News & Updates – March 11, 2014; Issue 197

Viewpoint: Confronting the Stigma of Opioid Use Disorder—and Its Treatment Published Online in Journal of the American Medical Association

jama-logoIncreasing numbers of overdoses from prescription opioids and a more recent increase in heroin-associated fatalities have caused heartbreak in communities across the country.

Given the severity of this national epidemic, it is time to confront the stigma associated with opioid use disorder and its treatment with medications. By limiting the availability of care and by discouraging people who use opioids from seeking effective services, this stigma is impeding progress in reducing the toll of overdose.

Health care practitioners can counter stigma by adopting accurate, nonjudgmental language to describe this disorder, those it affects, and its therapy with medications. States can promote the provision of comprehensive health services in opioid treatment programs and expand access to effective therapies in the criminal justice system. The public can fight back against the rising threat of overdose by supporting broad access to effective treatment with medications.”

Viewpoint by Yngvild Olsen, MD, MPH; Joshua M. Sharfstein, MD

http://jama.jamanetwork.com/article.aspx?articleID=1838170

Source: The Journal of the American Medical Association – Online February 26, 2014

Blog by William L. White: Waiting For Breaking Good: The Media and Addiction Recovery

“The major media outlets have long been chastised for the content and style of their coverage of alcohol- and drug-related problems.  Such criticisms include the glamorization of drug use, the demonization of drug users, and charges that the media is complicit in ineffective drug policies.  Few have raised parallel concerns that popular media coverage of addiction recovery is rare, often poorly selected, and told through a lens that does little to welcome the estranged person back into the heart of community life.  If media representatives do not “get it” (“it” being recovery), then what precisely is it that they don’t get?  What are the mistold and untold stories and their personal and public consequences to which media leaders ought to be held accountable?

Having closely observed such coverage for nearly half a century, I would offer twelve points from the perspective of a long-tenured recovery advocate.”

Blog available at: http://www.williamwhitepapers.com/blog/2014/03/waiting-for-breaking-good-the-media-and-addiction-recovery.html

The 5-page paper can we accessed at: http://www.williamwhitepapers.com/pr/2014%20The%20Media%20and%20Addiction%20Recovery.pdf

Source: WilliamWhitePapers.com – March 1, 2014

Doctors Urge FDA to Reverse Approval of Zohydro, Controversial New Pain Drug

zoA coalition of addiction experts, physicians and others is urging U.S. health officials to reverse course and block the launch of a powerful painkiller called Zohydro, expected to hit the market next month. The opioid drug, manufactured by Zogenix Inc, contains a potent amount of an active ingredient that could be lethal to new patients and children and is not safer than other current pain drugs, the groups told the Food and Drug Administration.

In December, attorneys general from 28 states also urged the FDA to reconsider its approval of the drug.”

http://www.nydailynews.com/life-style/health/docs-urge-fda-halt-launch-controversial-pain-drug-article-1.1706470

Source: New York Daily News – February 28, 2014

Killing Pain: Fewer Opioid Scripts

prescriiption pad“Doctors and other health providers wrote about 11 million fewer prescriptions for narcotic painkillers in 2013 than in 2012, but some experts expected a bigger drop-off given the brighter spotlight on the nation’s opioid epidemic.

In 2013, there were 230 million prescriptions for opioids such as Vicodin, OxyContin and Percocet, according to data from IMS Health, a drug market research firm. That represents about a 5% drop from a year earlier when 241 million were written.

Opioid prescriptions had grown substantially since the 1990s. At the same time, data show an increase in use of tranquilizers, and weaker opioids such as tramadol, suggesting that Americans are mixing and matching their narcotics and trying unpredictable and dangerous combinations.”

http://www.medpagetoday.com/PainManagement/PainManagement/44499

Source: MedPageToday.com – February 26, 2014

 

Teenagers Treated for Headache Were Prescribed Opioids Almost Half of the Time, According to Study in Journal of Adolescent Health

adolescentClinicians prescribed opioids for almost half of the teenagers they treated for headache when medications, such as aspirin, ibuprofen and naproxen, are recommended as first-line therapies, according to a study today in the Journal of Adolescent Health.

The study was conducted by WellPoint and HealthCore, the outcomes research subsidiary for WellPoint a health benefits company, in conjunction with representatives selected by the American Academy of Pediatrics, American Academy of Family Physicians and American Academy of Neurology. The study included 8,373 adolescents from 13 to 17 years of age with recurring headaches.

“Pediatric and adolescent use of opioids is a concern,” said Dr. Eric Wall, past chair of the American Academy of Family Physicians’ Commission on Science. “The risk of abuse, as well as the potential for redirection, such as sharing with others, is high among adolescents.”

Forty-six percent of those complaining of headache received an opioid prescription. Of those who received a prescription, nearly half – or 48 percent — received only one prescription, while 23 percent received two prescriptions and 29 percent received three or more prescriptions.

Teenagers with visits for headache to the emergency department had twice the rate of opioid prescriptions as those who had not visited the emergency department. And, those who had three or more emergency department visits were four times more likely to have opioid prescriptions.

The study showed much higher rates of opioid prescription than rates of around 12 percent that had been reported previously.

http://www.businesswire.com/news/rxtimes/20140228005350/en/Teenagers-Treated-Headache-Prescribed-Opioids-Time-Study

Source: BusinessWire.com – February 28, 2014

AATOD Conference Photos

AATODThe American Association for the Treatment of Opioid Addiction has posted photos from their November 2013 National Conference in Philadelphia on their website. Photos include:

http://www.aatod.org/national-conference/2013-aatod-conference-philadelphia/2013-conference-photos/

Source: American Association for the Treatment of Opioid Addiction – February 26, 2014

Fewer Opioid Treatment Programs Offer HIV Testing

“According to a study, fewer opioid treatment programs are offering onsite testing for HIV and sexually transmitted infections (STIs), despite guidelines from the Centers for Disease Control and Prevention (CDC) recommending routine HIV testing in all health care settings.

The absolute number of programs offering testing for HIV, STIs, and HCV increased from 2000 to 2011. However, the percentage of programs offering HIV testing decreased significantly, by 18%, and the percentage of those offering testing for STIs fell by 13% throughout the study. Testing for each infection did not change over time in public programs, but HIV testing dropped by 20% among for-profit programs and 11% in nonprofit programs.

http://www.pharmacytimes.com/publications/issue/2014/February2014/Fewer-Opioid-Treatment-Programs-Offer-HIV-Testing

Source: PharmacyTimes.com - February 19, 2014

National Institute on Drug Abuse (NIDA) Updated Research Report on Heroin

NIDA Blog: Addiction and Free Choice

choices“The recent death of Phillip Seymour Hoffman as a result of drug addiction has provoked many thoughtful, sympathetic responses in the media, from people in recovery who understand how hard it is to wrestle with addiction, as well as from scientifically informed journalists who understand that addiction is a disease. But it has also prompted others to express the age-old notion than drug use is a choice, and that those who die as a consequence of their drug use are just reaping the consequences of their freely chosen actions. It is unfortunate that that view persists in our society, despite the decades of scientific research soundly disproving it.

Choices do not happen without a brain—it is the mechanism of choice. The quality of a person’s choices depends on the health of that mechanism. However much we may wish that a person’s choices were free in all instances, it is simply a fact that an addicted person’s failures in the realm of choice are the product of a brain that has become greatly compromised—it is readily apparent when we scan their brains. Even if taking a drug for the first time is a “free” choice, the progression of brain changes that occurs after that involves the weakening of circuits in the prefrontal cortex and elsewhere that are necessary for exerting self-control and resisting the temptations of drug use. Once addiction takes hold, there is greatly diminished capacity, on one’s own, to stop using. This is why psychiatry recognizes addiction as a disease of the brain, and why professional intervention is needed to treat it in most instances.

Moreover, even the “freely willed” first choice to take a drug cannot be the basis for judgment and stigma against people suffering from addictions. Matters of choice and lifestyle—what you eat, how active you are, where you live—may contribute to the risk for, or even directly cause, a wide range of medical conditions, including chronic diseases like heart disease, type 2 diabetes, and several cancers. We do not withhold or impede treatment of people suffering from those conditions, even if their health may have turned out differently had they made different choices at various points in their lives.

There is no way of precisely predicting which freely chosen adolescent drink, or cigarette, or experimentation with an illegal substance, opened the door to a later loss of free-choice capacity in a person who has become addicted. But once addiction is established, the sufferer from this disease cannot will themselves to be healthy and avoid drugs any more than a person with heart disease can will their heart back to perfect functioning, or a person with diabetes can will their body’s insulin response to return to normal.

Thus, those who say “it was their own choice” after a person dies of an overdose fail to grasp that an addicted person’s brain has a disrupted choice mechanism. And as revealed by Hoffman’s tragic, ultimately fatal relapse into drug taking, the neuronal disruptions in the brain of an addicted person can persist even after decades of sobriety. Speaking of “free choice” is simply not useful when trying to understand an individual’s addiction or its consequences, as addiction is precisely a disease that disrupts the neuronal circuits that enable us to exert free choice.”

http://www.drugabuse.gov/about-nida/noras-blog/2014/02/addiction-free-choice

Source: National Institute on Drug Abuse Dr. Nora Volkow Director – February 18, 2014

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