News & Updates – March 2, 2015; Issue 215

MEDICATION-ASSISTED TREATMENT AND OPIOID USE/ADDICTION

GENERAL ADDICTION

MORE NATIONAL NEWS

Categories: 2015-03-02, News Updates, TOC

NIDA Notes: Study Points to Individualized Therapy for Opioid Addiction

pills-in-bottles“A recent NIDA-supported clinical trial affirmed one common supposition about medically assisted treatment for opioid addiction and challenged another. As anticipated, trial participants who were addicted to opioid painkillers and did not inject drugs stayed in treatment longer and achieved better outcomes than those who were addicted to heroin or injected drugs. However, the expectation that users of painkillers would benefit more from buprenorphine/naloxone (Bp/Nx) than from methadone therapy was not borne out.

The findings should help clinicians make optimal treatment choices for individual patients, says Dr. Jennifer S. Potter of the University of Texas Health Science Center at San Antonio. “People who inject drugs or use heroin may need more structured attention and a higher level of monitoring during treatment, because they have an increased risk for dropping out. When treating users of opioid painkillers, physicians should feel confident recommending either buprenorphine or methadone, depending on the medications’ availability and patients’ preference,” says Dr. Potter.”

Read more at: http://www.drugabuse.gov/news-events/nida-notes/2015/02/study-points-to-individualized-therapy-opioid-addiction

Source: National Institute on Drug Abuse – February 18, 2015

Categories: 2015-03-02, Medication-Assisted Treatment (MAT), News Updates, Opioid Abuse/Addiction
Tags: Addiction, Heroin, Prescription Opioids

Science Be Damned: Americans Prefer Broken Method of Heroin Treatment, Survey Finds

drug rehab“Asked whether it’s more effective for heroin addicts to detox completely and attend Narcotics Anonymous meetings, or for them to receive synthetic opiates under medical supervision, 50 percent of Americans chose the abstinence option, and just 19 percent favored the use of synthetic opiates. Another 32 percent were unsure.

That gap in opinion narrowed only somewhat after people were presented with common arguments for and against the use of synthetic drugs.

Forty percent of people said that synthetic drugs like Suboxone or methadone are more dangerous than helpful, because “it’s more important to get people off drugs entirely, even if that means recovery is more difficult.” Just 24 percent of respondents were sympathetic to the argument that such medications are more helpful than dangerous, since “the approved drugs are safer than heroin or pills bought on the street.” Another 36 percent remained unsure.”

Read more at: http://www.huffingtonpost.com/2015/02/23/heroin-treatment-poll_n_6736074.html

The results of the poll can be accessed at: https://today.yougov.com/news/2015/01/20/poll-results-heroin/

Source: HuffingtonPost.com – February 23, 2015

 

Categories: 2015-03-02, News Updates

Inside the Cruel and Illegal Police Practice of Targeting Methadone Clinic Patients

Police ligts“Courtney’s life spiraled out of control when she became dependent on opiates. After years of struggling with addiction, the 31-year-old Texas native heard about methadone treatment, a therapy in which patients take daily doses of medicine to control cravings for illicit opiates. Courtney enrolled as a patient at a methadone clinic outside Austin. She began visiting the clinic daily for a dose of methadone, which helped eliminate her cravings, and slowly, began to pick up the other pieces of her life. That changed the day she became the victim of illegal profiling by police.

Though it’s more the exception than the rule, methadone clinics across the country report harassment of patients by law enforcement. One study of methadone patients at 29 different locations in New York City reported that 40% of patients reported being stopped and frisked by police outside their clinic site and 70% reported witnessing police harassment of another person outside a methadone clinic.

Often it’s just one or two rogue officers with an ax to grind who cause most of the trouble, but the effects can be devastating. Harassing patients discourages people from seeking methadone therapy, a legal, effective, evidence-based treatment for the growing number of Americans dependent on opiates such as heroin or prescription pain pills.”

Read more at: http://www.alternet.org/drugs/how-cops-profile-methadone-patients

Source: Alternet.org – February 21, 2015

Categories: 2015-03-02, News Updates, Opioid Abuse/Addiction, Opioid Treatment Programs (OTPs), Uncategorized
Tags: Addiction, Heroin, Methadone Treatment, Opioid Treatment Programs, Prescription Opioids

Ask the Pharmacist: Acute Pain in Patients on Maintenance for Opioid Addiction

pain collage“Patients in recovery from opioid dependence or addiction present a conundrum when needing management of acute, severe pain. Not only is there a fear of addiction relapse among the patients and clinicians, but routine analgesic regimens also may not be sufficient to properly manage pain, especially in those receiving buprenorphine (or buprenorphine/naloxone combination), methadone, or naltrexone. Inadequate pain management has serious ramifications, including prolonged hospital stays, increased medical costs, unnecessary suffering, impaired quality of life, and progression to chronic pain.] Therefore, it is imperative that clinicians become knowledgeable in the management of pain in patients taking buprenorphine, methadone, or naltrexone.

In order to effectively treat patients on maintenance addiction treatment, it may be helpful to dispel common misconceptions that result in undertreatment of these patients. Alford and colleagues describe four such misconceptions associated with opioid agonist therapy:”

  • Maintenance opioid therapy provides analgesia;
  • Addiction relapse may occur from use of opioids for analgesia;
  • Opioid analgesics may cause respiratory and central nervous system (CNS) depression in patients receiving opioid agonist therapy; and
  • Reporting pain may be a manipulation to obtain opioid medications (“drug seeking”).

Read more at: http://www.medscape.com/viewarticle/839359

Source: Medscape.com – February 6, 2015

Categories: 2015-03-02, Addiction, News Updates, Opioid Abuse/Addiction
Tags: Addiction, Heroin, Opioid Treatment Programs, Pain, Prescription Opioids

Jana Burson Blog - Opioid Addiction in Pregnancy: More Information about the Use of Methadone versus Buprenorphine

baby“The MOTHER (Maternal Opioid Treatment: Human Experimental Research) trial of 2012 (Jones et al) gave us much-needed information about how buprenorphine compares to methadone when used to treat opioid-addicted pregnant women. This landmark study showed us buprenorphine can be just as effective as methadone. Babies born to moms on buprenorphine had the same incidence of opioid withdrawal (called neonatal abstinence syndrome, or NAS) at 50%, but the withdrawal was significantly less severe, the babies required about half the medication as the babies born to moms on methadone. Also, buprenorphine-exposed babies spent significantly less time in the hospital – about half as long as methadone-exposed infants.

Some doctors point out that more women on buprenorphine dropped out of that study than women on methadone, and say that proves buprenorphine is less effective. However, the majority of those women didn’t leave treatment; they just left the buprenorphine arm of the study.

This week I read another study, by Meyer et al, soon to be published in the Journal of Addiction Medicine. This study also looked at pregnant patients being treated for opioid addiction.

In this retrospective cohort study, 609 pregnant patients were started on either buprenorphine (361) or methadone (248). This study took place over the years from 2000 to 2012 at a single site, University of Vermont.

The authors of the study concluded that this evidence suggests that buprenorphine gives outcomes that are at least as good as with methadone.

I’d take that conclusion one step farther and say we now have several studies that show less neonatal withdrawal in babies exposed prenatally to buprenorphine compared to methadone. I have to ask myself: knowing what I do from these studies, which medication would I want to take during pregnancy? I’d prefer buprenorphine, and if it didn’t work for any reason, I’d switch to methadone.”

Read more at: https://janaburson.wordpress.com/2015/02/28/opioid-addiction-in-pregnancy-more-information-about-the-use-of-methadone-versus-buprenorphine/

Source: Jana Burson, MD – February 28, 2015

Categories: 2015-03-02, Addiction, News Updates, News Updates, Opioid Abuse/Addiction
Tags: Addiction, Heroin, Pregnancy, Prescription Opioids

Patients with Substance Abuse History Are More Likely To Misuse Therapeutic Opioids, Study Finds

“A report published in The Journal of Pain, the official journal of the American Pain Society, concluded that the history of substance abuse can predict the misuse of therapeutic opioids. For the study, researchers from the Cleveland Clinic, a non-profit academic medical center, observed 199 patients treated for chronic non-cancer pain. Their goal: Find out if there’s any kind of linkage between non-opioid substance abuse disorders, opioid dosage and therapeutic opioid abuse.

Researchers found that 25% of patients with no known history of a substance use disorder had therapeutic opioid abuse. In patients with a known history of substance abuse disorders, 83% had therapeutic opioid abuse. The study also revealed that patients with substance use disorders are more likely to receive opioids in higher dosages.”

Read more at: http://www.forbes.com/sites/cjarlotta/2015/02/25/patients-with-substance-abuse-history-are-more-likely-to-misuse-therapeutic-opioids-study-finds/

Source: Forbes.com – February 25, 2015

Categories: 2015-03-02, News Updates

New Resource: Opportunities to Address Overdose in Treatment - Guidance for Substance Use Disorder Treatment Providers Infographic

The Institute for Research, Education & Training in Addictions (ireta) has produced a one page chart that offers guidance related to waitlists, screening/assessment, counseling, induction, positive drug screens, and discharge.

The chart can be accessed at: https://magic.piktochart.com/output/4460984-od-prevention-in-treatment

Source: ireata – February 2015

Categories: 2015-03-02, Addiction, News Updates
Tags: Addiction, OTP Patient Safety, Overdose

William L. White Blog - From Trauma to Transformative Recovery in Women

Road to Recovery“Between 1986 and 2003, I served as the evaluator of an innovative approach to the treatment of addicted women with histories of neglect or abuse of their children.  Project SAFE eventually expanded from four pilot sites to more than 20 Illinois communities using a model that integrated addiction treatment, child welfare, mental health, and domestic violence services.   This project garnered considerable professional and public attention, including being profiled within Bill Moyers’ PBS documentary, Moyers on Addiction:  Close to Home.  My subsequent writings on recovery management and recovery-oriented systems of care were profoundly influenced by the more than 15 years I spent interviewing the women served by Project SAFE and the Project SAFE outreach workers, therapists, parenting trainers, and child protection case workers.  This blog offers a few reflections on what was learned within this project about the role of trauma in addiction and addiction recovery.”

Read more at: http://www.williamwhitepapers.com/blog/2015/02/from-trauma-to-transformative-recovery.html

Source: WilliamWhitePapers.com – February 28, 2015

Categories: 2015-03-02, Addiction, News Updates
Tags: Addiction, Recovery

MORE NATIONAL NEWS

New GAO Report – Prenatal Drug Use and Newborn Health: Federal Efforts Need Better Planning and Coordination – 2/10/15 

How Do Federal Drug Courts Work? – 2/16/15

Jana Burson Blog: Case Study of an Opioid-Addicted Patient: New England Journal of Medicine – 2/24/15

Categories: 2015-03-02, Addiction, News Updates
Tags: Drug Courts, Pregnancy

Science Be Damned: Americans Prefer Broken Method of Heroin Treatment, Survey Finds

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Categories: Featured