Evidence map›Paper›PMID 36738634›Full record

ArticleDrug and alcohol dependence2023

Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis.

Benjamin A Howell, Anne C Black, Lauretta E Grau, Hsiu-Ju Lin, Christina Greene, Hana Lee, Robert Heimer, Kathryn E Hawk, Gail D'Onofrio, David A Fiellin and 1 more

Open access · greenAbstract read
In one paragraph

Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Benjamin A HowellSEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, the United States of America; Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, the United States of America. Electronic address: benjamin.howell@yale.edu.
Anne C BlackProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, the United States of America; VA Connecticut Healthcare System, West Haven, CT, the United States of America.
Lauretta E GrauProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Yale School of Public Health, New Haven, CT, the United States of America.
Hsiu-Ju LinSchool of Social Work, University of Connecticut, Storrs, CT, the United States of America; Department of Mental Health and Addiction Services, Hartford, CT, the United States of America.
Christina GreeneU.S. Food and Drug Administration, Silver Spring, MD, the United States of America.
Hana LeeU.S. Food and Drug Administration, Silver Spring, MD, the United States of America.
Robert HeimerProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Yale School of Public Health, New Haven, CT, the United States of America.
Kathryn E HawkProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Yale School of Public Health, New Haven, CT, the United States of America; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, the United States of America.
Gail D'OnofrioProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Yale School of Public Health, New Haven, CT, the United States of America; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, the United States of America.
David A FiellinProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Yale School of Public Health, New Haven, CT, the United States of America; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, the United States of America.
William C BeckerProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT, the United States of America; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, the United States of America; VA Connecticut Healthcare System, West Haven, CT, the United States of America.
Yale University · USYale New Haven Health System · USUnited States Food and Drug Administration · USUniversity of Connecticut · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale-Mayo FDA Center for Excellence in Regulatory Science and InnovationU01FD005938 · FDA · YALE UNIVERSITY · PI Joseph Solomon Ross · 2016 to 2026
$25.4M
Yale Drug use, Addiction and HIV Research Scholars (DAHRS)K12DA033312 · NIDA · YALE UNIVERSITY · PI Gail D'Onofrio, Patrick O'Connor · 2013 to 2026
$7.2M
FDA HHS U01 FD005938NCATS NIH HHS UL1 TR001863NIDA NIH HHS K12 DA033312
6 · The paper itself

Abstract

backgroundOpioid overdoses are a leading cause of preventable death in the United States. There is limited research linking decedents' receipt of controlled substances and presence of controlled substances on post-mortem toxicology (PMT).

methodsWe linked data on opioid-detected deaths in Connecticut between May 3, 2016, and December 31, 2017 from the Office of the Chief Medical Examiner, Department of Consumer Protection, and Department of Mental Health and Addiction Services. Exposure was defined as receipt of an opioid or benzodiazepine prescription within 90 days prior to death. Our primary outcome was concordance between medication received and metabolites in PMT.

resultsOur analysis included 1412 opioid-detected overdose deaths. 47 % received an opioid or benzodiazepine 90 days prior to death; 36 % received an opioid and 27 % received a benzodiazepine. Concordance between receipt of an opioid or benzodiazepine and its presence in PMT was observed in 30 % of opioid-detected deaths. Concordance with an opioid was present in 17 % of opioid-detected deaths and concordance with a benzodiazepine was present in 21 % of opioid-detected deaths. Receipt of an opioid or benzodiazepine and concordance with PMT were less common in fentanyl or heroin-detected deaths and more common in pharmaceutical opioid-detected deaths. DISCUSSION: Our results suggest medically supplied opioids and benzodiazepines potentially contributed to a substantial number, though minority, of opioid-detected deaths during the study period. Efforts to reduce opioid and benzodiazepine prescribing may reduce risk of opioid-detected deaths in this group, but other approaches will be needed to address most opioid-detected deaths that involved non-pharmaceutical opioids.

Indexed as

Drug OverdoseOpiate OverdoseAnalgesics, OpioidBenzodiazepinesControlled SubstancesHumansUnited StatesAnalgesics, OpioidBenzodiazepinesControlled SubstancesBenzodiazepinesOpioid overdosesOpioids

Identifiers

PMID36738634
PMCPMC9975083
OpenAlexW4318459924

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.