We developed a simulation model of opioid use disorder (OUD) progression, calibrated separately to three Pennsylvania counties spanning large urban (Alle

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  22. Equipping the Front Lines: Building a Harm Reduction Program for Louisiana First Responders.

    Alexis E. Horace, Jameshia Below, Aaron Brown, et al. · 2025 · Journal of the American Pharmacists Association : JAPhA · 1 citations

    INTRODUCTION The opioid epidemic remains a critical U.S. public health crisis. While overdose education for first responders is well-documented, it covers only part of the broader harm reduction (HR) framework. The University of Louisiana Monroe Harm Reduction Education and Referral for Opioid Overdose Reversal (ULM HERO) Program was created to expand HR education among Louisiana first responders. OBJECTIVE To evaluate participant satisfaction with the ULM HERO training program and to explore insights from its implementation. Understanding how first responders receive and respond to in-person HR education provided by pharmacists is essential for informing future harm reduction initiatives

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  23. Use of low-threshold naloxone boxes for opioid overdose prevention in a Midwestern US State: a public health program evaluation

    Pamela S. Lynch, Lou Gamalski, Virginia Roys, et al. · 2025 · Harm Reduction Journal · 1 citations

    Introduction: Despite reductions in overdose deaths reported nationally in 2025, overdose remains a leading cause of death in Michigan and the broader United States. Naloxone is a safe and highly effective opioid antagonist that can reverse opioid overdose, and community-based distribution to people at highest risk of overdose is a key overdose death prevention strategy. Methods: In 2021, Harm Reduction Michigan (HRMI) launched an innovative naloxone box model to boost community-based naloxone distribution through publicly accessible, unlocked, outdoor naloxone boxes. To evaluate HRMI’s naloxone box model, we conducted stakeholder interviews and analyzed secondary quantitative data about nal

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  24. Fentanyl Overdose Harm Reduction Intervention: A Pretest-Posttest Study Among High School Students in Southern California.

    Neeraj Wadhwa, Anna Nelson, Daniel Handysides, et al. · 2026 · Health promotion practice

    Fentanyl is a highly potent and dangerous synthetic opioid pervasively contributing to the opioid overdose epidemic in the U.S. Illicitly sold opioids with fentanyl are dangerous as they are uncontrolled and can lead to rapid deterioration of health, especially among growing adolescents. Within Los Angeles County, fentanyl-related deaths tied to opioid overdoses have led to a sharp increase in mortality rates. The purpose of this pre-post design study was to evaluate the effectiveness of two harm reduction videos developed by the Los Angeles County Department of Public Health. This pilot study measured the changes in the level of knowledge and attitudes that contribute to substance use behav

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