News & Updates – November 29, 2012: Issue 175

Benzodiazepine & MAT Conference Videos Available From IRETA

On February 9, 2012 the Philadelphia Department of Behavioral Health and Intellectual Disability Services, the Institute for Research, Education, and Training in Addictions (IRETA), and Community Care Behavioral Health hosted a kickoff conference in Philadelphia that will lead to working guidelines for the management of benzodiazepines in medication-assisted treatment.

Recorded presentations from the conference are now available to view online. Experts in the field discuss local rates of concurrent use, the perspective of primary care, pregnancy, patient education, co-occurring disorders, and more. A total of 18 videos are available to view including: 

  • Jane C. Maxwell, PhD: Epidemiology, Morbidity and Mortality for Benzodiazepine Use
  •  James Schuster, MD, MBA: Rates of Benzodiazepine Use in Medication-Assisted Treatment
  •  Laura F. McNicholas, MD, PhD: Clinical Management of the Benzodiazepine-dependent Patient
  •  Karol Kaltenbach, PhD: Benzodiazepines and the Pregnant Patient: Special Challenges
  •  Peter R. Cohen, MD: Guidelines for Treating OMT Patients with Benzodiazepines

Source: Institute for Research, Education, and Training in Addictions – November 2012

Blog: Benzos at the Opioid Treatment Program

“Should patients in opioid treatment programs ever be approved to take benzodiazepines? Even addiction medicine doctors hold widely varying opinions on this issue. In my state (North Carolina), all of the doctors who work in opioid treatment programs are invited to participate in a conference call once per month. The people who head the state’s methadone authority and the Governor’s Institute on Substance Abuse are also usually on the call. We discuss difficult issues we’re facing, and discuss difficult cases. Last month, the question was asked pointedly by one of the doctors: “Is zero-tolerance for benzodiazepines now the standard of care for opioid treatment programs in our state?” For the people on this call, the consensus was that the ideal was zero tolerance or at least a restricted policy regarding benzodiazepine use.”

The blog is available at:

Source: Janaburson’s Blog – November 3, 2012

Blog: PTSD at the Opioid Treatment Program

“As in other studies, this study shows addiction and post-traumatic stress disorder (PTSD) are related, but we still don’t know which comes first. Does addiction put people in dangerous situations that are likely to become traumatic? Does drug use impair judgment about how to avoid dangerous situations? Or does the PTSD cause addiction, because patients with PTSD have unpleasant feelings, and drugs provide temporary relief from unpleasant feelings?

The blog is available at:

Source: Janaburson’s Blog – November 10, 2012

The Beginning of the End of the Abstinence Rule?

“The reaction to the news last week that Hazelden will be using medication-assisted treatment—including the maintenance drug, buprenorphine (Suboxone), potentially indefinitely for some patients—has been intense. “Hell froze over,” one tweeter responded, expressing shock that the granddaddy of abstinence-based treatment could make such a big change. “It’s about time,” said Dr. Charles O’Brien, director of the University of Pennsylvania’s prestigious Center for Studies on Addiction, and one of the field’s most eminent researchers. The head of the National Institute on Drug Abuse, Dr. Nora Volkow, also praised the decision.”

Source: – November 8, 2012

Perspective: Docs Feel Pressure to Give Addicts Opioids

doctors“A push to treat chronic pain and financial disincentives for treating addiction may pressure clinicians into prescribing opioids for patients who are already addicted, a researcher suggested.

Over the past decade, there’s been a perfect storm of changing clinician attitudes toward pain treatment and patient attitudes towards suffering, combined with a lack of compensation for time-consuming clinic visits such as addiction counseling, Anna Lembke, MD, of Stanford University, wrote in a perspective in the New England Journal of Medicine.”

The full perspective can be accessed at:

Source: – October 24, 2012

U.S. Addiction Diagnoses up 70 Percent

“The number of drug and alcohol problems diagnosed by US doctors increased by 70% in the first decade of the 2000s, reveals a new study, just as painkiller abuse in the country reached an all-time high. The number of visits involving a diagnosis of opioid painkiller abuse multiplied nearly sixfold in that time frame: from 772,000 to 4.4 million.

The study has its bright spots, however. Prescriptions aimed at treating drug and alcohol addiction have also increased drastically: from 643,000 between 2001 and 2003 to 3.9 million between 2007 and 2009. And the increase in diagnoses means that more people are seeking treatment for addiction, from medications such as methadone, to talk therapy.” (Note: the link is subject to change since it is in the news archives section of the website)

Source: – October 23, 2012

New Infographic From NIDA – Maternal Opiate Use and Newborns Suffering From Opiate Withdrawal Are On The Rise in The U.S.

Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). A new study to determine the extent, context, and costs of NAS found that incidence of NAS is rising in the US. The proportion of babies born with NAS tripled from 2000 to 2009, when an estimated 13,539 infants were born with NAS —equivalent to one baby suffering from opiate withdrawal born every hour.

The number of delivering mothers using or dependent on opiates rose even more—nearly five-fold—from 2000 to 2009, to an estimated 23,009. In 2009, newborns with NAS stayed in the hospital an average of 16.4 days (compared to 3.3. days for other newborns), costing hospitals an estimated $720 million; the majority of these charges (77.6%) were paid by state Medicaid programs, reflecting the greater tendency of opiate-abusing mothers to be from lower-income communities. The rising frequency (and costs) of drug withdrawal in newborns points to the need for measures to reduce antenatal exposure to opiates.

The full text description can be accessed at:

Source: National Institute on Drug Abuse

Commentary by Dr. Joseph Shrand: Drug Addiction is Not a Moral Failing

“There is an unfortunate tradition of being angry and disgusted at people who are addicted to heroin. Seeing addiction as a moral failing, these folks become outraged that our government spends their tax dollars on treating people who knew from the start they were using an addictive drug, in essence telling them they were on their own and we should not be spending a dime to help them. Their addiction was their fault and they were stuck with it. If those repelled by the addict had their way, all of these people would be cast aside to rot.”

Source: – November 17, 2012

Slide Show: The Brain Scans of Addiction, Unscrambled

“These slides are meant as a primer on some of the biggest stories to have emerged in addiction neuroimaging, and the insights they give. Of course, these examples are only a thin sliver of the available science—and scientists are still grappling with addiction’s overwhelming complexity. Without dismissing other relevant brain systems or equally important socio-cultural and environmental influences, our focus here is the striatum: a set of structures heavily involved in reward, motivation, habit formation—and the brain’s dopamine system.”

Source: – November 15, 2012

Blog: Why Addiction is NOT a Brain Disease

“Attempts to define addiction in concrete scientific terms have been highly controversial and are becoming increasingly politicized. What IS addiction? We as scientists need to know what it is, if we are to have any hope of helping to alleviate it.

There are three main definitional categories for addiction: a disease, a matter of choice, and self-medication. There is some overlap among these meta-models, but each has unique implications for treatment, from the level of government policy to that of available options for individual sufferers.”

Source: – November 12, 2012

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