TY - JOUR
KW - Adult
KW - Clinical Clerkship
KW - Curriculum
KW - Drug Overdose/prevention & control
KW - Epidemics/statistics & numerical data
KW - Female
KW - Harm Reduction
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Male
KW - Naloxone/therapeutic use
KW - Opioid-Related Disorders/epidemiology
KW - Rural Population/statistics & numerical data
KW - Surveys and Questionnaires
KW - Drug epidemic
KW - Hepatitis C
KW - Opioids
KW - rural Appalachia
KW - substance use
AU - C. A. Schalkoff
AU - K. E. Lancaster
AU - B. N. Gaynes
AU - V. Wang
AU - B. W. Pence
AU - W. C. Miller
AU - V. F. Go
A1 - 
AB - Background/aims: To examine trends in rural Appalachian opioid and related drug epidemics during the past 10 years, including at-risk populations, substance use shifts and correlates, and associated infections. Methods: We conducted this review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Seven databases were searched for quantitative studies, published between January 2006 and December 2017, of drug use, drug-related mortality, or associated infections in rural Appalachia. Results: Drug-related deaths increased in study states, and a high incidence of polydrug toxicity was noted. Rural substance use was most common among young, white males, with low education levels. A history of depression/anxiety was common among study populations. Prescription opioids were most commonly used, often in conjunction with sedatives. Women emerged as a distinct user subpopulation, with different routes of drug use initiation and drug sources. Injection drug use was accompanied by risky injection behaviors and was associated with hepatitis C. Conclusions: This review can help to inform substance use intervention development and implementation in rural Appalachian populations. Those at highest risk are young, white males who often engage in polysubstance use and have a history of mental health issues. Differences in risk factors among other groups and characteristics of drug use in rural Appalachian populations that are conducive to human immunodeficiency virus (HIV) spread also warrant consideration.
AD - Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; College of Public Health, The Ohio State University, Columbus, Ohio, USA.; Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; College of Public Health, The Ohio State University, Columbus, Ohio, USA.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; College of Public Health, The Ohio State University, Columbus, Ohio, USA.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
BT - Substance abuse
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 1
DO - 10.1080/08897077.2019.1635555
IS - 1
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Background/aims: To examine trends in rural Appalachian opioid and related drug epidemics during the past 10 years, including at-risk populations, substance use shifts and correlates, and associated infections. Methods: We conducted this review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Seven databases were searched for quantitative studies, published between January 2006 and December 2017, of drug use, drug-related mortality, or associated infections in rural Appalachia. Results: Drug-related deaths increased in study states, and a high incidence of polydrug toxicity was noted. Rural substance use was most common among young, white males, with low education levels. A history of depression/anxiety was common among study populations. Prescription opioids were most commonly used, often in conjunction with sedatives. Women emerged as a distinct user subpopulation, with different routes of drug use initiation and drug sources. Injection drug use was accompanied by risky injection behaviors and was associated with hepatitis C. Conclusions: This review can help to inform substance use intervention development and implementation in rural Appalachian populations. Those at highest risk are young, white males who often engage in polysubstance use and have a history of mental health issues. Differences in risk factors among other groups and characteristics of drug use in rural Appalachian populations that are conducive to human immunodeficiency virus (HIV) spread also warrant consideration.
PY - 2020
SN - 1547-0164; 0889-7077; 0889-7077
SP - 35
EP - 69
EP - 
T1 - The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases
T2 - Substance abuse
TI - The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 31403903
U3 - 10.1080/08897077.2019.1635555
VL - 41
VO - 1547-0164; 0889-7077; 0889-7077
Y1 - 2020
ER -