Experts Urge New Jersey
Legislators to Take Steps to Curb Opioid Abuse
Addiction treatment experts urged New Jersey legislators
last week to take steps to curb opioid abuse, including expanding what doctors
are required to learn about addiction, and making participation in the state’s
prescription drug monitoring program mandatory. The Daily Journal reports the
experts also recommended implementing video conference technology that would
allow doctors to discuss patient cases with pain management specialists.
According to Dr. Daren Anderson, the chief quality officer at Community Health
Center in Connecticut, a similar initiative in his state that used secure email
messages to consult with pain management specialists reduced specialty visits
by 56 percent. Experts urged legislators to support a campaign to educate the
public on opioid abuse, and to increase long-term treatment facilities for
addiction. They spoke at a hearing of the New Jersey Senate Health, Human
Services and Senior Citizens Committee. The committee’s work is likely to lead
to new legislation, because both Republicans and Democrats, as well as Governor
Chris Christie, have expressed concern about prescription painkiller and heroin
abuse, according to NJ Spotlight. Earlier this year, Christie signed into law a
measure that encourages people to report drug overdoses. The law allows people
to call 911 to report a drug overdose, without the fear of getting arrested for
drug possession themselves.
Drinking To 'Numb,' Women
Gain On Men In Alcohol Abuse
Carrie Bradshaw and her rounds of cosmopolitans; Bridget
Jones with her glasses of chardonnay; Chelsea Handler declaring her passion for
vodka. In sitcoms, rom-coms and comedy shows, female boozers are the stuff of
jokes. They suffer through hangovers, complain about their bar bills, promise
to cut back and then cheerfully renege. But many women find that their drinking
doesn't lead to laughter. In the U.S. and Western Europe, growing numbers of
women struggle with alcoholism; in some places, women's rates of alcohol abuse
have achieved parity with men's. Ann Dowsett Johnston, the author of the new
book Drink, speaks with NPR's Rachel Martin about what's driving the increase
in female binge drinking and alcoholism. She shares what she's learned, from
research and from her own alcoholism, about advertising, addiction and the
challenges facing women who seek treatment. Please
click here to continue reading.
Baby Boomers Continue
Substance Use as They Age
Baby boomers appear to be carrying their substance abuse
habits with them as they age, according to a behavioral health expert at the
University of Pennsylvania’s Perelman School of Medicine. David W. Oslin, MD,
says binge drinking and prescription drug use are particular concerns in this
population. The implications are important for the substance abuse field, since
there are 50 million people over age 65 in the United States, and people over
70 are the fastest growing group in the nation, he says. Despite the relatively
common occurrence of substance use issues in baby boomers, health care
providers often overlook them, Dr. Oslin observes. He adds that doctors and
other health care professionals should routinely screen for and consider
substance use when caring for older adults. The 2012 National Survey on Drug
Use and Health found the rate of binge drinking among people ages 65 and older
was 8.2 percent, and the rate of heavy drinking was 2 percent. Among adults
ages 50 to 64, the rate of current illicit drug use has increased during the
past decade, the survey found. The survey authors estimate the number of adults
age 50 and older who will need alcohol or drug treatment will increase from 2.8
million in 2002-2006, to 5.7 million by 2020. Currently, 4 million older adults
need substance use treatment, including 0.4 million needing treatment for
illicit drugs, 3.2 million needing treatment for alcohol, and 0.4 million
needing treatment for both. The rate of illicit drug use among baby boomers has
been higher than those of older generations, Dr. Oslin noted at the recent
California Society of Addiction Medicine meeting. Baby boomers, particularly
those born after 1950, had much higher rates of illicit drug use as teenagers
and young adults than people born in earlier years. According to the survey, in
2012, only 19.3 percent of persons aged 65 or older had ever used illicit drugs
in their lifetime, while the lifetime rates of use were 47.6 percent for those
aged 60 to 64 and were above 50 percent for those ages 20 to 59. The survey
found marijuana and prescription psychotherapeutic drugs used nonmedically were
the most commonly used illicit drugs among adults ages 50 or older in the past
year. Dr. Oslin says older adults have increased sensitivity to alcohol and
over-the-counter and prescription medications, compared with younger adults.
They also take more medications, and these drugs can interact with alcohol.
“It’s quite common for older adults to drink and to suffer from depression at
the same time,” he says. “Many of them are on antidepressants, but that won’t
help them stop drinking. They need an abstinence-oriented approach to get
better.” He is especially concerned about the increased use of benzodiazepines
and opioids among the aging population. He co-authored a study that found
despite continuing concerns about benzodiazepines in older adults, they continue
to be commonly prescribed in this age group. Older adults often are
successfully treated for substance use disorders, particularly if the treatment
is geared toward their age group, according to Dr. Oslin. “Many older adults
don’t want to go to group therapy with younger adults, but they will go to
individualized therapy or to groups with peers,” he says. In a study he
conducted, Dr. Oslin found treatment for alcohol dependence with the drug
naltrexone and therapy sessions was effective for older adults, who were less
likely to relapse than younger adults. While baby boomers with substance use
disorders have some considerations that are specific to their age group, Dr.
Oslin says he has found many strategies that work apply to all age groups.
Addiction treatment is not one size fits all, he says. “There are many
options—use them. Compliance with treatment is important. While abstinence is
often the goal, it is not the only goal. And getting the right treatment from
the beginning may not be as important as changing the treatment when it isn’t
working.”
DEA Should Establish
Buy-Back Program for Unused Prescription Drugs: NY Senator
U.S. Senator Charles Schumer of New York is calling on the
Drug Enforcement Administration (DEA) to establish a buy-back program for
unused prescription drugs. A buy-back program would encourage people to return
their unused prescriptions, he said. Schumer wrote a letter to DEA
Administrator Michele Leonhart recommending ways the agency could work with
pharmacies and law enforcement agencies to expand programs to collect unused
drugs, The Post-Standard reports. Under current DEA regulations, pharmacies
cannot hold take-back events. Schumer noted that take-back events are
infrequent and can be inconvenient. Schumer is recommending the agency amend
regulations under the Secure and Responsible Drug Disposal Act of 2010 so that
pharmacies and community organizations can hold take-back programs. “The DEA
needs to be working with local pharmacies, governments and law enforcement
agencies to get prescription drugs off the street, and take-back and buyback
programs are the way to do that. The DEA must change the regulations so
that certified pharmacies can hold take-back events and provide this vital
service, and should put more funding behind buybacks to incentivize people to
turn over their prescription drugs,” he said in a news release.
Heroin Use, Deaths on the
Rise in Middle Class America
Colorado ranks second in the nation for prescription pill
abuse. Experts say as prescription pills get harder to access, people turn to
cheaper, more accessible heroin. According to the Substance Abuse and Mental
Health Services Administration, heroin use in America is up 75 percent between
2007 and 2011. Deaths and overdoses are also on the rise. Many heroin addicts
start on prescription pain killers prescribed for minor injuries. When they run
out of their prescription, they often turn to heroin because it’s cheaper and
easier to get. One Oxycontin pill can cost up to $80 and may only last a few
hours whereas $100 worth of heroin can last several days. Click
here to continue.
Is Suboxone a Wonder Drug
that Helps Heroin Addicts Get Clean--Or Just Another Way to Stay High?
Five months ago, Chris resolved that it was finally time to
get clean. Sort of.
The 34-year-old Brooklyn real estate broker (who declined to
be identified by his real name; "Chris" is a pseudonym) had begun
using heroin and quit once before, in his late teens. But family problems and a
few tough months caused him to relapse, and soon he was snorting the drug two
or three times a week. After nearly a year of using, the days between doses
started to get dicey, and Chris got worried. On the off days, he says, "I
was never myself. I was irritable, exhausted, had no motivation or desire to do
things I once enjoyed doing. I wasn't happy." So, in between bags of
heroin, Chris scored Suboxone, a prescription painkiller used to treat opiate
addiction. He'd use it when he was making a halfhearted attempt to get sober,
or when he just didn't want to feel bad between bags. Thanks to its main
ingredient, buprenorphine hydrochloride, Suboxone eliminated the agonizing
heroin withdrawal, the "three days of complete hell" he had to go
through every time he tried not to use. Continue
here.
Patients Taking
Buprenorphine for Opioid Addiction May Benefit From Longer Detox
A new study suggests patients taking buprenorphine to treat
their opioid addiction may benefit from tapering off the medication over four
weeks instead of a shorter period. The longer detoxification is effective when
it is followed by treatment with naltrexone, a drug that blocks opioid
strength, the researchers found. Researchers at the University of Vermont
followed 70 people undergoing outpatient treatment for opioid addiction. For
the first two weeks of the 12-week study, patients took buprenorphine. They
were randomly selected to reduce the dose of the drug over one, two or four
weeks. All of them then received naltrexone treatment and behavior therapy,
HealthDay reports. Patients who tapered off buprenorphine over four weeks were
more likely to stop abusing opioids, compared with those who tapered off the
drug over one or two weeks. The findings are published in JAMA Psychiatry.
State Substance Use
Disorder Parity Laws Can Increase Treatment Rate: Study
State laws that require private health plans to provide
coverage for substance use disorders (SUD) that is equal to benefits for
general medical coverage can increase access to SUD treatment, a new study
suggests. More than half of states have enacted these laws, known as parity
laws. The Emory University researchers analyzed state-level SUD parity laws in
the private insurance market that were implemented between 2000 and 2008. They
found parity laws increased state-level treatment by 9 percent in all specialty
SUD treatment facilities, and 15 percent in facilities that accept private
insurance. The study appears in JAMA Psychiatry. The passage of the 2008 Mental
Health Parity and Addiction Equity Act and the 2010 Affordable Care Act
incorporated SUD parity into federal legislation, HealthCanal reports. “This
research suggests that the recent federal parity legislation holds promise for
improving access to SUD treatment in this country,” said lead researcher Hefei
Wen.
Poll of Teens Finds 77
Percent Say They Don’t Drink Alcohol
A poll of high school teens finds 77 percent say they don’t
drink alcohol. According to Mothers Against Drunk Driving (MADD), which
released the poll, 69 percent of teens say they don’t drink, and an additional
8 percent say they used to drink, but don’t anymore. When asked why they don’t
drink, teens said their top five reasons were because it’s illegal, it can be
harmful to their health, it can affect their grades, their parents disapprove,
and they don’t want to be like their peers who drink, according to HealthDay.
According to the poll of 695 students, more than half said they would be less
likely to be friends with or date someone who is an underage drinker, the
article notes. The results were released during Red Ribbon Week, a national
campaign to raise awareness about the dangers of drug and alcohol use among
young people. “As adults, we know how dangerous underage drinking is for our
kids, but these new survey results show that teens are getting the message,
too,” MADD National President Jan Withers said in a news release.
Longer Detox Might Work
Better for Prescription Pain Med Addiction
A longer period of detoxification may be more effective for
people being treated for addiction to prescription painkillers called opioids,
according to a small new study. Abuse of prescription opioids such as
oxycodone, hydrocodone and hydromorphone is a major public health problem in
the United States. The new 12-week study, which included 70 people undergoing
outpatient treatment for opioid addiction, was published online Oct. 23 in the
journal JAMA Psychiatry. Please
click here to continue reading.
'Just flooding us': Tenn.
spike in drug-dependent newborns is warning to nation
On an average day, neonatal nurse practitioner Carla
Saunders faces two dozen babies born hooked on drugs, infants so sick with the
pain of withdrawal that they cry nonstop, claw their faces and writhe in agony
at the sound of a voice or the touch of hand. But that’s just the average.
“Today, it may be even higher,” says Saunders, who staffs the 60-bed intensive
care unit at East Tennessee Children’s Hospital in Knoxville, Tenn. “It’s been
as high as 37.” The babies are part of a grim trend in Tennessee, where a new
report shows that the number of newborns dependent on drugs their mothers took
during pregnancy is higher than ever — and experts say it should be a warning
to the rest of the nation.
Rest of this story is here.
Experts Call for Better
Addiction Medicine Education for Physicians
Many doctors fail to diagnose and treat substance use
disorders, in part because they have not been educated about addiction
medicine, according to three experts. They call for better training in this
week’s Journal of the American Medical Association. A number of diseases are
caused by substance use disorders, and hospitals are “clogged” with patients
suffering from these illnesses, write Dr. Evan Wood of the University of
British Columbia, Dr. Jeffrey H. Samet, President of the American Board of
Addiction Medicine (ABAM), and Dr. Nora D. Volkow, Director of the National
Institute on Drug Abuse. The experts write that new therapies and behavioral
interventions have been developed for a number of addictions, Newswise reports.
“Despite the availability of these evidence-based prevention and treatment
strategies, only a small fraction of individuals receive prevention or
treatment consistent with scientific knowledge about what works,” Dr. Samet
said. “There is a remarkable gap between the science of addiction medicine and
the care that patients actually receive,” Dr. Wood said. “Ultimately, this
stems from the fact that investments in research have not been coupled with
strategies to adequately train physicians to deliver evidence-based care.” He
noted that only about 10 percent of people with an alcohol addiction receive
recommended care. Most treatment for addiction in the United States and Canada
is provided by layperons, the article notes. ABAM has accredited 18 addiction
medicine fellowship programs across the country. Doctors who complete one of
these fellowships are eligible to sit for the ABAM exam to become certified in
addiction medicine.
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