Addiction Treatment Forum reports on substance abuse news of interest to opioid treatment programs and patients in methadone maintenance treatment.

newsAT Forum NEWS NOTES & UPDATES #131

May 2009

Compiled & Edited by Sue Emerson - Publisher

Prior Edition: April 2009

List of all News/Updates

 

Contents

MEDICATION-ASSISTED TREATMENT

SAMHSA and FDA Introduce Public Education Safety Campaign on Methadone

2009 AATOD QTc Session Recap by Andrew Byrne, MD

NIATx Announces Opioid Treatment Provider Process Improvement Project

A First – New York Nursing Home Hopes to Open Satellite Methadone Clinic

SAMHSA Issues Clarification Letter on Buprenorphine Prescribing in OTPs

GOVERNMENT

New Drug Czar Disavows Drug 'War'

Obama Retains Ban on Federal Funding of Needle Exchange

New Report Issued on Prescription Drug Threat Assessment

NIDA Updates Principles Of Drug Addiction Treatment Guide

NIDA Releases April Issue of Addiction Science & Clinical Practice

RESEARCH

Pain and the Nonmedical Use of Prescription Opioids

Stigma Increases Likelihood That Female Drug Users Reoffend



MEDICATION-ASSISTED TREATMENT

SAMHSA and FDA Introduce Public Education Safety Campaign on Methadone

The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Food and Drug Administration (FDA) launched an initiative on April 28 to help ensure the safe use of methadone. The campaign responds to concerns about an escalating number of poisoning deaths linked to the improper use of this medication.

The public outreach effort, Follow Directions: How to Use Methadone Safely, is designed to inform consumers, health care professionals and treatment clinics about the safe use and misuse of the drug for both pain relief and drug addiction treatment.

Outreach materials about methadone for the public and health care professionals include a brochure, a poster and a fact sheet, available in English and Spanish. A point-of-sale information sheet will also be distributed in pharmacies where methadone is dispensed to pain management patients.

To learn more information about the campaign, visit www.dpt.samhsa.gov/methadonesafety

Source: SAMHSA – April 28, 2009

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session recap2009 AATOD QTc Session Recap by Andrew Byrne, MD

On May 20, Andrew Byrne, MD posted an informal recap of the April AATOD Conference that was held in New York City on his website. Of particular interest, is his coverage of the much anticipated session on QTc. Dr. Byrne was one of four speakers and panelists on a workshop/panel discussion on cardiac issues related to patients on methadone maintenance. You can access his AATOD meeting recap at:
http://www.redfernclinic.com/c/2009/05/new-york-addiction-conference-april.php4

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NIATx Announces Opioid Treatment Provider Process Improvement Project

Up to 30 opioid treatment providers will be selected to learn the NIATx model of process improvement. NIATx helps providers improve access to and retention in treatment for their patients by using process improvement methods to achieve the four NIATx aims:

Funded by CSAT, this year-long project begins in August 2009. The application deadline is June 12, 2009.

To learn more information about this project visit: https://www.niatx.net/Content/ContentPage.aspx?NID=445

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A First – New York Nursing Home Hopes to Open Satellite Methadone Clinic

The Riverdale Press reported on May 20, that a Westchester New York hospital and Kingsbridge nursing home hope to partner to open a satellite methadone clinic at the nursing home this Fall. The satellite clinic would initially serve 45 people who currently have to travel from the nursing home to the hospital to obtain their weekly doses.

Mary O’Mara, a vice president at St. Joseph’s hospital said that Medicaid spends $50,000 a year annually to shuttle the patients between the nursing home and hospital. The proposed satellite clinic would have a registered nurse on site seven days/week, counselors would be available five days/week, and there would be a part-time clerical staff member.

The article can be accessed at: http://riverdalepress.com/full.php?sid=8663&current_edition=2009-05-21

Source: The Riverdale Press – May 20, 2009

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SAMHSA Issues Clarification Letter on Buprenorphine Prescribing by Physicians in OTPs

The Substance Abuse and Mental Health Services Administration (SAMHSA) and Drug Enforcement Administration (DEA) issued a Dear Colleague letter on April 27, in response to requests for clarification regarding a physician's prescribing authority for buprenorphine in an Opioid Treatment Program (OTP). Key points of the clarification letter include:

The Dear Colleague letter can be accessed at: http://buprenorphine.samhsa.gov/DrClg-SubRx-0409.pdf

Source: SAMHSA – April 27, 2009

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GOVERNMENT

New Drug Czar Disavows Drug 'War'

The Obama administration's new 'drug czar' says he is open to a fundamental rethinking of the nation's approach to preventing illicit-drug use and wants to cast aside the language of war in describing the effort, the Wall Street Journal reported May 14.

"Regardless of how you try to explain to people it's a 'war on drugs' or a 'war on a product,' people see a war as a war on them," said Gil Kerlikowske, recently confirmed as the director of the Office of National Drug Control Policy (ONDCP). "We're not at war with people in this country."

Kerlikowske said that the Obama administration wants to focus on drug use as a public-health problem, with an increased emphasis on providing addiction treatment as an alternative to incarceration.

"While I don't necessarily disagree with Gil's focus on treatment and demand reduction, I don't want to see it at the expense of law enforcement," said James Pasco, executive director of the Fraternal Order of Police. "People need to understand that when they violate the law there are consequences."

Kerlikowske said he doesn't support legalization but is in favor of needle-exchange programs, which he said were "part of a complete public-health model for dealing with addiction."

Source: JoinTogether.org - May 14, 2009

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Obama Retains Ban on Federal Funding of Needle ExchangeObama Retains Ban on Federal Funding of Needle Exchange

Failing to keep a campaign promise, President Barack Obama has decided to keep in place a ban on using federal money to support needle-exchange programs, the Huffington Post reported May 7.

Obama's budget plan, released last week, still includes language prohibiting federal funding for needle exchanges, even though the White House website stated until very recently that, "The President ... supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users."

That statement has been removed from the White House website; an Obama spokesperson cast the issue as one of timing, not intent. "We have not removed the ban in our budget proposal because we want to work with Congress and the American public to build support for this change," said spokesperson Ben LaBolt. "We are committed to doing this as part of a National HIV/AIDS strategy and are confident that we can build support for these scientifically based programs."

However, Tom Angell, a spokesperson for the group Law Enforcement Against Prohibition, said it was "hard to imagine how removing mention of support for a proven lifesaving program from the White House website is part of a grand strategy to 'build support' for syringe exchange."

Source: JoinTogether.org - May 12, 2009

See related Time magazine article “Why Obama Isn't Funding Needle-Exchange Programs” by Maia Szalavitz from May 16: http://www.time.com/time/nation/article/0,8599,1898073,00.html?xid=rss-topstories

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reportNew Report Issued on Prescription Drug Threat Assessment

The Office of National Drug Control Policy (ONDCP), released a report on the diversion and abuse of prescription drugs on May 20. The report shows unintentional deaths involving prescription opioids increased 114 percent from 2001 to 2005, and treatment admissions increased 74 percent in a similar four-year period.

The National Prescription Drug Threat Assessment (NPDTA) was prepared by the National Drug Intelligence Center (NDIC) in conjunction with the Drug Enforcement Administration (DEA). It synthesizes reports and data from law enforcement and public health officials to evaluate the threat posed by the distribution, diversion, and abuse of controlled prescription drugs in the U.S.

Key Findings

The full press release can be accessed at: http://www.whitehousedrugpolicy.gov/news/press09/052009.html

The National Prescription Drug Threat Assessment 2009 can be accessed at: http://www.usdoj.gov/ndic/pubs33/33775/index.htm

Source: Office of National Drug Control Policy - May 20, 2009

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NIDA guideNIDA Updates Principles Of Drug Addiction Treatment Guide

The National Institute on Drug Abuse (NIDA) released an updated edition of their popular 80-page guide on drug addiction. Principles of Drug Addiction Treatment (2nd Edition) is intended to address addiction to a wide variety of drugs, including nicotine, alcohol, and illicit and prescription drugs. It is designed to serve as a resource for health care providers, family members, and other stakeholders trying to address the myriad of problems faced by patients in need of treatment for drug abuse or addiction. The guide addresses frequently asked questions and evidence-based approaches to addiction treatment.

The updated guide can be accessed at : http://www.nida.nih.gov/PODAT/PODATIndex.html

Source: National Institute on Drug Abuse – April 17, 2009

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Addiction Science & Clinical Practice April IssueNIDA Releases April Issue of Addiction Science & Clinical Practice

This issue features three articles on drug abuse and the criminal justice system.

The April 2009 issue can be accessed at: http://www.nida.nih.gov/ascp/index.html

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RESEARCH

perscription opioidsPain and the Nonmedical Use of Prescription Opioids

This population-based survey* collected demographic, psychiatric, and substance use data from 42,734 U.S. adults to determine whether nonmedical use of prescription opioids is driven by untreated pain. Respondents were questioned about past-year nonmedical use of prescription opioids and the extent to which pain interfered with their activities of daily living (i.e., low, moderate, high). Primary findings were as follows:

*The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Comments by James Harrison, MHS, CADC: This study helps raise clinician awareness that individuals who meet criteria for opioid abuse/dependence may have untreated pain. Pain and unhealthy alcohol use should be assessed in patients reporting nonmedical use of prescription opioids. This study was limited to adults only; it is not known if link between physical pain and nonmedical prescription analgesic use exists among youth.

Reference: Novak SP, Herman-Stahl M, Flannery B, et al. Physical pain, common psychiatric and substance use disorders, and the non-medical use of prescription analgesics in the United States. Drug Alcohol Depend. 2009;100(1–2):63–70.

Source: JoinTogether.org – Treatment Practitioner’s Research Bulletin - March 2009

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female drug usersStigma Increases Likelihood That Female Drug Users Reoffend

Research published in the journal Substance Abuse Treatment, Prevention, and Policy reveals how legal punishment, withdrawal of services and social stigmatization encourage a return to drug use, increased criminal activity and ultimately re-incarceration.

Juliana van Olphen from San Francisco State University led a team of researchers who held focus groups and conducted semi-structured interviews with 17 women who had recently left jail. She said, "After carrying out this research, our conclusion was that punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for users and former users to live a normal life and reintegrate into society".

The kind of policies the authors refer to include the federal ban on food stamps for people convicted of a drug offense and the "one strike, you're out" policy by which first-time drug offenders are evicted from public housing. According to van Olphen, "These policies have adversely and disproportionately affected women, especially poor women, ruining their chances of finding employment, housing or education upon release".

The researchers found that a central theme throughout women's narratives revolved around the double stigma of being a drug user and having a history of incarceration. While the stigmas are created to act as a deterrent to drug use, they often actually promote it by limiting the options of the victims of the 'War on Drugs'. The authors conclude, "In the future, launching campaigns to reduce the intersecting stigmas of drug use and incarceration may enhance the effectiveness of reintegration services while also assisting women leaving jail to find the support they need for successful reintegration into their families and communities".

The article can be accessed at: http://www.substanceabusepolicy.com/content/pdf/1747-597x-4-10.pdf

Source: Nowhere to go: How stigma limits the options of female drug users after release from jail Juliana E van Olphen, Michele J Eliason, Nicholas Freudenberg and Marilyn Barnes Substance Abuse Treatment, Prevention, and Policy (in press)

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Notice:

All facts and opinions are those of the sources cited. News reports may have been edited for length and/or modified for clarity without altering essential data as originally published.

Addiction Treatment Forum and its associates do not endorse any medications, products, or treatments described, mentioned, or discussed in any of the sources referenced. Nor are any representations made concerning efficacy, appropriateness, or suitability of any such products or treatments. This News Update is made possible by an educational grant from Mallinckrodt Inc., distributors of methadone and naltrexone.

In view of the possibility of human error or advances in medical knowledge, Addiction Treatment Forum and its associates do not warrant the information contained in the above news updates is in every respect accurate or complete, and they are not responsible nor liable for any errors or omissions that may be found in such information or for results obtained from use of such information.