News & Updates – June 12, 2013: Issue 185

Compiled & Edited by Sue Emerson – Publisher
Prior Edition: June 5, 2013
List of all News/Updates

MEDICATION-ASSISTED TREATMENT (MAT) AND OPIOID ABUSE/ADDICTION

GENERAL DRUG ADDICTION

GOVERNMENT

Medication-Assisted Treatment Of Opiate Dependence Is Gaining Favor

Cleveland ClinicThis article from the June 2013 issue of the Cleveland Clinic Journal of Medicine provides an overview of medication-assisted treatment (MAT) for opioid addiction discussing abstinence versus methadone maintenance treatment (MMT). The article also summarizes the history of MAT from the early days of MMT to the introduction of buprenorphine.

http://www.ccjm.org/content/80/6/345.full.pdf

Source: Cleveland Clinic Journal of Medicine – June 2013

New Drug-Drug Interactions in Opioid Therapy App for iPhones, iPad and Android Devices Now Available

A new tool is available that reviews the current evidence on the likelihood of drug−drug interactions between either methadone or buprenorphine and 120 commonly prescribed drugs. It is available as a website and an app for both Apple and Android devices.

The tool was created using content from the 7th Edition of ‘Drug–Drug Interactions in Opioid Therapy edited by Elinore McCance-Katz who was recently appointed Chief Medical Officer of the Substance Abuse and Mental Health Services Administration (SAMHSA). It was also peer reviewed by the European Opiate Addiction Treatment Association (Europad).

The tool is available at www.opioiddruginteractions.com.  You can use the tool online or click on the link to download the app on the Apple App Store or Google Play Store.

Source: OpioidDrugInteractions.com – April 2013

Q & A – Trends in Prescription Drug Abuse: ‘Bridging Medications’

Question: Outside of approved traditional opioid maintenance programs, I’ve heard that some drug addicts are using prescription drugs for “bridging.” What is this practice, and which prescription drugs may be involved?

Response from Michael G. O’Neil, PharmD: “The epidemic of unintended prescription drug overdoses continues to spread across the United States. The medications being abused and misused in these tragic events are often opioids and benzodiazepines.

A lesser known phenomenon involves use of other prescription medications to minimize physiologic withdrawal until individuals can obtain their next “chemical high” with their drug of choice. This practice is commonly referred to as “bridging.” Traditionally, the term “bridging” has been used in medication-assisted addiction treatment centers while stabilizing patients. Unfortunately, this terminology has gained a new meaning at the street level. Recognizing bridging behaviors may help clinicians identify patients with the disease of addiction or potential medication adverse effects.”

http://www.medscape.com/viewarticle/804740

Source: Medscape.com – May 28, 2013

Oxycodone Vaccine Passes Early Tests

In preclinical testing, a new vaccine hindered the often-abused prescription opioids oxycodone and hydrocodone from entering the brain and suppressed one of the drugs’ signature central nervous system (CNS) effects. According to vaccinologists Dr. Marco Pravetoni, Dr. Paul Pentel, and colleagues at the University of Minnesota, the findings warrant continued development of the vaccine as a potential aid in the treatment of oxycodone and hydrocodone abuse and dependence.

http://www.drugabuse.gov/news-events/nida-notes/2013/05/oxycodone-vaccine-passes-early-tests

Source: National Institute on Drug Abuse – May 28, 2013

Drug Addiction Relapse Infographic: The Revolving Door

relapse-the-revolving-door_0“One of the persistent challenges of fighting addiction is the risk of relapse, or the full return to an addictive lifestyle after an attempt to quit.”

This new infographic visually shows:

  • Rates of Drug Addiction Relapse vs. Chronic Illness
  • What Triggers a Relapse?
  • Relapse Rates by Drug
  • Factors Most Likely to Trigger Relapse
  • Demographics of Substance Abuse Treatment Admissions

http://healthworkscollective.com/107146/relapse-revolving-door

Source: HealthWorksCollective.com – June 8, 2013

Study: Many Arrested Men Use Illegal Drugs But Don’t Receive Treatment

jail“More than 60% of men arrested in five U.S. cities used at least one illegal drug, but fewer than 15% received drug treatment, a government report found.

Data from the Bureau of Justice Statistics indicate that 68% of jail inmates, 53% of state prison inmates and 46% of federal prison inmates abuse or are addicted to drugs and alcohol.”

http://www.usatoday.com/story/news/nation/2013/05/23/half-of-men-arrested-used-drugs/2356033/

Source: USAToday.com – May 23, 2013

Study: Sending Nonviolent Drug Offenders to Treatment Instead of Prison Saves Money

“When it comes to nonviolent drug offenses, systems that favor treatment over incarceration not only produce better health outcomes, they save money, too. It’s yet another example of how investing in public health and prevention yields valuable returns on investment.

In a new study published in the June issue of the American Journal of Public Health (AJPH), researchers found that California’s Substance Abuse and Crime Prevention Act, which diverts nonviolent drug offenders from the correctional system and into treatment, saved a little more than $2,300 per offender over a 30-month post-conviction period. In fact, researchers estimated more than $97 million in savings for the 42,000 offenders affected during the first year of the law’s implementation. And even though the law resulted in spending more on treatment, health care services and community service supervision, bypassing incarceration still yielded overall savings, said study co-author M. Douglas Anglin, founding director of the UCLA Drug Abuse Research Center and associate director of the university’s Integrated Substance Abuse Programs.

According to a 2009 report from California’s Legislative Analyst’s Office, incarcerating a single offender costs California approximately $49,000 per year.”

http://scienceblogs.com/thepumphandle/2013/05/24/study-sending-nonviolent-drugs-offenders-to-treatment-instead-of-prison-saves-money/

Source: Scienceblogs.com - May 24, 2013

Navigating the Gap: A Compelling Method for Working in the Space Between Addiction Research and Practice

“There’s a lot of work to do in MAT. Although MAT is an evidence-based practice, more and more questions are surfacing around how to deliver it in the real world to improve outcomes. Questions like:

  • How can we offer MAT to a broader population?
  • Which patients are best suited to which medications?
  • Which patients are best suited to which treatment settings?
  • What are the best guidelines to use around dose, duration, monitoring, and concurrent psychosocial treatment?

Research and practice in this area are both moving and changing quickly. Buprenorphine (Suboxone, Subutex) for opioid dependence has exploded onto the market (half a million people now use it) and has been joined by naltrexone for opioid and alcohol dependence.  Other addiction medications are right on their tails. Human testing for a cocaine vaccine is expected to begin within a year.

Amid this flurry, in the last two years, IRETA has created treatment practice guidelines in two areas—how to use buprenorphine for opioid dependence treatment and how to manage patient benzodiazepine use in MAT. We’ve been able to do that using the RAM.”

http://iretablog.org/2013/05/31/navigating-the-gap/

Source: IRETA.org – May 31, 2013

Health Law Could Overwhelm Addiction Services

health_care_reform“The number of people seeking treatment could double over current levels, depending on how many states decide to expand their Medicaid programs and how many addicts choose to take advantage of the new opportunity, according to an Associated Press analysis of government data. The analysis compared federal data on the addiction rates in the 50 states, the capacity of treatment programs and the provisions of the new health law.

The surge in patients is expected to push a marginal part of the health care system out of church basements and into the mainstream of medical care. Already, the prospect of more paying patients has prompted private equity firms to increase their investments in addiction treatment companies, according to a market research firm. And families fighting the affliction are beginning to consider a new avenue for help.”

http://www.crescent-news.com/local%20health/2013/06/09/health-law-could-overwhelm-addiction-services

Source: Crescent-News.com – June 9, 2013

News & Updates – June 5, 2013: Issue 184

June 5, 2013

Compiled & Edited by Sue Emerson – Publisher
Prior Edition: June 5, 2013
List of all News/Updates

MEDICATION-ASSISTED TREATMENT (MAT) AND OPIOID ABUSE/ADDICTION

GENERAL SUBSTANCE ABUSE ADDICTION

GOVERNMENT

American Society of Addiction Medicine Urges an End to Interference with Physician-Patient Decisions on Addiction Medications

Doctors 613The American Society of Addiction Medicine (ASAM) stated on April 30 that treatment decisions on the use of FDA-approved medications for addiction to opioids such as pain medicine and heroin should be made only by skilled physicians. Limits by governments and insurers on addiction medications can lead to patient relapse, crime, overdose and death, ASAM said in a major policy statement.

The action by the medical society of addiction specialist physicians is in response to the growing trend of state governments to place arbitrary limits contrary to medical necessity on FDA- approved addiction medications that treat opioid use disorders, including buprenorphine, buprenorphine/naloxone, extended-release injectable naltrexone and methadone. These actions by governments and some commercial payers reinforce stigmatization of the disease of addiction and prejudice against the use of addiction medications, which ASAM stated must be made available as needed by physicians treating opioid use disorder patients.

“State governments and insurers should not be involved in setting limits on types or duration of treatment for addiction,” said Stuart Gitlow, MD, ASAM President. “Governments and insurers would never interfere with physicians prescribing FDA-approved medications for any other chronic disease, such as diabetes or hypertension. Interfering with the treatment of addiction threatens the life and health of patients and disrupts families, workplaces and communities.”

ASAM’s Public Policy Statement on Pharmacological Therapies for Opioid Use Disorder stated that evidence-based treatment for opioid use disorders should be individually tailored, and usually requires chronic disease management that includes a combination of psychotherapeutic, psychosocial and pharmacological interventions. Decisions on which therapies will work best “should be made only by knowledgeable and skilled physicians, in whom patients have placed their trust and well-being,” the statement said.

Some people with opioid addiction can maintain long-term recovery through psychosocial treatment alone, but others cannot. For these people, research shows that FDA-approved addiction medications can significantly reduce death from overdose.

“Every effort should be made by the patient, the treatment provider, policy-makers and payers to maintain the optimal level of treatment for patients with an opioid use disorder, for the benefit of the patient, their family, the community and our society,” the ASAM statement said.

In addition, the statement said, arbitrary limits on the number of addiction patients who can be treated by a physician or the number and variety of therapies used by addiction medicine physicians should not be imposed by law or insurance practices. Currently, federal laws limit the number of opioid-dependent patients that physicians can treat with buprenorphine in an office- based setting.

“There’s no scientific basis for current limitations on addiction medications and specialist physicians who prescribe them,” Gitlow said. “These limits, and the public stigmatization of addiction medications that they arouse, are costing the lives of patients who relapse and overdose.”

ASAM recently launched a year-long project, Advancing Access to Addiction Medications, to analyze the effectiveness of medications used to treat opioid use disorder and to survey public and private payers to identify policies that limit patient access to these medications and policies that offer optimal medication benefits. The initiative will result in a major research and policy report, expected to be released this summer, which will provide the most extensive examination to date of the efficacy of opioid dependence pharmacotherapies and public policies regarding these medications. For more information about opioid dependence therapy and about this effort, please visit http://www.accesstoaddictionmedications.org/.

http://www.prweb.com/releases/2013/4/prweb10681365.htm

Source: PRWeb.com – April 30, 2013

Medication-Assisted Treatment for Substance Use Disorders: Research and Practice Training Session

SAMHSAThis full-day training session will precede the 75th Annual Meeting of the College on Problems of Drug Dependence, which will be held June 15–20, 2013 at the Hilton Bayfront Hotel in San Diego from 8:30 AM to 4:30 AM. Registration and CEUs are free.

Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA), the training will provide practitioners, clinicians, clinical supervisors, healthcare providers, researchers, and other participants the opportunity to learn the latest information and best practices on medication-assisted treatment (MAT) for substance use disorders (SUDs). Nationally renowned researchers and experts will present on topics such as:

  • Pain management and prescription opioid addiction.
  • Agonist and antagonist medications to treat opioid dependence.
  • Adolescents and young adults—treatment for opioid abuse.
  • Veterans and MAT.
  • Smoking cessation with SUD patients.
  • Integrating MAT and primary care.
  • A state’s response to prescription drug abuse.
  • A county’s approach to MAT.
  • Integrating MAT into a 12-step program.

This training will provide information on how MAT is being used to improve opioid dependence treatment outcomes, across a variety of settings and populations.

Register at: http://www.seiservices.com/samhsa/cpdd2013/Registration.aspx
Source: The Substance Abuse Mental Health Services Administration and the National Institute on Drug Abuse – May 2013

Terminating an Addicted Employee

Question: “We have an employee who is a chronic prescription drug abuser. He has not been performing at work but every time we try to terminate him for cause, he immediately enters a drug rehabilitation program in order to avoid termination under the ADA, claiming that he has a disability. Does the ADA require that we keep this under-performing employee on our payroll just because he is enrolled in a drug rehabilitation program?

Answer: No, it does not. Although an employee’s status as an alcoholic or a recovering drug addict may merit protection under the ADA in certain circumstances, including when the employee is in rehabilitation and is no longer using, an employee or job applicant is not “a qualified individual with a disability” if he or she is “currently engaging in the illegal use of drugs.”

For a detailed explanation go to: http://www.hreonline.com/HRE/view/story.jhtml?id=534355361

Source: Human Resource Executive – May 22, 2013

As DSM-5 Launches, the Drama Ends and the Effects Begin

“The newest edition of psychiatry’s “bible” of diagnosis, the DSM-5, made its long-awaited appearance on May 18 at the opening of the American Psychiatric Association’s (APA) national conference in San Francisco. This revision of the DSM-IV took the APA more than a decade to produce, and unprecedented criticism dogged it most of the way.

Because of the unique role the DSM-5 plays in the diagnosis of addiction—and, as a result, its influence on the allocation of billions of dollars for research, prevention and treatment—The Fix has devoted extensive coverage in recent months to the controversies. Now, with the book launched and the dust settling, we turn our attention to two questions about short- and long-term consequences, and what people with substance use problems stand to gain or lose:

• Will treatment for addiction become more accessible for more people?

• Will research into addiction produce more effective diagnostics and drugs?”

http://www.thefix.com/content/dsm-5-diagnosis-mental-health-addiction-controversy8434

Source: TheFix.com – May 21, 2013

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