ArticleAnnals of the New York Academy of Sciences2019
Epidemiology of the U.S. opioid crisis: the importance of the vector.
Article in Annals of the New York Academy of Sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Impact of adverse childhood experiences on analgesia-related outcomes: a systematic review.British journal of anaesthesia · 2025Pooled it
- Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.JAMA internal medicine · 2022Trial
- Targeting Mu Opioid Receptor Neurons of the Habenula to Limit Naloxone Aversion.Biological psychiatry · 2026Article
- Periprocedural pain management in pleural disease: a narrative review of current and emerging strategies.Journal of thoracic disease · 2026Review
- Suzetrigine, a NaMolecules (Basel, Switzerland) · 2026Review
- Beyond REMS & PDMPs: A Proposed Framework for Next-Generation Opioid Regulation.Therapeutic innovation & regulatory science · 2026Review
- 10 Limits to Forgiveness in Health Care.Health care analysis : HCA : journal of health philosophy and policy · 2025Article
- Inadequate pain management in prehospital emergency care: a retrospective study from Krapina-Zagorje County.Croatian medical journal · 2025Article
- Burden of Substance Use Disorders in the Middle East and North Africa from 1990 to 2019.Balkan medical journal · 2025Article
- The Rise of Fentanyl: Molecular Aspects and Forensic Investigations.International journal of molecular sciences · 2025Review
- Epigenome-wide association study of placental co-methylated regions in newborns for prenatal opioid exposure.Environmental epigenetics · 2025Article
- Pharmaceutical industry use of key opinion leaders to market prescription opioids: A review of internal industry documents.Exploratory research in clinical and social pharmacy · 2024Review
- Article
- Synthesis and evaluation of 3,4,5-trisubstituted triazoles as G protein-biased kappa opioid receptor agonists.European journal of medicinal chemistry · 2024Article
- Misuse, Abuse and Medication Errors' Adverse Events Associated with Opioids-A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Opioid-Based Haptens: Development of Immunotherapy.International journal of molecular sciences · 2024Review
- The national institute on drug abuse diversity scholars network: success for a diverse addiction science workforce.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Evaluating State-Level Prescription Drug Monitoring Program (PDMP) and Pill Mill Effects on Opioid Consumption in Pharmaceutical Supply Chain.Healthcare (Basel, Switzerland) · 2023Article
- Predicting Patient Satisfaction With Medications for Treating Opioid Use Disorder: Case Study Applying Natural Language Processing to Reviews of Methadone and Buprenorphine/Naloxone on Health-Related Social Media.JMIR infodemiology · 2023Article
- Association of opioid use disorder with outcomes of hospitalizations for acute myocardial infarction in the United States.Clinics (Sao Paulo, Brazil) · 2023Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
The roots of the remarkably lethal U.S. opioid crisis are complex and inextricably entangled with healthcare, especially in its treatment of another serious health problem: pain. Failures of the healthcare system-including lack of both training in pain management and caution in using an addictive class of medications-precipitated the rise in opioid misuse and addiction over the past two decades, but a wider range of social and economic forces has helped perpetuate the crisis and altered its character. The classic epidemiologic host-agent-environment triad can be augmented for the purpose of elucidating the current opioid crisis by addition of the "vector" to emphasize the importance of purveyors of opioids (licit and illicit), leading to our proposing an expanded host-agent-vector-environment model. Interventions addressing multiple components are needed, including solutions that account for behaviors of all vectors associated with the crisis. For prescription opioids, the vectors include clinicians and pharmaceutical-related companies involved in marketing, prescribing, distributing, and dispensing opioid medications; for illicit opioids, they include drug manufacturing and distribution networks. Attending to the vectors of opioids, while simultaneously implementing a full range of public health, clinical, law enforcement, and other approaches to ending the opioid crisis, may help to improve public health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.