Maxwell Krieger

Maxwell Krieger
Brown University · Department of Epidemiology

BSc

About

20
Publications
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479
Citations

Publications

Publications (20)
Article
Background The overdose epidemic has been exacerbated by a dramatic increase in deaths involving illicitly manufactured fentanyl (IMF). Drug checking is a novel strategy to identify IMF in illicit drugs. We examined the uptake and acceptability of rapid fentanyl test strips among young adults. Methods From May to September 2017, we recruited 93...
Article
Full-text available
Background: Synthetic opioid overdose mortality among young adults has risen more than 300% in the USA since 2013, primarily due to the contamination of heroin and other drugs with illicitly manufactured fentanyl. Rapid test strips, which can be used to detect the presence of fentanyl in drug samples (before use) or urine (after use), may help inf...
Article
Background We conducted an epidemiological investigation of fentanyl and non-fentanyl overdose deaths in Rhode Island to inform overdose prevention efforts. Methods All drug overdose deaths occurring in Rhode Island between January 1, 2014 and September 30, 2016 were included. Overdose circumstances and decedent characteristics were ascertained fr...
Article
Full-text available
Objectives: To identify payments that involved opioid products from the pharmaceutical industry to physicians. Methods: We used the Open Payments program database from the Centers for Medicare and Medicaid Services to identify payments involving an opioid to physicians between August 2013 and December 2015. We used medians, interquartile ranges,...
Article
Despite the increasing contribution of heroin and illicitly manufactured fentanyl to opioid-related overdose deaths in the United States, 40% of deaths involve prescription opioids.¹ Prescription opioids are commonly the first opioid encountered in a trajectory toward illicit consumption.² Although opioid prescribing has declined nationally, rates...
Article
Background Rates of fatal opioid overdose in Massachusetts (MA) and Rhode Island (RI) far exceed the national average. Community-based opioid education and naloxone distribution (OEND) programs are effective public health interventions to prevent overdose deaths. We compared naloxone distribution and opioid overdose death rates in MA and RI to iden...
Article
Predictors of opioid overdose death in neighborhoods are important to identify, both to understand characteristics of high-risk areas and to prioritize limited prevention and intervention resources. Machine learning methods could serve as a valuable tool for identifying neighborhood-level predictors. We examined statewide data on opioid overdose de...
Article
Background and aims: In light of the accelerating drug overdose epidemic in North America, new strategies are needed to identify communities most at risk to prioritize geographically the existing public health resources (e.g., street outreach, naloxone distribution efforts). We aimed to develop PROVIDENT (Preventing Overdose using Information and...
Article
Intro Understanding sex differences in toxicological etiologies of opioid-related drug overdose death could inform future sex- and gender-specific approaches to prevention and treatment. Methods A retrospective review of accidental or undetermined opioid-involved overdose deaths in Rhode Island 2016-2019 was performed using the Rhode Island Depart...
Article
Full-text available
Background Multiple areas in the United States of America (USA) are experiencing high rates of overdose and outbreaks of bloodborne infections, including HIV and hepatitis C virus (HCV), due to non-sterile injection drug use. We aimed to identify neighbourhoods at increased vulnerability for overdose and infectious disease outbreaks in Rhode Island...
Article
Purpose: Drug overdose mortality remains a public health concern in many countries globally. In the US, overdoses involving synthetic opioids are the primary contributor to overdose mortality. We aimed to assess trends in overdose death due to synthetic opioids among young people and describe key demographic and temporal changes. Methods: Data fro...
Article
Background Buprenorphine is a unique μ-opioid receptor partial agonist with avid receptor binding, nominal euphoric reward, and a ceiling effect on sedation and respiratory depression. Despite a pharmacologic profile that enhances safety, cases of fatal opioid overdose with buprenorphine on postmortem toxicology are reported, but details of these c...
Article
Full-text available
Use of prescription stimulants doubled from 2006 to 2016 in the United States¹ and, as of 2013, it resulted in more pharmaceutical expenditures for children than any other medication class.² Although the rise in stimulant use parallels increasing attention-deficit/hyperactivity disorder diagnosis rates, stimulants, even when appropriately prescribe...
Technical Report
Full-text available
The current drug overdose crisis is causing a rise in infectious diseases. Our team at Brown University worked with the Rhode Island Department of Health to understand the state's risk for an outbreak of new HIV or hepatitis C infections. We needed new tools to help identify an outbreak if it occurred. Using these tools, we can establish resources...
Article
Full-text available
Background In light of the accelerating and rapidly evolving overdose crisis in the United States (US), new strategies are needed to address the epidemic and to efficiently engage and retain individuals in care for opioid use disorder (OUD). Moreover, there is an increasing need for novel approaches to using health data to identify gaps in the casc...
Article
Full-text available
Background: From 2011 to 2016, the United States has experienced a 55% increase in overall overdose deaths and a 260% increase in fatal fentanyl-related overdoses. Increasing engagement in harm reduction practices is essential to reducing the rate of fentanyl-related overdoses. This study sought to examine the uptake of harm reduction practices amo...
Article
Full-text available
The authors regret that the Abstract was not published with this article. The abstract for this article is as follows: Background: U.S. opioid overdose deaths have increased five-fold since 1999. In 2014, two Rhode Island emergency departments (EDs) began providing take-home naloxone and peer recovery coach consultation to patients identified at r...
Article
Full-text available
Background In 2016, drug overdose deaths exceeded 64,000 in the United States, driven by a sixfold increase in deaths attributable to illicitly manufactured fentanyl. Rapid fentanyl test strips (FTS), used to detect fentanyl in illicit drugs, may help inform people who use drugs about their risk of fentanyl exposure prior to consumption. This quali...
Article
Background U.S. opioid overdose deaths have increased five-fold since 1999. In 2014, two Rhode Island emergency departments (EDs) began providing take-home naloxone and peer recovery coach consultation to patients identified at risk of opioid overdose. Similar programs have been initiated throughout the country, but patient outcomes of ED naloxone...

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Projects

Projects (3)
Project
Building off of RAPIDS II, a pilot study assessing whether fentanyl test strips were a convenient and feasible harm reduction study, this clinical trial will test the efficacy of fentanyl test strips to prevent fatal and non-fatal overdose among people who use drugs in Rhode Island. We will evaluate if incorporating fentanyl testing into a theory-driven overdose education program reduces rates of overdose compared to a standard overdose education and naloxone distribution training.
Archived project
In response to the need for novel intervention to address fentanyl-related overdose, this study will determine whether rapid fentanyl testing strips can decrease overdose among adults. From May - September 2017, we enrolled 93 young adults in Rhode Island with self-reported drug use to participate in this pilot study aimed at understanding the efficacy and acceptability of rapid fentanyl test strips.
Project
In response to Rhode Island’s overdose epidemic, we developed a collaborative, statewide online “dashboard” to communicate real-time overdose related data, promote transparency, and track the state’s strategic plan for reducing overdose mortality. The web site—www.PreventOverdoseRI.org (PORI)—offers user-friendly data visualizations, plain language education, and interactive resource maps. Development of the site has improved overdose data sharing and transparency in Rhode Island.