TY - JOUR
KW - Analgesics, Opioid/adverse effects
KW - Buprenorphine/therapeutic use
KW - Fentanyl/therapeutic use
KW - Humans
KW - Male
KW - opioid epidemic
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - United States/epidemiology
KW - Drug/mental illness
KW - Rural Health
KW - Stimulant/opioid epidemic
AU - R. A. Jenkins
A1 - 
AB - The current opioid epidemic in the United States has been characterized as having three waves: prescription opioid use, followed by heroin use, and then use of synthetic opioids (e.g., fentanyl), with early waves affecting a population that was younger, less predominantly male, and more likely to be Caucasian and rural than in past opioid epidemics. A variety of recent data suggest that we have entered a fourth wave which can be characterized as a stimulant/opioid epidemic, with mental illness co-morbidities being more evident than in the past. Stimulant use has introduced new complexities in terms of behavioral consequences (e.g., neurological deficits, suicidal ideation, psychosis, hostility, violence), available treatments, and engagement into services. These compound existing issues in addressing the opioid epidemic in rural areas, including the low density of populations and the scarcity of behavioral health resources (e.g., fewer credentialed behavioral health professionals, particularly those able to prescribe Buprenorphine). Considerations for addressing this new wave are discussed, along with the drawbacks of a wave perspective and persistent concerns in confronting drug abuse such as stigma.
AD - National Institute on Drug Abuse, Bethesda, MD, United States of America. Electronic address: jenkinsri@mail.nih.gov.
BT - Preventive medicine
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - Pt 2
CY - United States
DO - 10.1016/j.ypmed.2021.106541
IS - Pt 2
JF - Preventive medicine
LA - eng
M1 - Journal Article
N2 - The current opioid epidemic in the United States has been characterized as having three waves: prescription opioid use, followed by heroin use, and then use of synthetic opioids (e.g., fentanyl), with early waves affecting a population that was younger, less predominantly male, and more likely to be Caucasian and rural than in past opioid epidemics. A variety of recent data suggest that we have entered a fourth wave which can be characterized as a stimulant/opioid epidemic, with mental illness co-morbidities being more evident than in the past. Stimulant use has introduced new complexities in terms of behavioral consequences (e.g., neurological deficits, suicidal ideation, psychosis, hostility, violence), available treatments, and engagement into services. These compound existing issues in addressing the opioid epidemic in rural areas, including the low density of populations and the scarcity of behavioral health resources (e.g., fewer credentialed behavioral health professionals, particularly those able to prescribe Buprenorphine). Considerations for addressing this new wave are discussed, along with the drawbacks of a wave perspective and persistent concerns in confronting drug abuse such as stigma.
PP - United States
PY - 2021
SN - 1096-0260; 0091-7435
SP - 106541
T1 - The fourth wave of the US opioid epidemic and its implications for the rural US: A federal perspective
T2 - Preventive medicine
TI - The fourth wave of the US opioid epidemic and its implications for the rural US: A federal perspective
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 34482994
U3 - 10.1016/j.ypmed.2021.106541
VL - 152
VO - 1096-0260; 0091-7435
Y1 - 2021
Y2 - Nov
ER -