Applying principles of injury and infectious disease control to the opioid mortality epidemic in North America: critical intervention gaps.


Journal

Journal of public health (Oxford, England)
ISSN: 1741-3850
Titre abrégé: J Public Health (Oxf)
Pays: England
ID NLM: 101188638

Informations de publication

Date de publication:
23 11 2020
Historique:
received: 12 03 2019
revised: 13 08 2019
accepted: 02 11 2019
pubmed: 12 12 2019
medline: 29 6 2021
entrez: 12 12 2019
Statut: ppublish

Résumé

North America has been experiencing an acute and unprecedented public health crisis involving excessive and increasing levels of opioid-related overdose mortality. In the present commentary, we examine current interventions (as existent mainly in Canada) to date and compare them against established intervention frameworks and practices in other areas of public health, specifically injury and infectious disease control. We observe that current interventions focusing on opioid drug safety or exposure-specifically those that focus on distinctly potent and toxic opioid products driving major increases in overdose mortality-may be considered the equivalent of 'agent-' or 'vector'-based interventions. Such interventions have been largely neglected in favor of 'host' (e.g., drug user-oriented) or 'environmental' measures among strategies to reduce opioid-related overdose, likely contributing to the limited efficacy of current measures. We explore potential reasons, implications and remedies for these gaps in the overall public health strategy employed towards improved interventions to reduce opioid-related health harms.

Identifiants

pubmed: 31822889
pii: 5671801
doi: 10.1093/pubmed/fdz162
pmc: PMC7685850
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

848-852

Subventions

Organisme : CIHR
ID : SMN-139150
Pays : Canada
Organisme : CIHR
ID : SAF-94814
Pays : Canada

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health.

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Auteurs

Benedikt Fischer (B)

Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.

Michelle Pang (M)

Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.

Mark Tyndall (M)

British Columbia Centre for Disease Control (BCCDC), Vancouver, BC, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.

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