Addiction Treatment Forum reports on substance abuse news of interest to opioid treatment programs and patients in methadone maintenance treatment.
Researchers have identified a possible new target for the development of a vaccine against the hepatitis C virus (HCV).
Such a vaccine — which could help control the growing global problem of HCV infection – has been difficult to come by because the virus’s constant mutations have thwarted previous attempts to attack it.
Link to article abstract: http://www.pnas.org/content/early/2012/04/03/1114927109.abstract
Source: medpagetoday.com – April 6, 2012
The Centers for Disease Control and Prevention (CDC) reported I February that the hepatitis C virus (HCV) now kills more Americans annually than HIV, the virus that causes AIDS. Most of the deaths occur in middle-aged adults — 3% of baby boomers are infected — and about half of people infected don’t know they have the virus.
Healthland spoke with Dr. John Ward, who heads the CDC’s effort to fight hepatitis C, about who is at risk of infection, how the disease is really spread and why it’s important to know your hepatitis C status now.
http://healthland.time.com/2012/02/23/qa-what-you-need-to-know-about-hepatitis-c/#ixzz1oYgLQSw9
Source: Healthland.time.com – February 23, 2012
TIP 53: Addressing Viral Hepatitis in People with Substance Use DisordersThis TIP was developed to assist behavioral health professionals who treat people with substance abuse problems in understanding the implications of a diagnosis of hepatitis. The TIP discusses screening, diagnosis, and referrals and explains how to evaluate a program’s hepatitis practices.
http://atforum.com/addiction-resources/documents/TIP53.pdf
TIP 54 was developed to help equips clinicians with practical guidance and tools for treating chronic pain in adults with a history of substance abuse. The document discusses chronic pain management, including treatment with opioids, and offers information about substance abuse assessments and referrals.
http://www.atforum.com/addiction-resources/documents/TIP54.pdf
Source: The Substance Abuse and Mental Health Services Administration – December 2011 & January 2012
Deaths from liver-destroying hepatitis C are on the rise, and new data shows baby boomers especially should take heed – they are most at risk.
Federal health officials are considering whether anyone born between 1945 and 1965 should get a one-time blood test to check if their livers harbor this ticking time bomb. The reason: Two-thirds of people with hepatitis C are in this age group, most unaware that a virus that takes a few decades to do its damage has festered since their younger days.
http://www.huffingtonpost.com/2012/02/21/hepatitis-c-deaths-up-bab_0_n_1290469.html
Source: Huffingtonpost.com – February 21, 2012
Opiate users on methadone maintenance therapy can be successfully treated for chronic hepatitis C and can achieve outcomes similar to those of people not on methadone, according to data presented at the 13th European AIDS Conference in Belgrade.
Shared use of injection drug equipment is a major risk factor for both HIV and hepatitis C virus (HCV) infection; an estimated 30% of people with HIV also have hepatitis C. But some clinicians have been reluctant to treat active or former drug users for hepatitis C, largely due to concern about suboptimal adherence and poor outcomes.
Karin Neukam from Hospital Universitario de Valme in Seville, Spain, and colleagues compared treatment response amongst 214 hepatitis C patients – a majority of them injection drug users – who started treatment with pegylated interferon plus ribavirin between January 2003 and May 2010. Just over one-third of participants (38%) were on methadone maintenance while 62% were not.
Most participants were men (88% in the methadone group, 77% in the non-methadone group) and the average age was about 42 years. About 25% in both arms were HIV-positive. Methadone recipients were slightly less likely to have the favorable IL28B “CC” gene pattern and more likely to have liver cirrhosis, but were significantly less likely to have hard-to-treat hepatitis C genotypes 1 or 4.
Almost all participants in both study groups reported 80% or better adherence to hepatitis C therapy. Rates of sustained virological response (SVR) – or continued undetectable HCV viral load 24 weeks after completion of treatment – were similar in the methadone and non-methadone groups.
“The efficacy of HCV therapy in methadone maintenance therapy patients is similar to that found in subjects not taking methadone,” the researchers concluded. “Methadone maintenance therapy patients should be equally considered for treatment with pegylated interferon plus ribavirin.”
These findings indicate that methadone maintenance should not be considered a contraindication to hepatitis C treatment.
http://www.aidsmap.com/People-on-methadone-can-succeed-on-hepatitis-C-treatment/page/2107408/
Original Source: Neukam K et al. Methadone maintenance therapy does not influence on the outcome of chronic hepatitis C treatment with pegylated interferon and ribavirin. 13th European AIDS Conference, PS7/5, Belgrade, 2011.
Source: NAM AidsMap – October 18, 2011
Treatment is the only way out of the spiral of opiate addiction, doctors say. But it isn’t cheap.
MaineCare payments for all substance abuse treatment totaled more than $100 million in the fiscal year that ended last June, according to figures provided by DHHS. Prescription pain relievers account for about one-third of the admissions for substance abuse treatment in Maine, second only to alcohol, according to the Office of Substance Abuse.
The biggest cost to MaineCare, however, is health care services related to abuse and addiction, from emergency department visits for withdrawal and overdoses, to treatments for hepatitis C and collapsed veins to the care provided to pregnant addicts and their babies.
http://www.pressherald.com/special/opiates/Sunday/MaineCare-at-core-of-pain-pill-epidemic-.html
Source: Portland Press Herald – October 16, 2011
Patients being treated for chronic hepatitis C become less likely to take their medications over time, according to a new study from the Perelman School of Medicine at the University of Pennsylvania. Since the study also showed better response to the drugs when they’re taken correctly, the researchers say the findings should prompt clinicians to assess patients for barriers to medication adherence throughout their treatment, and develop strategies to help them stay on track. The study was published online in September in Annals of Internal Medicine.
“Our findings are particularly timely since many chronic hepatitis C patients are now being prescribed direct-acting antiviral drugs, which have a complex dosing regimen that may be even harder for patients to maintain than the two-drug standard therapy,” said lead author Vincent Lo Re, MD, MSCE, an assistant professor of Infectious Disease and Epidemiology
Literacy issues, financial hurdles, and socioeconomic problems such as unstable living situations can all hamper patients’ abilities to properly maintain their drug regimen. The authors suggest that refilling patients’ pill boxes for them, creating easy-to-follow dosing and refill schedules, and helping them set alarms to remind them to take their medicine may all help improve adherence.
Monitoring for and treating drug-related side effects may also be a key factor in boosting adherence, Lo Re says. The study results showed that patients who received medication for thyroid dysfunction, anemia, or low white blood cell counts – common side effects associated with hepatitis C drugs – were more likely to remain adherent to their antiviral therapy. Although those drugs added more steps into their self-care, Lo Re said the resulting relief for symptoms, including depression, fatigue and irritability, and more frequent visits to health care providers typically required with administration of these drugs, may play a role in patients’ ability to maintain the regimen overall.
“We know that a major barrier to adherence is side effects of these drugs. People don’t feel good when they’re on them,” he said. “If we can identify those problems and treat them when they occur, patients may be more motivated and feel well enough to continue with their prescribed regimen.”
Article abstract available at: http://www.annals.org/content/155/6/353.abstract
Source: University of Pennsylvania School of Medicine Press Release – September 29, 2011
Site last updated May 15, 2012 @ 3:33 am