Exploring The Changing Intensity Of Opioid Use

12 hours ago

Illegal opioids tin create important harms, but nan grade of those harms depends connected aggregate factors, including nan magnitude consumed. In a caller study, researchers assessed whether opioid consumption intensity varies appreciably complete clip aliases context. They recovered that intensity-as opposed to prevalence-of forbidden opioid usage varies enormously. These findings person implications for supplier curen and policy.

The study, by researchers astatine Carnegie Mellon University, RAND, and nan University of Maryland, appears successful The American Journal of Drug and Alcohol Abuse.

The proviso of forbidden opioids has grown pinch nan dispersed of illegally manufactured fentanyl and different synthetic opioids (e.g., nitazenes). Legal proviso to individuals who person purchased successful forbidden markets has besides grown pinch description s successful medications for opioid usage upset and prescribed safer proviso (programs that supply medicine pharmaceutical opioids on pinch supportive services to individuals astatine precocious consequence of constituent use-related harms). Yet contempt these changes, location is small systematic monitoring of depletion intensity.

"We wanted to research whether various populations who usage opioids often devour astir nan aforesaid amounts per time of use, connected average, aliases whether location is appreciable variety from spot to spot aliases from clip to time," explains Jonathan P. Caulkins, professor of operations investigation and nationalist argumentation astatine Carnegie Mellon's Heinz College, who led nan study.

Caulkins and his coauthors searched 2 world databases (EBSCOhost and PubMed) for lit connected different kinds of users: 1) individuals who purchased opioids successful forbidden markets, 2) individuals who reported pre-existing usage upon intake into treatment, and 3) individuals pinch opioid usage upset who received opioids done nan wellness attraction system. They identified 135 applicable articles. Based connected their analysis, nan authors conclude:

Average depletion intensities alteration enormously, from beneath 100 morphine milligram equivalents (MME) per time for usage extracurricular curen programs wherever prices are high, to about 600 MME successful emblematic forbidden markets, and from 1,100 to 1,800 MME a time erstwhile proviso is free (e.g., successful heroin assisted curen and injectable hydromorphone treatment).
Individuals entering curen study higher depletion intensities than do those not connected to treatment.
Intensities person tended to beryllium higher recently, while prices person been lower.
Studies during nan fentanyl era are fewer and difficult to interpret, but propose that MMEs per time whitethorn beryllium overmuch higher than successful nan past.

Generally speaking, reported mean regular depletion tends to beryllium higher for populations pinch entree to cheaper aliases much abundant supplies. This variety and nan adaptability of depletion person respective imaginable implications, nan authors say, including:

Expansions successful proviso could person greater effects connected amount consumed than is evident erstwhile looking only astatine information connected prevalence.
Treatment protocols and overdose prevention strategies whitethorn request to set for higher baseline consumption.
Assumptions astir wellness harms from semipermanent usage whitethorn request to beryllium revisited if they are predicated connected lower, humanities depletion intensities.

The authors besides propose that epidemiological monitoring programs way mean intensities of use, not conscionable numbers of users.

There are astatine slightest 2 ways to amended our knowing of depletion intensities. One is to regularly inquire group who usage opioids astir their depletion and harvester this pinch purity accusation obtained from rule enforcement aliases supplier checking services."

Beau Kilmer, co-Director of RAND's Drug Policy Research Center and study co-author

"Another is to inquire group who usage opioids astir their spending connected opioids and harvester this pinch rule enforcement information connected supplier prices, accounting for variety successful purity."

Source:

Journal reference:

Caulkins, J. P., et al. (2025). Historical and contextual variety successful regular opioid depletion rates: implications for proviso control, work delivery, and research. The American Journal of Drug and Alcohol Abuse. doi.org/10.1080/00952990.2025.2504147

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