APA Citation:
1) Daniulaityte, R., Falck, R., Carlson, R. (2012) I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids International Journal of Drug Policy 23 p374-384
2) Kanate, D., Folk, D., Cirone, S., Gordon, J., Kirlew, M., Veale, T., Bocking, N., Rea, S., Kelly, L., (2015) Community-side measures of wellness in a remote First Nations community experiencing opioid dependence Canadian Family Physician, Vol. 61, p. 160-165
3) Meyer, R., Patel, A., Rattana, S., Quock, T., Mody, S. (2014) Prescription Opioid Abuse: A Literature Review of the Clinical and Economic Burden in the United States Population Health Management, Vol. 17, p. 372-387
Research Question:
1) What significant clinical and economic burden does opioid abuse lead to?
2) How can a small community in a remote area hold opioid-dependence treatment centers for almost half of the adult community?
3) Do prescribed drugs appeal more to drug users because they are prescribed from a doctor?
Research Design:
1) Quantitative Comprehensive literature search of MEDLINE and PubMed. Identifying 183 unique citations.
2) Quantitative measure of community wellness and response to community-based opioid-dependence treatment.
3) Qualitative sub-sample selected from a larger sample of 396 young-adults. Qualitative interviews were conducted. Mixed method design.
Target Population:
1) Opioid abusers vs non-abusers medical access.
2) 140 self-referred opioid-dependent community members
3) Young-adult non-medical users of pharmaceutical opioids.
Measurement Tools:
1) Articles were included if they were original studies that reported clinical or economic burdens associated with opioid abuse. Data abstraction focused on the relevance of the research studies.
2) Health-related data collected from 1 year before and 1 year after the buprenorphine-naloxone program. Community-wide measures collected to assess for effectiveness of the program. The data was collected by keeping track of the number of emergency calls taken, vaccination rates, child protective calls made, local police calls made, and the number of needles given out at the shelter.
3) Qualitative life history interviews-open-ended questions designed to gain perspective of the individuals’ drug using habits. Ranking tasks (ethnographic approach) given to the participants to rank the drugs used. Deductive and inductive analysis approach.
Findings:
1) The findings of the article implicated that medicare, Medicaid, the military, and other government health care paid for opioid abuse treatment in at least 80% of the population and private health insurance supplemented 30% of the population.
2) There were 41% adults receiving opioid therapy between the ages 20-50. During this substitution therapy of buprenophine-naloxone to opioid abusers, medical evacuations from the community fell by 30%. Police criminal charges fell by 61.1%, including 94.1% decrease in robbery and arson charges. During this therapy the needle distribution fell less than half its previous volume. Community members also noted the increase use of the community clinic for primary care rather than a trauma clinic. The attendance of children at the schools also increased.
3) The individuals of the studies varied from their experience of drug use. Overall, the risks associated with prescribed opioids were believed to be null and void because they “came from the doctor”, which enticed the users to use these drugs even more. Prevention and intervention education should be the major priority to reducing opioid use among young-adults.

Interventions: using alternative medications/monitoring opioid use.