2024
Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options
Thompson R, Sabounchi N, Ali S, Heimer R, D’Onofrio G, Heckmann R. Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut’s Good Samaritan Laws and identify effective policy options. Harm Reduction Journal 2024, 21: 124. PMID: 38937759, PMCID: PMC11210010, DOI: 10.1186/s12954-024-00990-3.Peer-Reviewed Original ResearchMeSH KeywordsConnecticutDrug OverdoseHarm ReductionHealth PolicyHumansLaw EnforcementNaloxoneNarcotic AntagonistsOpiate OverdoseConceptsSamaritan lawsGood Samaritan lawsBystander behaviorGroup model buildingFear of legal consequencesKnowledge of protectionResponses to opioid overdosesCriminal liabilityDrug arrestsLegal consequencesLaw enforcementNaloxone useLawStakeholder-engaged processOpioid overdoseHealth care providersFatal opioid overdoseSustainable system changeOpioid-related outcomesBystander experiencesSamaritanCare providersHarm reductionPotential bystandersPolicy determination
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesControlled SubstancesDrug OverdoseHumansOpiate OverdoseUnited StatesConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2010
Epidemiologic trends and geographic patterns of fatal opioid intoxications in Connecticut, USA: 1997–2007
Green TC, Grau LE, Carver HW, Kinzly M, Heimer R. Epidemiologic trends and geographic patterns of fatal opioid intoxications in Connecticut, USA: 1997–2007. Drug And Alcohol Dependence 2010, 115: 221-228. PMID: 21131140, PMCID: PMC3095753, DOI: 10.1016/j.drugalcdep.2010.11.007.Peer-Reviewed Original ResearchConceptsPrescription opioidsOpioid typeIntoxication deathsRisk factorsDrug intoxication deathsHeroin-related deathsOpioid-related deathsFatal opioid overdoseChief Medical ExaminerOpioid intoxicationOpioid deathsDrug poisoningInjury deathsEpidemiologic trendsOpioid overdoseOpioidsDeath locationPrevention effortsDeathMedical examinersRegression analysisSignificant increasePublic healthEpidemiologyHeroin[The study of characteristics of overdose among users of opioid drug injections].
Iliuk R, Krupitskiĭ E, Torban M, Kozlov A, Blinnikova K, Heimer R, Green T, Grau L. [The study of characteristics of overdose among users of opioid drug injections]. Zhurnal Nevrologii I Psikhiatrii Im S S Korsakova 2010, 110: 33-43. PMID: 21322146.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidDrug OverdoseFemaleHumansInjectionsMaleOpioid-Related DisordersYoung AdultConceptsOpioid overdose riskMore health problemsNonfatal overdosesRole of alcoholDrug injectionOverdose riskEarly diagnosisComorbid disordersOverdose preventionSomatic disordersHealth problemsOverdoseLonger abstinenceMental disordersOverdose situationsDeath casesDisordersSufficient helpOverdosesAdditional predictorsFamily psychotherapyDrug qualityHigher numberDiagnosisAbstinence
2008
Social and structural aspects of the overdose risk environment in St. Petersburg, Russia
Green TC, Grau LE, Blinnikova KN, Torban M, Krupitsky E, Ilyuk R, Kozlov A, Heimer R. Social and structural aspects of the overdose risk environment in St. Petersburg, Russia. International Journal Of Drug Policy 2008, 20: 270-276. PMID: 18774283, PMCID: PMC2696401, DOI: 10.1016/j.drugpo.2008.07.002.Peer-Reviewed Original ResearchConceptsDrug usersRisk behaviorsIntervention feasibilityOpioid overdosesModerate-risk behaviorAbstinence-based treatmentMost drug usersOpioid injectorsSuboptimal responseOverdose response trainingTreatment modalitiesCommon causeOverdose riskNaloxone distributionOverdose mortalityModifiable aspectsAmbulance staffRisk environmentOverdosesTreatment providersMortalityStructural interventionsKey informant interviewsMore ambulancesInterventionDistinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States
Green TC, Heimer R, Grau LE. Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction 2008, 103: 979-989. PMID: 18422830, PMCID: PMC3163671, DOI: 10.1111/j.1360-0443.2008.02182.x.Peer-Reviewed Original Research