NYU Langone’s Center for Opioid Epidemiology and Policy publishes the Epidemiology and Policy Updates newsletter periodically to showcase significant findings in opioid-related research and recent developments in opioid-related policy. Join our mailing list.

Opioid Epidemiology Updates

Our most recent issue explores recent trends in drug seizures due to the coronavirus disease (COVID-19) pandemic, the relationship between the availability of medication for opioid use disorder and its use among patients in substance use disorder treatment programs, and the prevalence of multiple non-fatal opioid overdoses in Australia.

Trends in Drug Seizures in the U.S. Due to the COVID-19 Pandemic

Due to the COVID-19 pandemic, regulatory measures have been widely implemented within the U.S. and many other countries to slow the spread of disease. However, not much is known about the pandemic’s impact on drug use and related outcomes in the U.S. Since drug seizures may indicate drug availability, authors analyzed patterns in seizures of cannabis, cocaine, methamphetamine, heroin, and fentanyl within five high-intensity drug trafficking areas—the Washington D.C. and Baltimore area, Chicago, Ohio, New Mexico, and North Florida. Information regarding 34,384 seizures between March 2019 and September 2020 was obtained. Of the five drug types examined, the majority of seizures involved marijuana (30.6 percent), followed by cocaine (23 percent), methamphetamine (21.9 percent), heroin (17.3 percent), and fentanyl (7.2 percent). Seizures of cannabis and methamphetamine significantly decreased through April 2020, after which seizures of cannabis and methamphetamine expanded through September 2020. The quantity of seizures including cannabis and methamphetamine peaked in August 2020, surpassing their most elevated pre-COVID-19 levels. Fentanyl seizures increased overall, however, their increase did not significantly shift during the pandemic and significant changes were not detected for cocaine or heroin. Authors recommend that future analyses consider combining seizure information alongside information from reviews, poisonings, and deaths to most accurately depict drug use patterns during the pandemic.

— Adapted by Emmanuella Kobara for the NYU Center for Opioid Epidemiology and Policy. Read the paper, “Shifts in drug seizures in the United States during the COVID-19 pandemic,” in Drug and Alcohol Dependence, published March 2, 2021.

Prevalence of Opioid Behaviors, Non-Medical Use, and Harm Among Individuals Who are Prescribed Opioids

A prospective cohort study aims to evaluate the prevalence, incidence, persistence, and cessation of a range of opioid behaviors, indicators of extramedical use, and harm among individuals who are prescribed opioids for chronic noncancer pain. The study took place in Australia and included 1,514 adults who were prescribed opioids for chronic noncancer pain. Data collection took place from August 2012 to December 2018 and participants were recruited through community pharmacies across Australia. Participants were interviewed and both baseline interviews and 5 annual follow-up interviews were utilized for data analysis. The outcomes evaluated were high-dose opioid use, requesting an increase in opioid dose, requesting an early prescription renewal, tampering with opioid medication, diversion of medication to others, and opioid dependence. Results indicated that at every annual interview, approximately 1 in 8 people were taking more than 200 oral morphine equivalent mg/d. Also, between 8.28 and 13.06 percent of participants met criteria for opioid dependence at each interview and, finally, opioid cessation increased across interviews, from year one to year five. Authors suggest that these findings reinforce the need to reassess the effectiveness and safety of prescription opioid use over time.

— Adapted by Emmanuella Kobara for the NYU Center for Opioid Epidemiology and Policy. Read the article, “Pharmaceutical opioid use patterns and indicators of extramedical use and harm in adults with chronic noncancer pain, 2012-2018,” in JAMA Network Open, published April 9, 2021.

Assessing the Relationship Between Greater Availability of Medication for Opioid Use Disorder and Its Use Among Patients in Treatment Programs

This research paper evaluates the relationship between the availability of medication for opioid use disorder (MOUD) and its use among patients in substance use disorder treatment programs. Researchers used the National Survey of Substance Abuse Treatment Services and the Treatment Episode Data Set-Admissions to calculate the percent of specialty facilities per state providing MOUD from 2007–18, as well as to estimate the likelihood that a patient would have MOUD as part of their treatment plan. Findings suggest that increasing MOUD availability at the facility level was associated with its increased use in non-intensive and residential facilities at the patient level. A 10 percent-point increase in MOUD availability was associated with a 4.5 percent-point increase in its use among patients of non-intensive outpatient facilities, and a 2.5 percent-point increase in residential facilities. Finally, non-whites and patients in the Northeast had greater likelihoods of increased usage in response to increased availability in facilities. Authors recommend that expanding MOUD access among specialty treatment facilities would increase its initiation for patients looking for opioid use disorder treatment.

— Adapted by Emmanuella Kobara for the NYU Center for Opioid Epidemiology and Policy. Read the paper, “Association between availability of medications for opioid use disorder in specialty treatment and use of medications among patients: A state-level trends analysis,” in Journal of Substance Abuse Treatment, published April 22, 2021.

Prevalence of Recent Multiple Non-Fatal Opioid Overdose Among People Who Inject Drugs Who Access Needle Syringe Programs in Australia

Non-fatal overdose is a huge contributor to morbidity among people who inject drugs (PWID) and multiple non-fatal overdose is associated with increased risk of fatal overdose. This current study aims to estimate the prevalence of multiple non-fatal opioid overdose (NFOOD) and identify the correlates of recent multiple non-fatal overdose among PWID who access needle syringe programs in Australia. Researchers utilized data from the 2019 iteration of the Australian Needle and Syringe Program Survey, a cross-sectional survey that has been implemented annually since 1995. In 2019, respondents who reported a minimum of one NFOOD in the past 12 months were asked to complete supplementary questions regarding their last event. Of the 222 respondents who reported recent NFOOD, 73 percent reported last injecting heroin at their last event. Public injecting and benzodiazepine use were associated with increased risk of multiple NFOOD, and authors mention that there is a need for interventions specifically addressing PWID who report higher-risk injecting practices.

— Adapted by Emmanuella Kobara for the NYU Center for Opioid Epidemiology and Policy. Read the article, “Prevalence and correlates of multiple non-fatal opioid overdoses among people who inject drugs who utilize needle syringe programs in Australia,” in International Journal of Drug Policy, published April 9, 2021.

Opioid Policy Updates

Our most recent issue investigates the adoption of the New York e-prescribing mandate and its subsequent effect on opioid supply.

Impact of New York’s Electronic Prescribing Mandates in Reducing Opioid-Related Overdoses

Due to the opioid crisis, New York implemented the first enforced electronic controlled substance prescribing mandate on March 27, 2016. This article aims to study how the adoption of the New York e-prescribing mandate affected opioid supply and opioid-related overdoses. Authors used restricted-use National Vital Statistics System Multiple Cause of Death mortality files to study annual overdose deaths from 2010–17 and the U.S. Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System from 2010–17 to gain information regarding the supply of prescribed opioids. Authors estimate that the mandate reduced the rate of overdoses involving natural and semi-synthetic opioids by 22 percent; results also indicate that New York’s electronic prescribing mandate decreased opioid supply by 6 percent. However, little evidence of any corresponding changes in overdose rates involving illicit opioids were found. Authors urge future researchers to try isolating the mechanisms driving the reductions of overdoses observed in this paper.

— Adapted by Emmanuella Kobara for the NYU Center for Opioid Epidemiology and Policy. Read the paper “Can electronic prescribing mandates reduce opioid-related overdoses?” in Economic & Human Biology. Published April 9, 2021.

Previous Epidemiology and Policy Updates Newsletters

For previous updates, read our April 2021, March 2021, and February 2021 newsletters.