News & Updates – November 5, 2012: Issue 174

More Addictions Treated with Drug Therapy

Ambulatory visits for opioid use disorders rose six-fold between 2001-2003 and 2007-2009 (P=0.004), but treatment with pharmacotherapy rose at a similar rate (P<0.001), Joseph Frank, MD, of Brigham & Women’s Hospital, and colleagues wrote in a research letter in the Archives of Internal Medicine. That increase was driven largely by greater use of buprenorphine (Subutex, Suboxone) to treat opioid addiction, they wrote.

Visits for opioid abuse rose six-fold, from 772,000 to 4.4 million. In the beginning of that time period, opioid abuse accounted for 7% of all substance use disorder visits, but by the end of the study period, it accounted for a quarter (P=0.004).

http://www.medpagetoday.com/Psychiatry/Addictions/35492

Source: MedPageToday.com – October 22, 2012

Methadone Protects Injected Drug Users from HIV Infection

Methadone reduces risk of HIV infection in people who inject drugs, a new study says.

Researchers analyzed previous research on opioid substitution therapy (OST) and HIV transmission available from countries like the USA, Canada, UK, Netherland, Austria, Italy, Thailand, Puerto Rico, etc. A total of nine studies were selected for the analysis. The studies were mostly conducted on men between the ages of 26 and 39 years.

Researchers found that OST reduced the risk of HIV infection by 54 percent. Absolute reduction in HIV risk was difficult to calculate because the study participants had different risk backgrounds. However, researchers found an association between OST use and lower HIV risk.

http://www.medicaldaily.com/articles/12552/20121006/methadone-protects-injected-drug-users-hiv-infection.htm

Source: MedicalDaily.com – October 6, 2012

Reckitt to Discontinue Suboxone Tablets in U.S.

Reckitt Benckiser plans to withdraw its Suboxone heroin treatment tablets in favor of a film version in the United States over the next six months due to the higher risk of children getting hold of the tablets.

The press release can be accessed at: http://www.rb.com/site/RKBR/Templates/MediaInvestorsGeneral2.aspx?pageid=1328&cc=GB

See related Blog: http://janaburson.wordpress.com/2012/09/30/reckitt-benckiser-to-stop-manufacturing-suboxone-tablets/

Source: Reuters.com – September 25, 2012

As Prescription Painkiller Overdoses Mount, Researchers Outline Effective Approaches to Curb Epidemic

Prescription painkillers are responsible for more fatal overdoses in the U.S. than heroin and cocaine combined. And while most states have programs to curb abuse and addiction, a new report from Brandeis University shows that many states do not fully analyze the data they collect.

Experts from the Prescription Drug Monitoring Program (PDMP) Center of Excellence at Brandeis University’s Heller School for Social Policy and Management systematically assessed prescription drug monitoring programs and found a patchwork of strategies and standards. Their report also outlines best practices that all U.S. states and territories can use to improve their effectiveness.

Among the study’s primary conclusions: prescription drug monitoring programs should shift from a reactive to a proactive approach.

“Being proactive is the key to success in the fight against prescription painkiller abuse,” said John L. Eadie, Director, PDMP Center of Excellence at the Heller School for Social Policy and Management, Brandeis University. “While doctors may routinely collect and report data to a state program that signals where and when prescription painkillers are likely being misused, the program might not share that information with others who can best use it.”

The press release can be accessed at: http://www.pewhealth.org/news-room/press-releases/as-prescription-painkiller-overdoses-mount-researchers-outline-effective-approaches-to-curb-epidemic-85899418402

The full report can be accessed at: http://www.pewhealth.org/reports-analysis/reports/prescription-drug-monitoring-programs-an-assessment-of-the-evidence-for-best-practices-85899418404

Source: PewTrusts.org – September 20, 2012

Decrease in Nonmedical Use of Prescription Drugs Among U.S. Residents Fueled by Decrease in Pain Reliever Use

While the nonmedical use of prescription drugs continues to be the second most commonly used illicit drug among U.S. residents, the number of past year users recently declined for the first time since 2008 (see CESAR FAX, Volume 21, Issue 40). According to data from the National Survey on Drug Use and Health (NSDUH), the decline was driven by a decrease in the nonmedical use of pain relievers. In 2011, 14.7 million U.S. residents reported the nonmedical use of prescription pain relievers, down from the most recent peak of 16.5 million in 2006.

Decreases in nonmedical use of pain relievers occurred among youth (12 to 17 years old) as well as young adults (18 to 25), while use among adults ages 26 or older has remained unchanged for the past ten years (data not shown). The only other prescription drug to decrease from 2010 to 2011 was the nonmedical use of sedatives, which decreased from 906,000 to 526,000—primarily due to a decrease in use by adults ages 26 or older.

Estimated Number (in thousands) of Past Year Users of Prescription Drugs Used Nonmedically,
U.S. Residents Ages 12 and Older, 2002-2011

Need to insert chart

The difference between the 2010 and 2011 estimate is statistically significant at p < 0.05.

NOTES: While the NSDUH (previously named the National Household Survey on Drug Abuse) has been conducted since 1971, the survey underwent several methodological improvements in 2002 that affected prevalence estimates. As a result, the 2002 through 2010 estimates are not comparable with estimates before 2002.

Nonmedical Use of Prescription Drugs is defined as use of pain relievers, tranquilizers, stimulants, and/or sedatives without a prescription belonging to the respondent or use that occurred simply for the experience or feeling the drug caused. It does not include the use of over-the-counter drugs.

The complete survey findings are available on the SAMHSA website at: http://www.samhsa.gov/data/NSDUH/2k11Results/NSDUHresults2011.pdf

Source: CesarFax.com – October 15, 2012

New American Society for Addiction Medicine (ASAM) Advocacy Paper – The Impact of Managed Care on Addiction Treatment

In a document issued in September, ASAM acknowledged that “the current opioid abuse and opioid overdose epidemic in the U.S. is real and it is undoubtedly the cause of increased morbidity and mortality that has surpassed the numbers of people that have been killed as a result of motor vehicle accidents over the past several years. ASAM noted that “while there are many contributing factors involved, the interface of access to appropriated addiction treatment and affordability for the same is fertile ground to begin to plant the seeds for solutions.”

“It is now time that the treatment and managed care communities examine the issues on the treatment side of the equation and develop policies that will lead to better access to clinically indicated treatment and better treat outcomes with patients who suffer from opiate and other addictions.”

ASAM also advocated that “insurers should not dictate or restrict the dosages or length of opioid maintenance treatment that are well established and determined to be efficacious, and in line with the best practices recommendations by the FDA and other agencies (CSAT, NIDA, and NQF) solely to manage cost concerns.”

http://www.asam.org/docs/advocacy/2012-9-25_nj-opiate-document.pdf?sfvrsn=2

Source: American Society for Addiction Medicine – September 25, 2012

Get Ready Now for Influx of Patients under Affordable Care Act, Expert Urges

“Substance abuse treatment providers must take steps now to get ready for the influx of new patients they will begin to see in January 2014 as a result of the Affordable Care Act, according to an expert speaking at the National Conference on Addiction Disorders. Most behavioral health providers have not yet adequately begun to prepare for the “huge tsunami” of new patients, says Ron Manderscheid, PhD, Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors.”

http://www.drugfree.org/join-together/addiction/get-ready-now-for-influx-of-patients-under-affordable-care-act-expert-urges?utm_source=Join+Together+Daily&utm_campaign=47b42b3b96-JT_Daily_News_Get_Ready_Now_for_Influx&utm_medium=email

Source: JoinTogether.org – October 9, 2012

Dear Mr. President: A Modest Proposal No need to debate this: Treating addiction as a disease is America’s greatest single opportunity to reduce costs to taxpayers, improve health and reduce crime.

“Although Obama and Romney don’t agree on much, they both say that reducing the budget is a priority. What neither candidate realizes (or acknowledges) is a substantial cut that’s hiding in plain sight: call addiction a disease. Taking this simple step would not only reduce the federal tab, it also would cut state and local spending, lower crime, traffic accidents, suicides, domestic violence, homelessness, birth defects and a host of other devastating and costly health and social ills. This relatively simply policy change also would improve the health and productivity of Americans across the country. It’s a no-brainer.”

http://www.thefix.com/content/addiction-disease-obama-romney-proposal70014?page=all

Source: TheFix.com: October 8, 2012

How Would the Candidates Debate Drugs?

In round 2 of the Obama vs. Romney debates there were no questions about drugs. The Fix surveyed their columnists and contributing writers for the top five drug questions they would ask Obama and Romney.

What follows is what they told us, along with an at-a-glance comparison of the two candidates’ positions, based on what they have said or done.

  • As president, would you support the disease model of addiction and, if so, would you reallocate funding so that these medical matters have a bigger share of the pie?
  • As president, how would you address this growing epidemic among our soldiers and veterans?
  • As president, what policies would you support to insure that the benefits of our current drug laws outweigh the costs?
  • As president, how would you prosecute a more effective effort to reduce drug trafficking and drug use?
  • As president, what would your policy be regarding the legalization or decriminalization of marijuana?

http://www.thefix.com/content/drugs-drug-war-presidential-debate8997

Source: TheFix.com – October 15, 2012

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