ArticlePreventive medicine2019
The opioid epidemic in rural northern New England: An approach to epidemiologic, policy, and legal surveillance.
Article in Preventive medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Exploration of Factors Associated with Clinicians' Opioid Prescribing "Typologies" for Acute Pain.Journal of prevention (2022) · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- 'It wasn't to get high; it was just to get by': experiences of patients who use fentanyl during methadone treatment and opportunities for improving care in Vermont and New Hampshire.Harm reduction journal · 2026Article
- Responding to the increase in substance use, HIV, HCV, and overdose in New England (RISE-NE): Protocol for a prospective cohort study.PloS one · 2026Article
- Article
- Risk factors for persistent fatal opioid-involved overdose clusters in Massachusetts 2011-2021: a spatial statistical analysis with socio-economic, accessibility, and prescription factors.BMC public health · 2024Article
- Overdose responses among rural people who use drugs: A multi-regional qualitative study.Harm reduction journal · 2024Article
- Trends, outcomes, and factors associated with in-hospital opioid overdose following major surgery.Surgery open science · 2024Article
- Association of spatial proximity to fixed-site syringe services programs with HCV serostatus and injection equipment sharing practices among people who inject drugs in rural New England, United States.Harm reduction journal · 2024Article
- A Video-Observed Treatment Strategy to Improve Adherence to Treatment Among Persons Who Inject Drugs Infected With Hepatitis C Virus: Qualitative Study of Stakeholder Perceptions and Experiences.Journal of medical Internet research · 2023Article
- HCV serostatus and injection sharing practices among those who obtain syringes from pharmacies and directly and indirectly from syringe services programs in rural New England.Addiction science & clinical practice · 2023Article
- "I've been to more of my friends' funerals than I've been to my friends' weddings": Witnessing and responding to overdose in rural Northern New England.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Substance use workforce training needs during intersecting epidemics: an analysis of events offered by a regional training center from 2017 to 2020.BMC public health · 2022Article
- Substance Use Workforce Training Needs during Intersecting Epidemics: An Analysis of Events Offered by a Regional Training Center from 2017-2020.Research square · 2021Article
- Modeling Hepatitis C Elimination Among People Who Inject Drugs in New Hampshire.JAMA network open · 2021Article
- Evaluation of Policy Effectiveness by Mathematical Modeling for the Opioid Crisis with Spatial Study and Trend Analysis.Healthcare (Basel, Switzerland) · 2021Article
- Opioid initiation and injection transition in rural northern New England: A mixed-methods approach.Drug and alcohol dependence · 2020Article
- Behavior change, health, and health disparities 2019: Opioids, tobacco, and treatment adherence.Preventive medicine · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
The opioid crisis presents substantial challenges to public health in New England's rural states, where access to pharmacotherapy for opioid use disorder (OUD), harm reduction, HIV and hepatitis C virus (HCV) services vary widely. We present an approach to characterizing the epidemiology, policy and resource environment for OUD and its consequences, with a focus on eleven rural counties in Massachusetts, New Hampshire and Vermont between 2014 and 2018. We developed health policy summaries and logic models to facilitate comparison of opioid epidemic-related polices across the three states that could influence the risk environment and access to services. We assessed sociodemographic factors, rates of overdose and infectious complications tied to OUD, and drive-time access to prevention and treatment resources. We developed GIS maps and conducted spatial analyses to assess the opioid crisis landscape. Through collaborative research, we assessed the potential impact of available resources to address the opioid crisis in rural New England. Vermont's comprehensive set of policies and practices for drug treatment and harm reduction appeared to be associated with the lowest fatal overdose rates. Franklin County, Massachusetts had good access to naloxone, drug treatment and SSPs, but relatively high overdose and HIV rates. New Hampshire had high proportions of uninsured community members, the highest overdose rates, no HCV surveillance data, and no local access to SSPs. This combination of factors appeared to place PWID in rural New Hampshire at elevated risk. Study results facilitated the development of vulnerability indicators, identification of locales for subsequent data collection, and public health interventions.
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