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Quality & safety in the literature: January 2019
  1. Ashwin Gupta1,2,
  2. Nathan Houchens1,2,
  3. Jennifer Meddings1,2,3
  1. 1 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  2. 2 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Ashwin Gupta, Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA; ashwing{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last 6 months. Some articles will focus on a particular theme, while others will highlight unique publications from high - impact medical journals.

Key points

  • Opioid-related deaths disproportionately affect males, those in lower socioeconomic classes and those with concurrent addiction or mental health disorders. Fentanyl and synthetic opioids have emerged as the new leading drugs implicated in opioid abuse and overdose in North America. BMJ. 29 Aug 2018.

  • Opioid-related adverse drug events in patients undergoing hospital-based procedures occur more often in older, sicker patients and those who receive higher cumulative doses and longer duration of opioids. These events are associated with deleterious quality outcomes for hospitals such as higher odds of inpatient mortality, 30-day readmission, longer length of stay and higher cost of hospitalisation. JAMA Surgery. 1 Aug 2018.

  • Following opioid overdose, pharmacological treatment with methadone maintenance therapy or buprenorphine results in decreased all-cause and opioid-related mortality. Annals of Internal Medicine. 7 Aug 2018.

Opioids now constitute a leading cause of premature death in much of the world.1 The opioid crisis has hit hardest in North America, with an exponential growth in mortality from unintentional drug overdose in the USA in the past three decades.1 2 Over 42 000 deaths in the USA annually are now attributable to opioids.3 In 2016, the opioid-related death rate per 100 000 people was 13.1 in the USA3 and 8.3 in Canada,4 with rates varying greatly by region of country. That year, North American healthcare leaders issued a call to action to …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.