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Thursday, October 31, 2013

ATOD & Advocacy Update - Week Ending November 1, 2013



First Single-Ingredient Hydrocodone Drug Receives FDA Approval
The Food and Drug Administration on Friday approved the first pure hydrocodone drug in the United States. The drug, Zohydro ER (extended release), was approved for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Drugs such as Vicodin contain a combination of hydrocodone and other painkillers such as acetaminophen, the Associated Press reports. In December, a panel of experts assembled by the FDA voted against recommending approval of Zohydro ER. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the drug’s maker, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone. Patient safety advocates criticized the FDA’s decision. “We’re just going to kill more kids and then the FDA is going to come back and say, ‘oh, we made a mistake,’” said Avi Israel, whose son Michael committed suicide while struggling with painkiller addiction. Israel is the founder of a group that aims to combat painkiller abuse in young people. In a statement, the FDA noted, “Zohydro ER will offer prescribers an additional therapeutic option to treat pain, which is important because individual patients may respond differently to different opioids.” The agency will require postmarketing studies of Zohydro ER to evaluate the known serious risks of misuse, abuse, increased sensitivity to pain, addiction, overdose, and death associated with long-term use beyond 12 weeks.

Treating Trauma and Addiction in Health Care Professionals
Health care professionals who are dealing with substance use disorders face particular challenges, according to the executive director of an organization dedicated to serving this population. These professionals must learn to cope with the emotional challenges of having ready access to medications, says Maureen Sullivan Dinnan, J.D. of HAVEN. “The disease of addiction is the same for everyone, but for health care professionals, relapse prevention strategies need to be different because of their access to drugs,” she says. “They need to be prepared to deal with how they will feel when they administer medication and see the patient’s pain is relieved, while they are also suffering emotional or physical pain.” As with many other people, health care professionals who abuse drugs often do so not to get high, but to self-medicate to help them deal with having suffered trauma, Dinnan says. “When their coping mechanism is taken away, they may lapse because they have no other way to deal with the trauma.” Her Connecticut-based organization is holding a symposium on Trauma and Recovery for health care professionals on November 1 at Quinnipiac University in North Haven. HAVEN is a voluntary confidential assistance program for health care professionals facing the challenges of physical illness, mental illness, chemical dependence or emotional disorder. It is designed as a peer-based process to encourage early identification of health care professionals who are at risk for impairment. The program helps health care professionals manage their own well-being in addition to the well-being of their patients. “Over the last decade there has been a growing understanding that if health care professionals don’t get care for themselves, it not only hurts them, but may impact the quality of care they can deliver,” Dinnan says, adding there is a misperception that health care professionals are stronger or more able-minded than other people, and are therefore better equipped to deal with the consequences of trauma. HAVEN has a high success rate that is due in large part to the monitoring they conduct, according to Dinnan. “We make sure if the person’s plan requires therapy, that they are engaged in therapy, and if a person doesn’t commit to therapy, we are notified.” The program also conducts random drug testing. They partner with a workplace monitor who is aware of the health care professional’s treatment, and can notify HAVEN if the person appears stressed and needs extra support.

Doctors Try New Non-Narcotic Approach to Pain Management After Surgery
Doctors are trying a new approach to pain management after surgery, in an attempt to reduce patients’ reliance on narcotic painkillers, according to The Wall Street Journal. This “multimodal” approach includes cocktails of medications given to patients before, during and after surgery. The medication is delivered orally, intravenously and through injection into the tissues and nerves around the surgical site. By avoiding giving patients heavy doses of opioids, doctors hope to prevent the risk that patients will become addicted to painkillers. They also avoid the grogginess, nausea, hallucinations and constipation that can result from taking opioids. Martin Clark Jr., an orthopedic surgeon at Sharon Hospital in Sharon, Connecticut, says when his patients rely entirely on narcotics, they are “drowsy and apathetic, they aren’t into physical therapy and they sit in bed.” In contrast, patients being treated with the new pain protocols are more able to stick with physical rehabilitation regimens to regain muscle strength and range of motion. Patients undergoing knee replacement surgery at Canton-Potsdam Hospital in Potsdam, New York, receive medication before surgery including the anti-inflammatory Celebrex, and Lyrica, which treats nerve pain and blocks pain impulses to the central nervous system. During surgery, patients receive anesthesia in the lower spine, as well as a sedative, intravenous Tylenol and an anti-nausea medication. The anesthesia lasts up to 24 hours after surgery. The surgeon also injects medications into the tissues around the knee, including a numbing agent, a drug to control bleeding and another anti-inflammatory agent. Once patients are in recovery, they receive a continuous cooling pad to decrease swelling and stimulate nerve endings, which reduces pain. They receive 24 hours of intravenous Tylenol and more Celebrex and Lyrica. Patients are given oral narcotics such as oxycodone, but they generally don’t need them for more than two weeks, and often stop taking them after several days.

A Year After Federal Legislation Bans Synthetic Drugs, More Than 250 Types Still Sold
A little more than a year after President Obama signed legislation banning the sale of 26 designer drugs, more than 250 types of these synthetic drugs are still sold in the United States, Roll Call reports. Legislators and law enforcement agencies are trying to keep up with drug makers, who are continually introducing slight variations of their products to keep one step ahead of the law. They say the federal law was an important step in fighting designer drugs, but it was not enough. “A change of a molecule or two to a banned drug is sometimes enough to make a new and legal alternative,” said Senator Charles E. Grassley of Iowa during a recent hearing of the Senate Caucus on International Narcotics Control, of which he is co-chairman. After the law was passed, law enforcement officials saw a slight reduction in calls to poison control centers and visits to emergency rooms related to synthetic drugs. Usage appears to be on the rise once again as drug manufacturers continue to modify their products. Legislators are introducing more bills to stem the tide, but it is unclear what Congress can do to help law enforcement battle these drugs, the article notes. Synthetic drugs are popular because they are easily available and less detectable by standard drug tests. Users may incorrectly assume these drugs are less harmful than regular drugs. Joseph Rannazzisi, Deputy Assistant Administrator of the Drug Enforcement Administration’s (DEA) Office of Diversion Control, told senators at the hearing, “DEA is constantly behind the clandestine chemists and traffickers who quickly and easily replace newly controlled substances with new, non-controlled substances.” He noted from January to August 2013, poison control centers received 1,821 calls regarding exposures to synthetic marijuana. Because synthetic drugs are unregulated, users don’t know what they are actually getting when they buy the products in gas stations or online, Rannazzisi said.

Epilepsy Medication Could Help Treat Cocaine Dependence: Study
The drug topiramate, used to treat epilepsy and migraine headaches, may be an effective treatment for cocaine dependence, a new study suggests. There are currently no medications approved by the Food and Drug Administration to treat cocaine addiction, Science Daily reports. The study was conducted by Dr. Bankole A. Johnson of the University of Maryland School of Medicine, who previously found topiramate was a safe and effective treatment for alcohol dependence. The new study, published in JAMA Psychiatry, included 142 adults who were seeking treatment for cocaine dependence. They were randomly assigned to receive either topiramate or a placebo. The researchers found topiramate was more effective at increasing the likelihood that participants would have cocaine-free weeks. The drug was also significantly associated with a decrease in cocaine craving, and an improvement in participants’ overall functioning. Side effects of the drug were mild, and included abnormal tingling skin sensations, taste distortions, anorexia, and difficulty concentrating. “Our findings reveal that topiramate is a safe and robustly efficacious medicine for the treatment of cocaine dependence, and has the potential to make a major contribution to the global health crisis of addiction,” Dr. Johnson said in a news release. “However, topiramate treatment also is associated with glaucoma, and higher doses of the drug can increase the risk of side effects; therefore, caution must be exercised when prescribing the drug, especially when given in high doses.” A study published in July 2013 found topiramate may help reduce cocaine use in people addicted to cocaine and alcohol.


Why doesn't alcohol have nutrition labels?
A recently proposed change could mean uniform nutritional labels across all consumable goodies (including booze).
How much fiber is in your shot of Jim Beam? What vitamins are in your gin? If those questions sound odd, get ready: The same nutritional information you see on Gatorade may soon be coming to raspberry vodka. It turns out the government has different regulatory bodies for food and spirits, but a recently proposed change could mean uniform nutritional labels across all consumable goodies (including booze). It all stems from some fairly complicated legal designations that separate food (headed up by the FDA) from some, but not all, alcohol (which is regulated by the Department of the Treasury's Alcohol and Tobacco Tax and Trade Bureau). Continue reading here.

Study finds about 20% of Md. college students show signs of alcohol abuse or dependency
A new report has found that about 19 percent of underage and 22 percent of college students ages 21 to 24 in Maryland show signs of alcohol abuse or dependency. The report was done by a collaborative of Maryland's higher education institutions that have joined forces to address excessive drinking in college. The University System of Maryland and the Bloomberg School of Public Health at the Johns Hopkins University have formed a coalition of 10 college presidents from across the state to establish the Maryland Collaborative to Reduce College Drinking and Related Practices. According to a new report issued by the group, Maryland college students drink at levels similar to the national average, but its highest risk drinkers drink more than their peers and are less likely to seek help. The report also found that nearly one-third of Maryland college students drove under the influence of alcohol and drugs. The coalition said Maryland colleges will be encouraged to develop “multi-level” interventions at colleges where campus drinking occurs. Officials said that while most Maryland schools offer alcohol programs and basic training, the collaborative recommends going the extra step to help change students’ behavior and “modifying the settings that influence students’ drinking decisions.”

New insights on college drinking - Psychologists' research is pinpointing who is most at risk for drinking problems in college and developing more targeted, evidence-based interventions.
At the University at Albany in 2000, Chad Waxman fit the profile of a college student primed for risky drinking: A freshman male fraternity brother who drank in high school, Waxman chose Albany in part for its balance between work and play. "I wanted that time to let loose," he says. Despite the predictors, Waxman sailed through college in health and happiness, even serving in student government and winning multiple leadership awards at the university before graduating in 2003. He went on to earn his master's degree in counseling psychology and school counseling from Albany in 2005 and is now a PsyD candidate at Nova Southeastern University.  How did Waxman, now 33, avoid the pitfalls of drinking common among college students? That's a question psychologists are probing deeply. After all, each year, more than 1,825 college students die from alcohol-related accidents and nearly 600,000 are injured while drunk, according to a 2009 study in the Journal of Studies on Alcohol and Drugs. Another 696,000 are assaulted by another student who has been drinking, and 97,000 are victims of alcohol-related sexual assault or date rape, the study found. Then there's the 25 percent of college students who report academic consequences related to alcohol — a hangover can quickly derail plans for class or study — and the 11 percent who admit damaging property after a night of drinking (Journal of American College Health, 2002). An estimated 5 percent get into legal trouble as a result of alcohol, the same study found. In all, of the 80 percent of college students who drink alcohol, half "binge drink," or consume about four drinks in two hours for women and five in two hours for men, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Click here to read the full article.

FDA and Opioids: What's Going On Here?
Against the recommendation of its own advisors, the U.S. Food and Drug Administration approved a new high-dose narcotic painkiller, a drug that the FDA concedes has a high risk for abuse and one which was using a method that critics say may give the drug the appearance of greater efficacy. Zohydro ER will be the first hydrocodone-only opioid, and it will come in doses packing five to 10 times more heroin-like narcotic than traditional hydrocodone products such as Vicodin that combine hydrocodone with over-the-counter pain relievers such as acetaminophen or ibuprofen. Continue reading here.

Study: 10% of Teens Treated in the ER Admit to Misusing Prescription Drugs
Ten percent of 14- to 20-year-olds treated in the emergency room for any reason say they have misused prescription drugs at least once in the last year, a new study finds. The researchers at the University of Michigan found most of the teens who admitted to misusing prescription drugs used other people’s medications. Teens who misused prescription drugs were significantly more likely to also have abused alcohol and non-prescription drugs such as cough medicine, or to have used marijuana, in the past year, the study found. They were also more likely to have ridden with a drinking driver. The findings appear in the journal Pediatrics. The researchers say this is the first time prescription drug abuse in teens has been studied in an emergency department setting, even though opioid painkillers and sedatives are often prescribed by emergency department doctors, PsychCentral reports. While school-based studies have found rates of prescription drug misuse among young people to be around 8 percent, these studies do not include teens who have dropped out of school or did not continue their education past high school, the article notes. Study author Lauren Whiteside, M.D., said the findings suggest that emergency departments could be an effective place to screen teens and young adults for prescription drug misuse, and for intervening early before problems begin. “These patients are often using the emergency department for their medical care, not primary care settings,” she noted in a news release. “So, in order to curb this problem and address overdose and addiction, the ED is a good place to start.”

Friday, October 25, 2013

ATOD & Advocacy Update - Week Ending October 25, 2013



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.