- The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years
- New Medication Formulations Could Quickly Make a Difference for Treating Opioid Addiction (Nora Volkow Director, National Institute on Drug Abuse)
- New Vaccine Could Someday Fight the Effects of Opioid Combinations
- Revising the Language of Addiction
- Can Safe Injection Sites Calm the Opioid Crisis? Critics, Proponents Battle Over Decades-Old Issue
- Hospitals Could Do More for Survivors of Opioid Overdoses, Study Suggests
- Families Seek Involuntary Commitment Laws as Key Tool in Saving Opioid Addicts
- Women Who Inject Drugs May Be at Greater Risk of HCV Than Men
- Doctors from Lower-Tier Medical Schools Prescribe Far More Opioids
- Investigation: How Many Lives Are Lost to Opioids? No One Knows.
- Journal Article: Risk of Neonatal Drug Withdrawal After Intrauterine Co-Exposure To Opioids And Psychotropic Medications: Cohort Study
LINKS TO ADDITIONAL NEWS OF INTEREST
- CDC: Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region — United States, 2006–2015 – 9/1/17
- The Hill Opinion: America’s Opioid Crisis Calls for Rethinking Federal Marijuana Ban – 8/24/17
- The New York Times Upshot: Is the Opioid Crisis a National Emergency? No (At least not officially.) – 8/24/17
- The Hill Opinion: The Heroin Gap in Opioid Tracking Is Killing Americans – 8/24/17
- Elinore F. McCance-Katz, M.D., Ph.D. Appointed Assistant Secretary for Mental Health and Substance Use
“The first governmental account of nationwide drug deaths in 2016 shows overdose deaths growing even faster than previously thought.
Drug overdoses killed roughly 64,000 people in the United States last year, according to the first governmental account of nationwide drug deaths to cover all of 2016. It’s a staggering rise of more than 22 percent over the 52,404 drug deaths recorded the previous year — and even higher than The New York Times’s estimate in June, which was based on earlier preliminary data.
Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher. Drug deaths involving fentanyl more than doubled from 2015 to 2016, accompanied by an upturn in deaths involving cocaine and methamphetamines.”
Source: NYTimes.com – September 2, 2017
New Medication Formulations Could Quickly Make a Difference for Treating Opioid Addiction (Nora Volkow Director, National Institute on Drug Abuse)
“As Francis Collins and I wrote in May, NIH and NIDA are committed to an “all scientific hands on deck” effort to end the opioid crisis in America by halving the time it takes to develop new medications to treat pain and addiction and reverse overdoses.
The goals of the new initiative range from innovative and ambitious new treatment approaches that will take some time to develop, such as vaccines or transcranial magnetic stimulation for pain and addiction, to goals that are relatively achievable in the short term, such as improved formulations of existing medications.
Effective medications are already available to treat opioid addiction—buprenorphine, methadone, and naltrexone—but only a fraction of people with opioid use disorders are being treated with them, due to limited access and treatment capacity, stigma around their use, lack of provider training, and cost. Also, for those treated, compliance tends to be low and few are retained in treatment for sufficient periods of time. New formulations of these medications that can facilitate access to treatment and improve compliance could be a real game-changer that could quickly make a dent in this crisis.”
Source: HuffingtonPost.com – August 22, 2017
Categories: Addiction, Buprenorphine, Medication-Assisted Treatment (MAT), Methadone, News Updates, Opioid Abuse/Addiction
Tags: Buprenorphine, Medication-Assisted Treatment, Methadone Treatment, naltrexone, Substance Abuse Treatment
“Substance abuse is a continuing problem in the U.S., particularly with heroin and other opioids, to the point of being an epidemic. Treatments exist, but far too often patients relapse with devastating impacts on themselves and those around them. Now, scientists report that they have made progress toward a vaccine against the effects of fentanyl, a synthetic opioid, in combination with heroin.”
Source: Eurekalert.org – August 21, 2017
When confronting the power of addiction, the power of language is important to keep in mind, specialists say.
“The Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s diagnostic handbook, describes someone struggling with addiction as having “opioid use disorder.” But many of us are more familiar with “drug abuser,” as well as the term’s negative connotations.
“It’s so hard for people to give up the ‘abuse’ word,” said Sarah Wakeman, medical director of the Substance Use Disorders Initiative and the Addiction Consult Team at Harvard-affiliated Massachusetts General Hospital (MGH), during an interview at her office.
The terms “abuse” and “abuser,” she wrote in an article published last year by the American Society of Addiction Medicine, “imply a willful misconduct and have been shown to increase stigma and reduce the quality of care.” Equally harmful, she added, is the language often applied to the most effective form of treatment.”
Source: MedicalXpress.com – August 29, 2017
“Support for establishing safe injection facilities (SIFs) — places where people can use their own illicit drugs under medical supervision — is growing in the United States, but the backlash against the model has been fierce.
Proponents of these sites, also called “safe consumption spaces” argue the facilities reduce the risk of dying from an overdose, prevent needles and other drug-related litter, and, in some instances, connect the substance users with treatment. Critics charge that the facilities are a form of government-sanctioned heroin addiction that do little to improve substance users’ quality of life.
To date, there are no legally sanctioned SIFs in the United States; however, a recent study suggests the presence of at least one unsanctioned facility in an undisclosed urban area in the U.S., according to the American Journal of Preventive Medicine (AJPM).”
Read more at: https://www.medpagetoday.com/psychiatry/addictions/67411
Source: MedPageToday.com – August 21, 2017
“To get a sense of how severe the opioid crisis is in the U.S., you can look at the number of fatal overdoses — more than 33,000 in 2015, according to the Centers for Disease Control and Prevention. That means, on average, 91 people are dying after overdosing on opioids each day. And for every fatal overdose, there are believed to be roughly 30 nonfatal overdoses.
Clinicians and researchers trying to get a handle on the epidemic look at those nonfatal experiences as opportunities to jump in and figure out whether there is overprescribing going on or whether the patient needs help getting treatment for an addiction. But a paper published Tuesday in the Journal of the American Medical Association, suggests such interventions don’t happen often enough.
“This is a time when people are vulnerable, potentially frightened by this event that’s just occurred and amenable to advice, referral and treatment recommendations,” says Julie Donohue, associate professor of health policy and management at the University of Pittsburgh and senior author of the paper. “It’s safe to characterize it as a missed opportunity for the health system to respond.”
Source: NPR.org – August 22, 2017
“Across the country, other addiction advocates and terrified parents are similarly pushing policymakers to expand the use of involuntary commitment laws as a tool to combat the opioid epidemic. It’s a controversial tactic, with logistical and constitutional implications.
“What are we locking people into, for how long, and what happens afterwards?” asked Dr. Sarah Wakeman, medical director for substance use disorders at Massachusetts General Hospital, who said studies suggest coerced treatment is not effective. “If we are going to be removing someone’s autonomy … it’s concerning if we’re doing that in a way that’s not even effective over the long term.”
But proponents argue it’s a vital, last-resort option at a time when the opioid crisis is killing more than 90 Americans every day.
Source: USAToday.com – August 23, 2017
“There is a clear body of research assessing sex and gender differences in risk behaviors among people who inject drugs, however little or no research has investigated sex differences in hepatitis C (HCV) susceptibility. A newly published analysis examining data from more than 1800 people suggests that women who inject drugs have a 38% higher risk of contracting HCV than their male counterparts. Interestingly, while sharing of syringes and other injection equipment is a significant risk factor for HCV, differences in these behaviors did not account for the higher risk among women. The research was funded by the National Institute on Drug Abuse (NIDA), part of the National institutes of Health.”
Source: DrugAbuse.gov – August 25, 2017
“A new report suggests that the rank of the medical school where a doctor received initial training may have something to do with how frequently they prescribe opioids later on.
In a report published this month, researchers from the National Bureau of Economic Research (NBER) looked at data for all opioid prescriptions written by doctors in the United States between 2006 and 2014.
Doctors who did their initial training at the lowest-ranked medical schools in the United States prescribed almost three times as many opioids each year, compared with doctors who trained at Harvard University, the top-ranked medical school.”
Source: Healthline.com – August 28, 2017
“In 2015, state officials reported at least 1,451 men, women and children died from drug overdoses in Tennessee – but that’s far from an accurate count.
There are likely hundreds more. No one knows the true number.
Drug deaths reported in Tennessee are fundamentally flawed and represent an under-count of the toll taken by opioids, the nation’s most deadly drug epidemic, a USA TODAY NETWORK-Tennessee investigation found.
Tennessee found multiple levels of breakdowns in death investigations, making it impossible to sketch the mortality rate from drug abuse or overdoses, including:
- Inconsistencies in how medical examiners, hospitals and law enforcement officials flag possible overdose deaths.
- County budget constraints that limit the number of autopsies performed.
- Incomplete or inaccurate information recorded on death certificates.
Source: Tennessean.com – August 25, 2017
Journal Article: Risk of Neonatal Drug Withdrawal After Intrauterine Co-Exposure To Opioids And Psychotropic Medications: Cohort Study
Objectives To assess the impact of in utero co-exposure to psychotropic medications and opioids on the incidence and severity of neonatal drug withdrawal.
Setting Nationwide sample of pregnancies in publicly insured women in the US, nested in the Medicaid Analytic eXtract (2000-10).
Participants 201 275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.
Interventions In utero exposure to psychotropic medications, in particular antidepressants, atypical antipsychotics, benzodiazepines, gabapentin, and non-benzodiazepine hypnotics (Z drugs), with prescriptions filled within the same time window as prescriptions for opioids.
Main outcome measure Diagnosis of neonatal drug withdrawal in infants exposed in utero to opioids and psychotropic medications compared with opioids alone.
Results The absolute risk for neonatal drug withdrawal ranged from 1.0% in infants exposed in utero to prescription opioids alone to 11.4% for those exposed to opioids co-prescribed with gabapentin. Among neonates exposed in utero to prescription opioids, the relative risk adjusted for propensity score was 1.34 (95% confidence interval 1.22 to 1.47) with concomitant exposure to antidepressants, 1.49 (1.35 to 1.63) with benzodiazepines, 1.61 (1.26 to 2.06) with gabapentin, 1.20 (0.95 to 1.51) with antipsychotics, and 1.01 (0.88 to 1.15) with Z drugs. In utero exposure to two or more psychotropic medications along with opioids was associated with a twofold increased risk of withdrawal (2.05, 1.77 to 2.37). The severity of the withdrawal seemed increased in neonates exposed to both opioids and psychotropic medications compared with opioids alone.
Conclusions During pregnancy, the use of psychotropic medications in addition to prescription opioids is common, despite a lack of safety data. The current findings suggest that these drugs could further increase the risk and severity of neonatal drug withdrawal.
Free access to the journal article can be found at: http://www.bmj.com/content/358/bmj.j3326
Source: BMJ.com – August 2017
See related article on NAS: Treating Neonatal Abstinence Syndrome: Is Faster Better? available at: http://www.medscape.com/viewarticle/884877