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  1. AU="Pustz, Jennifer"
  2. AU="McEntagart, Meriel M"
  3. AU=Zou X AU=Zou X
  4. AU="Benyus, Janine"
  5. AU=Siddiqui Ruqaiyyah AU=Siddiqui Ruqaiyyah
  6. AU="Ruf, Hans-Georg"
  7. AU="Laginestra, Maria Antonella"
  8. AU="Novak, Jeff M"
  9. AU="Singh, Suvir"
  10. AU="Cannon, Carolyn L"
  11. AU="Hamidi, Mohammad"
  12. AU="Alam, Md Noor A"
  13. AU="Yang, Panting"
  14. AU="Jeff Lewis"
  15. AU=Carbone Antonino
  16. AU="Walker, Naomi"
  17. AU="Alaskar, Turki M"
  18. AU=Hofstra Julia M
  19. AU="Françoise Baldi"
  20. AU="Chen, Zipeng"
  21. AU=Bilinski Alyssa
  22. AU="Honboh, Takuya"
  23. AU=Dobie David Robertson
  24. AU=Gagnon R F
  25. AU="Suthaharan, Praveen"
  26. AU=Freeman Alexandra F
  27. AU="Szabo, Gergo"

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  1. Artikel ; Online: Perspectives of opioid prescribers in overdose hotspots and coldspots, Massachusetts, 2019.

    Santelices, Claudia / Pustz, Jennifer / Chase, Charlotte / Kim, Ja Young / Stopka, Thomas J

    Substance use & misuse

    2023  Band 58, Heft 8, Seite(n) 1069–1074

    Abstract: Background: Prescription opioids (POs) have had a devastating effect on people and public health systems in the U.S. Due to the urgency and complexity of the opioid crisis, there is a need to expand qualitative research on the medical community's ... ...

    Abstract Background: Prescription opioids (POs) have had a devastating effect on people and public health systems in the U.S. Due to the urgency and complexity of the opioid crisis, there is a need to expand qualitative research on the medical community's perspectives on opioid prescribing practices and the role that prescription drug monitoring programs (PDMPs) have played in mitigating this crisis.
    Methods: We conducted qualitative interviews with clinicians (
    Results: Respondents consistently recognized the role clinicians played in the opioid crisis and reported reductions in their opioid prescribing, which were motivated by the crisis itself. The limitations of opioids in pain management were frequently discussed. While clinicians appreciated having greater awareness of their opioid prescribing and increased access to patient prescription histories, they also expressed concerns about surveillance of their prescribing and other unintended consequences. We observed that clinicians in opioid prescribing hotspots had more detailed and specific reflections on their experiences with the Massachusetts PDMP, MassPAT.
    Conclusion: Clinician perceptions of the severity of the opioid crisis in Massachusetts and thoughts on their role as prescribers were consistent across specialty, prescribing level, and practice location. Many clinicians in our sample cited use of the PDMP as an influence on their prescribing. Those practicing in opioid overdose hotspots had the most nuanced reflections about the system.
    Mesh-Begriff(e) Humans ; Analgesics, Opioid/therapeutic use ; Practice Patterns, Physicians' ; Drug Overdose/epidemiology ; Prescription Drug Monitoring Programs ; Massachusetts
    Chemische Substanzen Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2023-04-19
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1310358-1
    ISSN 1532-2491 ; 1082-6084
    ISSN (online) 1532-2491
    ISSN 1082-6084
    DOI 10.1080/10826084.2023.2201840
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Relationships between places of residence, injury, and death: Spatial and statistical analysis of fatal opioid overdoses across Massachusetts.

    Pustz, Jennifer / Srinivasan, Sumeeta / Larochelle, Marc R / Walley, Alexander Y / Stopka, Thomas J

    Spatial and spatio-temporal epidemiology

    2022  Band 43, Seite(n) 100541

    Abstract: Understanding the factors associated with where people who use opioids live, where their fatal overdoses occur, and where deaths are recorded can improve our knowledge of local risk environments and inform intervention planning. Through geospatial ... ...

    Abstract Understanding the factors associated with where people who use opioids live, where their fatal overdoses occur, and where deaths are recorded can improve our knowledge of local risk environments and inform intervention planning. Through geospatial analyses of death certificate data between 2015 and 2017, we found that a majority of opioid-involved fatal overdoses in Massachusetts occurred at home. Age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI], 1.02-1.04), living in a census tract with a higher percentage of crowded households (AOR, 1.04; 95% CI, 1.01-1.08), households without vehicles (AOR, 1.01; 95% CI, 1.00-1.02), and Hispanic ethnicity (AOR, 0.56; 95% CI, 0.42-0.74) were independently associated with fatal overdose at home. Using geographically weighted regression, we identified locations where these associations were stronger and could benefit most from home-based and culturally sensitive overdose prevention efforts, including expanded overdose education and naloxone distribution.
    Mesh-Begriff(e) Humans ; Opiate Overdose ; Odds Ratio ; Research Design ; Drug Overdose/epidemiology ; Massachusetts/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2022-10-10
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ZDB-ID 2515896-X
    ISSN 1877-5853 ; 1877-5845
    ISSN (online) 1877-5853
    ISSN 1877-5845
    DOI 10.1016/j.sste.2022.100541
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Spatial access to buprenorphine-waivered prescribers in the HEALing communities study: Enhanced 2-step floating catchment area analyses in Massachusetts, Ohio, and Kentucky.

    Shrestha, Shikhar / Lindstrom, Megan R / Harris, Daniel / Rock, Peter / Srinivasan, Sumeeta / Pustz, Jennifer C / Bayly, Ric / Stopka, Thomas J

    Journal of substance use and addiction treatment

    2023  Band 150, Seite(n) 209077

    Abstract: Introduction: The opioid overdose epidemic continues to impact a large swath of the population in the US. Medications for opioid use disorders (MOUD) are an effective resource to combat the epidemic; however, there is limited research on MOUD treatment ... ...

    Abstract Introduction: The opioid overdose epidemic continues to impact a large swath of the population in the US. Medications for opioid use disorders (MOUD) are an effective resource to combat the epidemic; however, there is limited research on MOUD treatment access that accounts for both supply of and demand for services. We aimed to examine access to buprenorphine prescribers in the HEALing Communities Study (HCS) Wave 2 communities in Massachusetts, Ohio, and Kentucky during 2021, and the association between buprenorphine access and opioid-related incidents, specifically fatal overdoses and opioid-related responses by emergency medical services (EMS).
    Methods: We calculated Enhanced 2-Step Floating Catchment Area (E2SFCA) accessibility indices for each state, as well as Wave 2 communities in each state, based on the location of providers (buprenorphine-waivered clinicians from the US Drug Enforcement Agency Active Registrants database), population-weighted centroids at the census block group level, and catchment areas defined by the state or community's average commute time. In advance of intervention initiation, we quantified the opioid-related risk environment of communities. We assessed gaps in services by using bivariate Local Moran's I analysis, incorporating accessibility indices and opioid-related incident data.
    Results: Massachusetts Wave 2 HCS communities had the highest rates of buprenorphine prescribers per 1000 patients (median: 165.8) compared to Kentucky (38.8) and Ohio (40.1). While urban centers in all three states had higher E2SFCA index scores compared to rural communities, we observed that suburban communities often had limited access. Through bivariate Local Moran's I analysis, we identified numerous locations with low buprenorphine access surrounded by high opioid-related incidents, particularly in communities that surrounded Boston, Massachusetts; Columbus, Ohio; and Louisville, Kentucky.
    Conclusion: Rural communities demonstrated a great need for additional access to buprenorphine prescribers. However, policymakers should also direct attention toward suburban communities that have experienced significant increases in opioid-related incidents.
    Mesh-Begriff(e) Humans ; Buprenorphine/therapeutic use ; Analgesics, Opioid/therapeutic use ; Ohio/epidemiology ; Kentucky/epidemiology ; Opiate Substitution Treatment ; Massachusetts/epidemiology
    Chemische Substanzen Buprenorphine (40D3SCR4GZ) ; Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2023-05-19
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ISSN 2949-8759
    ISSN (online) 2949-8759
    DOI 10.1016/j.josat.2023.209077
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  4. Artikel ; Online: Methods for jurisdictional vulnerability assessment of opioid-related outcomes.

    Shrestha, Shikhar / Bayly, Ric / Pustz, Jennifer / Sawyer, Jared / Van Handel, Michelle / Lingwall, Cailyn / Stopka, Thomas J

    Preventive medicine

    2023  Band 170, Seite(n) 107490

    Abstract: In 2020, an estimated 2.7 million people in the US had opioid use disorder, increasing their risk of opioid-related morbidity and mortality. While jurisdictional vulnerability assessments (JVA) of opioid-related outcomes have been conducted previously in ...

    Abstract In 2020, an estimated 2.7 million people in the US had opioid use disorder, increasing their risk of opioid-related morbidity and mortality. While jurisdictional vulnerability assessments (JVA) of opioid-related outcomes have been conducted previously in the US, there has been no unifying methodological framework. Between 2019 and 2021, we prepared ten JVAs, in collaboration with the Council of State and Territorial Epidemiologists, the Centers for Disease Control and Prevention, and state public health agencies, to evaluate the risk for opioid-involved overdose (OOD) fatalities and related consequences. Our aim is to share the framework we developed for these ten JVAs, based on our study of the work of Van Handel et al. from 2016, as well as a summary of 18 publicly available assessments of OOD or associated hepatitis C virus infection vulnerability. We developed a three-tiered framework that can be applied by jurisdictions based on the number of units of analysis (e.g., counties, ZIP Codes, census tracts): under 10 (Tier 1), 10 to <50 (Tier 2), and 50 or more (Tier 3). We calculated OOD vulnerability indices based on variable ranks, weighted variable ranks, or multivariable regressions, respectively, for the three tiers. We developed thematic maps, conducted spatial analyses, and visualized service provider locations, drive-time service areas, and service accessibility relative to OOD risk. The methodological framework and examples of our findings from several jurisdictions can be used as a foundation for future assessments and help inform policies to mitigate the impact of the opioid overdose crisis.
    Mesh-Begriff(e) Humans ; Analgesics, Opioid/adverse effects ; Opioid-Related Disorders/epidemiology ; Hepatitis C ; Opioid Epidemic ; Drug Overdose/drug therapy
    Chemische Substanzen Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2023-03-22
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2023.107490
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  5. Artikel ; Online: Food Choice With Economic Scarcity and Time Abundance: A Qualitative Study.

    Folta, Sara C / Anyanwu, Oyedolapo / Pustz, Jennifer / Oslund, Jennifer / Penkert, Laura Paige / Wilson, Norbert

    Health education & behavior : the official publication of the Society for Public Health Education

    2021  Band 49, Heft 1, Seite(n) 150–158

    Abstract: Consumers with low income in the United States have higher vulnerability to unhealthy diets compared with the general population. Although some literature speculates that scarcity is an explanation for this disparity, empirical evidence is lacking. We ... ...

    Abstract Consumers with low income in the United States have higher vulnerability to unhealthy diets compared with the general population. Although some literature speculates that scarcity is an explanation for this disparity, empirical evidence is lacking. We conducted a qualitative study of food choice to explore whether scarcity-related phenomena, such as tunneling and bandwidth tax, may contribute to unhealthy dietary choices. We used participant-driven photo elicitation (
    Mesh-Begriff(e) Choice Behavior ; Diet ; Food ; Food Preferences ; Food Supply ; Humans ; Poverty ; United States
    Sprache Englisch
    Erscheinungsdatum 2021-10-12
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1362906-2
    ISSN 1552-6127 ; 1090-1981
    ISSN (online) 1552-6127
    ISSN 1090-1981
    DOI 10.1177/10901981211045926
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  6. Artikel ; Online: Opioid-Involved Overdose Vulnerability in Wyoming: Measuring Risk in a Rural Environment.

    Pustz, Jennifer / Shrestha, Shikhar / Newsky, Sarah / Taylor, Melissa / Fowler, Leslie / Van Handel, Michelle / Lingwall, Cailyn / Stopka, Thomas J

    Substance use & misuse

    2022  Band 57, Heft 11, Seite(n) 1720–1731

    Abstract: Background: Between 2009 and 2019 opioid-involved fatal overdose rates increased by 45% and the average opioid dispensing rate in Wyoming was higher than the national average. The opioid crisis is shaped by a complex set of socioeconomic, geopolitical, ... ...

    Abstract Background: Between 2009 and 2019 opioid-involved fatal overdose rates increased by 45% and the average opioid dispensing rate in Wyoming was higher than the national average. The opioid crisis is shaped by a complex set of socioeconomic, geopolitical, and health-related variables. We conducted a vulnerability assessment to identify Wyoming counties at higher risk of opioid-related harm, factors associated with this risk, and areas in need of overdose treatment access to inform priority responses.
    Methods: We compiled 2016 to 2018 county-level aggregated and de-identified data. We created risk maps and ran spatial analyses in a geographic information system to depict the spatial distribution of overdose-related measures. We used addresses of opioid treatment programs and buprenorphine providers to develop drive-time maps and ran 2-step floating catchment area analyses to measure accessibility to treatment. We used a straightforward and replicable weighted ranks approach to calculate final county vulnerability scores and rankings from most to least vulnerable.
    Findings: We found Hot Springs, Carbon, Natrona, Fremont, and Sweetwater Counties to be most vulnerable to opioid-involved overdose fatalities. Opioid prescribing rates were highest in Hot Springs County (97 per 100 persons), almost two times the national average (51 per 100 persons). Statewide, there were over 90 buprenorphine-waivered providers, however accessibility to these clinicians was limited to urban centers. Most individuals lived further than a four-hour round-trip drive to the nearest methadone treatment program.
    Conclusions: Identifying Wyoming counties with high opioid overdose vulnerabilities and limited access to overdose treatment can inform public health and harm reduction responses.
    Mesh-Begriff(e) Analgesics, Opioid/therapeutic use ; Buprenorphine/therapeutic use ; Drug Overdose/epidemiology ; Humans ; Opiate Overdose ; Opioid-Related Disorders/drug therapy ; Practice Patterns, Physicians' ; Wyoming
    Chemische Substanzen Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ)
    Sprache Englisch
    Erscheinungsdatum 2022-08-17
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1310358-1
    ISSN 1532-2491 ; 1082-6084
    ISSN (online) 1532-2491
    ISSN 1082-6084
    DOI 10.1080/10826084.2022.2112229
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  7. Artikel ; Online: Applied risk mapping and spatial analysis of address-level decedent data to inform opioid overdose interventions: The Massachusetts HEALing Communities Study.

    Pustz, Jennifer / Srinivasan, Sumeeta / Shrestha, Shikhar / Larochelle, Marc R / Walley, Alexander Y / Samet, Jeffrey H / Babakhanlou-Chase, Hermik / Carpenter, Jane F / Stopka, Thomas J

    Drug and alcohol dependence

    2023  Band 251, Seite(n) 110947

    Abstract: Background: Death certificate data provide powerful and sobering records of the opioid overdose crisis. In Massachusetts, where address-level decedent data are publicly available upon request, mapping and spatial analysis of fatal overdoses can provide ... ...

    Abstract Background: Death certificate data provide powerful and sobering records of the opioid overdose crisis. In Massachusetts, where address-level decedent data are publicly available upon request, mapping and spatial analysis of fatal overdoses can provide valuable insights to inform prevention interventions. We describe how we used this approach to support a community-level intervention to reduce opioid-involved overdose mortality.
    Methods: We developed a method to clean and geocode decedent data that substituted injury locations (the likely location of fatal overdoses) for deaths recorded in hospitals. After geomasking for greater privacy protection, we created maps to visualize the spatial distribution of decedent residence addresses, alone and juxtaposed with drive and walk-time distances to opioid treatment programs (OTPs), and place of death by overdose address. We used spatial statistical analyses to identify locations with significant clusters of overdoses.
    Results: In the 8 intervention communities, 785 individuals died from opioid-involved overdoses between 2017 and 2020. We found that 19.7% of fatal overdoses were recorded in hospitals, 50.2% occurred at the decedent's residence, and 30.1% at another location. We identified overdose hotspots in study communities. By juxtaposing decedent residence data with drive- and walk-time analyses, we highlighted actionable spatial gaps in access to OTP treatment.
    Conclusion: To better understand local fatal opioid overdose risk environments and inform the development of community-level prevention interventions, we used publicly available address-level decedent data to conduct nuanced spatial analyses. Our approach can be replicated in other jurisdictions to inform overdose prevention responses.
    Sprache Englisch
    Erscheinungsdatum 2023-08-23
    Erscheinungsland Ireland
    Dokumenttyp Journal Article
    ZDB-ID 519918-9
    ISSN 1879-0046 ; 0376-8716
    ISSN (online) 1879-0046
    ISSN 0376-8716
    DOI 10.1016/j.drugalcdep.2023.110947
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel: Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017.

    Sawyer, Jared L / Shrestha, Shikhar / Pustz, Jennifer C / Gottlieb, Robert / Nichols, Deborah / Van Handel, Michelle / Lingwall, Cailyn / Stopka, Thomas J

    Preventive medicine reports

    2021  Band 24, Seite(n) 101538

    Abstract: The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled ... ...

    Abstract The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-related and socioeconomic indicators from publicly available state and federal sources. First, we assessed the spatial distribution of opioid-related indicators in a geographic information system (GIS). Next, we used a novel regression-weighted ranking approach with mean standardized covariates and an opioid-involved overdose mortality outcome to calculate county-level vulnerability scores. Finally, we examined accessibility to opioid use disorder treatment services and opioid response programs at the census tract-level (n = 1511) using two-step floating catchment area analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, unemployment rate, and percent of female-led households were independently and positively associated with opioid-involved overdose mortality (p < 0.05). We identified high-risk counties across the rural-urban continuum and primarily in east central Indiana. We found that only one of the 19 most vulnerable counties was in the top quintile for treatment services and had naloxone provider accessibility in all of its census tracts. Findings from our vulnerability assessment provide local-level context and evidence to support and inform future public health policies and targeted interventions in Indiana in areas with high opioid overdose vulnerability and low service accessibility. Our approach can be replicated in other state and local public health jurisdictions to assess opioid-involved public health vulnerabilities.
    Sprache Englisch
    Erscheinungsdatum 2021-08-27
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2785569-7
    ISSN 2211-3355
    ISSN 2211-3355
    DOI 10.1016/j.pmedr.2021.101538
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