MEDICATION-ASSISTED TREATMENT & OPIOID ABUSE/ADDICTION
- DEA Announces “360 Strategy” to Address Heroin, Prescription Drugs and Violent Crime
- 60 Minutes – Heroin in the Heartland
- Research Article Abstract: Sex Differences in Substance Use, Health, and Social Functioning Among Opioid Users Receiving Methadone Treatment in Canada: A Multicenter Cohort Study
- How Other States Are Adopting Massachusetts’ Drug Addiction Treatment Program
- Benzodiazepine Use is an Independent Risk Factor for HIV Infection Among People with Injection Drug Use
- Narcotic Painkiller Use in Adolescence May Raise Risk of Adult Addiction
- Dr. Jana Burson Blog – Injecting Buprenorphine (Suboxone, Subutex)
- How an Illegal Psychedelic Drug Could Help Treat Opiate Addiction
- With Massive Prisoner Release, Averting Fatal Reentry
PRESIDENTIAL ELECTION NEWS
- New SAMHSA Resource – Risk and Protective Factors and Initiation of Substance Use: Results from the 2014 National Survey on Drug Use and Health
LINKS TO ADDITIONAL NEWS OF INTEREST
- Opinion: Should Drug Addicts Be Forced Into Treatment? (The New York Times) – 11/12/15
- Naloxone, the Little-Known Drug That Reverses Heroin Overdoses, Explained – 11/5/15
- Dark Web Marketplace Increases Availability, Acceptability of Drugs: Expert – 11/4/15
- Criminally Yours: Can White Heroin Addiction Change The Paradigm? – 11/2/15
- New York Times: In Heroin Crisis, White Families Seek Gentler War on Drugs – 10/30/15
- New York Times: The Numbers Behind America’s Heroin Epidemic – 10/30/15
- Huffington Post Blog by A. Thomas McLellan: Stopping Opioid Overdose Deaths and Addictions: Finally, a Sensible Plan for Action – 10/30/15
- Practicing Medicine Without a License: Medication-Assisted Treatment in the Courts – 10/28/15
Categories: 2015-11-16, News Updates, TOC
The United States Drug Enforcement Administration (DEA) announced Pittsburgh as the pilot city for a comprehensive law enforcement and prevention “360 Strategy” to help cities dealing with a heroin and prescription drug abuse epidemic, and its associated violent crime.
The DEA 360 Strategy comprises a three-fold approach to fighting drug traffickers:
- Provide DEA leadership with coordinated DEA enforcement actions targeting all levels of drug trafficking organizations and violent gangs supplying drugs in our neighborhoods, as we have been doing with ongoing law enforcement operations.
- Have a long-lasting impact by engaging drug manufacturers, wholesalers, practitioners and pharmacists to increase awareness of the heroin and prescription drug problem and push for responsible prescribing and use of these medications throughout the medical community.
- Change attitudes through community outreach and partnership with local organizations following DEA enforcement actions to equip and empower communities with the tools to fight the heroin and prescription drug epidemic.
Read more at: http://www.dea.gov/divisions/hq/2015/hq111015.shtml
Source: DEA.gov – November 10, 2015
Categories: 2015-11-16, Heroin, News Updates, Opioids, Prescription Drugs
Tags: DEA, Heroin, Prescription Opioids
The following script is from “Heroin in the Heartland” which aired on 60 Minutes November 1, 2015. Bill Whitaker is the correspondent.
“Federal and local authorities all over the country say it’s the biggest drug epidemic today.
You might think of heroin as primarily an inner-city problem. But dealers, connected to Mexican drug cartels, are making huge profits by expanding to new, lucrative markets: suburbs all across the country. It’s basic economics. The dealers are going where the money is and they’re cultivating a new set of consumers: high school students, college athletes, teachers and professionals.
Heroin is showing up everywhere — in places like Columbus, Ohio. The area has long been viewed as so typically Middle American that, for years, many companies have gone there to test new products. We went to the Columbus suburbs to see how heroin is taking hold in the heartland.”
The script and video are available at: http://www.cbsnews.com/news/heroin-in-the-heartland-60-minutes/
Source: CBSNews.com – November 1, 2015
“This excerpt from a CBS 60 minute program shows a great sensitivity to the suffering of those with opiate addiction as well as their families. Too bad they missed a most important point. There is treatment for this disease, highly successful treatment. But in the entire report, not one word about methadone or Suboxone. What a missed opportunity by a program watched by millions.”
Categories: 2015-11-16, Heroin, News Updates
Tags: Addiction, Heroin
Research Article Abstract: Sex Differences in Substance Use, Health, and Social Functioning Among Opioid Users Receiving Methadone Treatment in Canada: A Multicenter Cohort Study
“Despite the growing numbers of men and women with opioid use disorder in Canada, sex-specific issues in treatment have not been re-examined in the current population of patients with opioid addiction. We aimed to evaluate sex differences in substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid use disorder in Ontario, Canada.
We recruited 503 participants with opioid dependence disorder receiving methadone maintenance treatment. We collected data on demographics, treatment characteristics, psychiatric history, addiction severity, and drug use patterns through urinalysis. We performed adjusted univariate analyses and logistic regression to identify distinct factors affecting men and women.
Among our sample of 54 % (n = 266) men and 46 % women (n = 226) with mean age 38.3 years, less than half of participants were employed (35.6 %) and married (31.8 %) and had completed a high school education (27.9 %). Compared to men, women had frequent physical and psychological health problems, family history of psychiatric illness, and childcare responsibilities and began using opioids through a physician prescription. Men had higher rates of employment, cigarette smoking, and cannabis use compared to women.
Our results have revealed different patterns of substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid addiction in Ontario, Canada. This information can be used to develop an integrative treatment regimen that caters to the individual needs of men and women, as well as to inform methadone treatment protocols to include specialized services (including vocational counseling, childcare and parenting assistance, medical assistance, relationship or domestic violence counseling, etc.) and increase their availability and accessibility on a larger scale.”
The article is available online at: http://www.bsd-journal.com/content/6/1/21
Source: Biology of Sex Differences – November 10, 2015
Categories: 2015-11-16, Addiction, Methadone, News Updates, Opioid Abuse/Addiction, Opioid Treatment Programs (OTPs), Opioids
Tags: Heroin, Opioid Treatment Programs, OTP Patients, Prescription Opioids, Research, Substance abuse treatment
“A police program in northern Massachusetts that helps fast-track heroin addicts into treatment is catching on in other states and showing signs of reducing crimes associated with addiction.
Gloucester police say dozens of departments in nine states have taken a page from their ANGEL program, which gives addicts a chance to make treatment rather than arrest the first response they get from police.
Addicts can come to the police station and be connected to a treatment program if they commit to getting clean. They are assigned a volunteer “angel” — sometimes a recovering addict — who works with them. They can turn in their drugs and drug paraphernalia, no questions asked.
Police Chief Leonard Campanello developed the program that started in June, and says statistics suggest it may also help reduce crime. This summer, shoplifting, breaking and entering, and larceny were down 23 percent in Gloucester compared to the same season last year.”
Source: ChristianScienceMonitor.com – November 1, 2015
Categories: 2015-11-16, Addiction, Heroin, News Updates, News Updates
Tags: Addiction, Heroin, Substance abuse treatment
Benzodiazepine Use is an Independent Risk Factor for HIV Infection Among People with Injection Drug Use
People who inject drugs (PWID) are at risk for contracting HIV, and benzodiazepine use is an established risk factor for hazardous behaviors associated with HIV transmission. However, no direct association between benzodiazepine use and HIV infection has previously been demonstrated among this population. Researchers prospectively tracked a cohort of 1682 HIV-negative PWID to determine whether self-reported benzodiazepine use was directly associated with HIV seroconversion.
At baseline, 501 participants reported benzodiazepine use; of these, 99% reported the mode of use to be non-injection.
Among the overall population, 176 seroconverted for an incidence density of 1.5 cases per 100 person-years.
Participants who reported benzodiazepine use at baseline were more likely to seroconvert over the course of the study period.
Multivariable models controlling for age, ancestry, and at least daily injection cocaine use demonstrated that benzodiazepine use was independently and positively associated with an elevated risk of HIV seroconversion (adjusted rate ratio, 1.50).
These findings emphasize not only the need for targeted HIV prevention programs for this population, but also the importance of prescriber education regarding the limited proven clinical benefits and known risks of benzodiazepines. Seonaid Nolan, MD
Ickowicz S, Hayashi K, Dong H, et al. Benzodiazepine use as an independent risk factor for HIV infection in a Canadian setting. Drug Alcohol Depend. 2015;155:190–194.
Source: Alcohol, Other Drugs, and Health: Current Evidence – September/October 2015
Categories: 2015-11-16, Addiction, Heroin, News Updates, Opioid Abuse/Addiction
Tags: Benzodiazepines, Heroin, HIV/AIDS, Injecting Drug Users, Prescription Opioids
“Teens who are given prescription narcotic painkillers may run a higher risk of abusing narcotics after high school, a new study suggests.
Researchers said teen painkiller use was associated with a 33 percent increased risk of later abuse. And it was seen mostly among those with little to no history of drug use and those who strongly disapproved of illegal drug use.
“A prescription for a pain reliever can put adolescents at risk for future pain reliever misuse,” said study author Richard Miech, a research professor at the Survey Research Center at the University of Michigan in Ann Arbor.
The report was published online Oct. 26 in the journal Pediatrics.”
Source: Health Day – October 28, 2015
Categories: 2015-11-16, Addiction, News Updates, Opioid Abuse/Addiction, Prescription Drugs
Tags: Addiction, Prescription Opioids
“I know why addicts inject buprenorphine (Subutex): they think it saves them money. Over the long run, however, I doubt that’s true, given the hidden costs of addiction.
Buprenorphine has a relatively low bioavailability, at around 30%, when taken sublingually (under the tongue). This means only 30% of the total dose reaches the blood stream. If the pH of the mouth is lowered, bioavailability is reduced even further. This is why we recommend patients on buprenorphine avoid eating or drinking anything acidic for about twenty minutes prior to taking their dose.
By definition, when a drug in injected, it has 100% bioavailability. Therefore, some people inject their prescribed buprenorphine in order to get the desired blood level with a lower dose of buprenorphine. If they are prescribed 8mg per day, perhaps they use 4mg intravenously and sell the rest of their dose, or stockpile it.
People who misuse buprenorphine in this way may be blinded by their addiction to the multiple dangers of injecting drugs.”
Source: Dr. Jana Burson – November 1, 2015
Categories: 2015-11-16, Addiction, Buprenorphine
Tags: Buprenorphine, Injecting Drug Users, Prescription Opioids
“Kevin is in the fetal position on a warm bed in Mexico, in the throes of opiate withdrawal. Suddenly, a buzzing noise enters his ear, as if a wasp is building a nest in there. It’s the first sign the ibogaine he just consumed is taking effect, and things are about to get weird.
“This really intense energy slowly began to build in the center of my body and permeated throughout,” Kevin tells The Verge, recalling that night.
Kevin was a 24-year-old with an intense opiate addiction — heroin and OxyContin were his drugs of choice — at the time, and the ibogaine was part of his chance to free himself from the addiction. He tried the standard treatments, like rehab and the prescription drug Suboxone, but they weren’t working for him. He then decided to enroll in a study evaluating the psychedelic substance ibogaine, for use in kicking an opiate addiction,
But ibogaine is illegal, and that’s slowed research progress.
Actually, ibogaine research isn’t without encouragement in the mainstream. Mark Parrino, president of the American Association for the Treatment of Opioid Dependence (AATOD), believes there could be a place for ibogaine in opiate addiction treatment. Since opiate addictions are so difficult to treat, doctors are desperate for anything that might work. “It’s not a widely used medication, but the general view is that if it has some helpful approach for some people who don’t want to be using one of the three federally approved medications, that’s great,” he tells The Verge. Kevin is one of those people.”
Source: TheVerge.com – November 11, 2015
Categories: 2015-11-16, Addiction, News Updates, Opioid Abuse/Addiction
Tags: AATOD, Addiction, Buprenorphine, Heroin, ibogogaine, Prescription Opioids, Substance abuse treatment
This November marks the beginning of the largest prisoner release in this country’s history. Just over the first weekend, the federal prison system discharged over 6,000 inmates who saw their drug-related sentences reduced as a result of recent reforms. An estimated 40,000 additional federal prisoners will be eligible for early release in the coming months. This is just one part of a broader drive to slash senselessly harsh sentences for drug crimes, reduce prison overcrowding, and generally move away from mass incarceration and the War on Drugs.
Although generally positive (and long overdue) for the inmates, their families, and the taxpayer, this monumental de-incarceration effort is also a source of grave risk. Few will be surprised to hear that the U.S. is in the midst of an overdose crisis, but there is little recognition that re-entering individuals are nearly 130 times more likely to die of an overdose in the first two weeks after their release than the population as a whole. Multiple factors drive this astronomical risk, including low tolerance after a period of abstinence, use of drugs from unfamiliar sources and of unknown strength, mixing multiple substances, and the disorienting chaos inherent to the reentry process.”
Source: HuffingtonPost.com – November 3, 2015
Categories: 2015-11-16, Drug Courts & Criminal Justice, News Updates
Tags: Addiction, Overdose
“Another one of my patients was denied coverage for his buprenorphine treatment because he’s still using marijuana.
I’ve written about this kind of situation before, and I have mixed feelings.
It was time for me to fill out this patient’s prior authorization form, which must be completed every year, before for the insurance company will agree to continue to pay for his Suboxone. Among other questions, the form asked if all the patient’s urine drug screens have been negative for illicit drugs. Much as I personally may be tempted to answer “No” in order to save the patient some aggravation, that would be a lie. I’m not willing to commit insurance fraud, so I answered honestly. In the insurance company’s eyes, this means my patient is noncompliant with treatment.
Last year, we had no problems. I answered all the questions the same as this year, but I suspect insurance company workers inadvertently overlooked my answer. Not this year. We got news that the prior authorization was denied, and I suspected the positive drug screens were the reason.”
Source: Dr. Jana Burson – November 16, 2015
Categories: 2015-11-16, Buprenorphine, Medication-Assisted Treatment (MAT), News Updates, Opioid Abuse/Addiction, Opioid Treatment Programs (OTPs)
Tags: Addiction, Buprenorphine, Prescription Opioids