NCADD-SD News & Blog

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Kellyanne Conway Will Oversee White House Response to Opioid Epidemic

Kellyanne Conway Will Oversee White House Response to Opioid Epidemic

White House counselor Kellyanne Conway will lead the White House response to the opioid epidemic, U.S. Attorney Jeff Sessions announced.

Sessions said Conway will be charged with helping change the perception about opioids and reducing addictions and deaths, Newsweek reports.

Conway, a lawyer, has no formal experience in drug policy or law enforcement, the article notes.

Before working for the Trump Administration, she had her own polling company.

Conway has promoted prevention programs as a way to combat drug use. In October, Conway told Fox News, “The best way to stop people from dying from overdoses and drug abuse is by not starting in the first place. That’s a big core message for our youth.”

Original linkOriginal author: Ezra
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60 Percent of People Who Die From Opioid Overdose Suffer Chronic Pain

60 Percent of People Who Die From Opioid Overdose Suffer Chronic Pain

A study of people who die from opioid overdoses found just over 60 percent suffer from chronic pain, HealthDay reports.

Many also struggle with anxiety or depression, the researchers report in the American Journal of Psychiatry.

The study included medical records of more than 13,000 adults who died from an opioid overdose between 2001 and 2007.

“The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems,” said lead investigator Dr. Mark Olfson of Columbia University Medical Center.

Original linkOriginal author: Ezra
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Significant Inequalities Between Mental and Physical Health Payments Uncovered

Significant Inequalities Between  Mental and Physical Health Payments Uncovered

Medical and surgical healthcare providers are receiving significantly higher payments from insurers than addiction and mental health practitioners for the same types of services, finds a groundbreaking, independent report published by Milliman, Inc. and released by a coalition of America’s leading mental health and addiction advocacy organizations including the Legal Action Center.

In the Milliman report, commissioned by the Bowman Family Foundation, researchers found that along with payment disparities, which occur in 46 out of 50 states, “out-of-network” use of addiction and mental health treatment providers by consumers is extremely high when compared to medical and surgical providers.

This perfect storm of factors reveals that patients are being forced into more costly out-of-network care, and can mean that treatment is abandoned altogether.

When taken together, the analysis paints a stark picture of restricted access to affordable and much-needed addiction and mental health care in an era of escalating suicide rates and opioid overdose deaths. Further, these disparities point to potential violations of federal and state parity laws, which require insurance companies to treat diseases of the brain, such as clinical depression and opioid addiction, the same way they treat illnesses of the body, such as cancer and heart disease.

One of the most dramatic disparities outlined in the report is the low reimbursements paid to behavioral health providers when compared to physical health providers – a factor likely influencing network access and overall practitioner shortages.

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SAVE THE DATE: Join us December 14 for a Twitter Chat about Women and Alcohol

SAVE THE DATE:  Join us December 14 for a Twitter Chat about Women and Alcohol

Why are drinking guidelines different for women than men? How do the health effects of heavy drinking differ? Where can women turn for help if they have an alcohol problem?

The National Council on Alcoholism and Drug Dependence (NCADD) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) are partnering for a Twitter Chat on women and alcohol. Bring your questions for NCADD and NIAAA experts as we discuss what women need to know about alcohol and their health.

Date: Thursday, December, 14, 1:00-2:00 pm ETHashtag: #FAQWomenDrinkingNCADD Expert: Julie Dostal, PhD, Executive Director, LEAF Council on Alcoholism and Addictions, Oneonta, NY and NCADD Board MemberNIAAA Expert: Deidra Roach, MD, NIAAA Medical Project OfficerOriginal linkOriginal author: Ezra
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SAMHSA Releases Resource on Preventing Opioid Overdose

SAMHSA Releases Resource on Preventing Opioid Overdose

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a resource titled “Preventing Opioid Overdose: Understanding Good Samaritan Laws”.

This resource provides an overview of this overdose prevention strategy, including the aims of these laws and types of protections they can offer.

Overdose Good Samaritan laws are policies that provide legal protections for individuals who call for emergency assistance (such as 9-1-1) in the event of a drug overdose. This may include protection from arrest and/or prosecution for crimes related to drug possession, drug paraphernalia possession, and other crimes. These laws are designed to encourage people to summon emergency assistance if they experience or witness a drug overdose.

As of July 2017, 40 states and the District of Columbia have instituted Good Samaritan laws. Yet, lack of awareness and understanding of the protections these laws provide, as well as concerns about their limitations, may be limiting their effectiveness in encouraging overdose bystanders to call for help. These barriers may also prevent the criminal justice system from fully observing them.

The resource further outlines some of the obstacles that prevent overdose bystanders and the criminal justice system from applying their state’s Good Samaritan laws, and steps prevention practitioners can take to raise awareness of these laws among various target populations.

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Cost of Opioid Crisis Estimated at $504 Billion by the Council of Economic Advisers

Cost of Opioid Crisis Estimated at $504 Billion by the Council of Economic Advisers

The Council of Economic Advisers (CEA) recently announced that the opioid drug problem has reached crisis levels in the United States—in 2015, over 33,000 Americans died of a drug overdose involving opioids.

CEA finds that previous estimates of the economic cost of the opioid crisis greatly understate it by undervaluing the most important component of the loss—fatalities resulting from overdoses.

The CEA report estimates the economic cost of these deaths using conventional economic estimates for valuing life routinely used by U.S. Federal agencies. It also adjusts for underreporting of opioids in overdose deaths, includes heroin-related fatalities, and incorporates nonfatal costs of opioid misuse.

CEA estimates that in 2015, the economic cost of the opioid crisis was $504.0 billion, or 2.8 percent of GDP that year. This is over six times larger than the most recently estimated economic cost of the epidemic.

Copy of the full report is available here.

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Separating Side Effects Could Hold Key for Safer Opioids

Separating Side Effects Could Hold Key for Safer Opioids

NIH-funded scientists may have revealed brain functions in pre-clinical research that widen the safety margin for opioid pain relief without overdose

Opioid pain relievers can be extremely effective in relieving pain, but can carry a high risk of addiction and ultimately overdose when breathing is suppressed and stops. Scientists have discovered a way to separate these two effects -- pain relief and breathing -- opening a window of opportunity to make effective pain medications without the risk of respiratory failure. The research, published today in Cell, was funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Opioid medications suppress pain by binding to specific receptors (proteins) in the brain; these same receptors also produce respiratory suppression. However, the way these receptors act to regulate pain and breathing may be fundamentally different. Studies using mouse genetic models suggest that avoiding one particular signaling pathway led to more favorable responses to morphine (pain relief without respiration effects). The investigators then explored if they could make drugs that would turn on the pathways associated with pain relief and avoid the pathways associated with respiratory suppression.

"We are pleased to have uncovered a potential new mechanism to create safer alternatives to opioid medications, ones that would be far less likely to cause the side effects that lead to overdose deaths associated with the misuse of opioids," said NIDA Director Nora D. Volkow, M.D. "We are excited that basic research on how opioid drugs work in the brain has led to this novel approach, and that we continue to make critical progress in this area."

How the pathways split following receptor activation is referred to as biased signaling. The study showed that as the degree of bias (divergence) increased, so too did the ability of an opioid to reduce pain in mice without affecting breathing. Similarly, compounds that favor the breathing pathway produced more respiratory side effects at lower doses. Ultimately, opioids with a larger divergence (bias factor) had a larger margin of safety, or therapeutic window, opening up an opportunity for medication intervention.

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Some Experts Question Opioid Commission’s Marijuana Warning

Some Experts Question Opioid Commission’s Marijuana Warning

The chair of President Trump’s Opioid Commission warned about the dangers of marijuana, in a letter accompanying the release of the commission’s final report.

Some experts are questioning the commission’s view that marijuana could further fuel the opioid crisis.

New Jersey Governor Chris Christie, the chair of the commission, warned against legalizing marijuana in the midst of the opioid epidemic.

One researcher, Dr. Chinazo Cunningham, a professor of medicine at the Albert Einstein College of Medicine, told CNN she is surprised to see negative language about marijuana in the opioid report. “Research that examines pain and marijuana shows that marijuana use significantly reduces pain,” she said. “In addition, the majority of studies examining marijuana and opioids show that marijuana use is associated with less opioid use and less opioid-related deaths.”

Dr. Cunningham is conducting the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV.

Original linkOriginal author: Ezra
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Long-Acting and Daily Medications to Treat Opioid Addiction Found Equally Effective

Long-Acting and Daily Medications to Treat Opioid Addiction Found Equally Effective

A new study finds a long-acting medication and a short-term drug that must be taken daily are equally effective in treating opioid addiction.

Researchers at NYU Langone Health found extended-release naltrexone (Vivitrol) was as safe and effective as more commonly prescribed buprenorphine-naloxone (Suboxone) in curtailing opioid use, relapse, treatment drop-out, and overdose.

The study, which was sponsored by the National Institute on Drug Abuse, was published in The Lancet.

The study is the first major head-to-head comparison of the treatments, according to The Washington Post. Researchers found each treatment had disadvantages. Short-acting medicines must be taken daily for years or even a lifetime. Naltrexone, which is given as a monthly injection, cannot be started until a person is fully detoxified from opioids—which more than 25 percent of the study subjects failed to do.

More than half of the study subjects relapsed at least once, regardless of which treatment they received.

Original linkOriginal author: Ezra
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DEA Rule Allows Criminal Prosecution for Fentanyl Trafficking

DEA Rule Allows Criminal Prosecution for Fentanyl Trafficking

The Drug Enforcement Administration (DEA) will classify illicit versions of fentanyl at the same level as heroin, Reuters reports.

The action will make it easier for federal prosecutors and agents to prosecute traffickers of all forms of fentanyl-related substances, the agency said.

Legally prescribed fentanyl is classified as a Schedule II drug, which means it is highly addictive but has a medical purpose.

The new DEA order classifies illicit fentanyl as a Schedule I drug, along with heroin. Schedule I drugs are considered addictive, with no medicinal purpose.

The DEA order will last up to two years, with a possibility of a one-year extension if certain conditions are met. In a statement, Attorney General Jeff Sessions said, “By scheduling all fentanyls, we empower our law enforcement officers and prosecutors to take swift and necessary action against those spreading these deadly poisons. I also urge the many members of Congress who clearly share our concern and alarm over fentanyl’s role in our opioid overdose epidemic to do their part by permanently scheduling these lethal substances.”

Original linkOriginal author: Ezra
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Teens Dependent on Marijuana and Alcohol Struggle with Success Later in Life

Teens Dependent on Marijuana and Alcohol Struggle with Success Later in Life

Teens who are dependent on marijuana and alcohol struggle to achieve hallmarks of adult success, such as graduating from college, getting married, having a full-time job and earning a good salary, a new study finds.

Researchers at the University of Connecticut tracked 1,165 study participants, starting at age 12.

They checked in on them at two-year intervals, until they were between 25 and 34 years old, HealthDay reports. Most of the participants had a grandparent, parent, aunt or uncle with an alcohol problem. Marijuana and alcohol dependence appeared to have a more severe effect on young men.

“Parents should try to delay their children’s onset of use as much as possible,” said researcher Victor Hesselbrock. “If you can push regular use back well into adolescence, the kids do a lot better.”

The study was presented at the annual meeting of the American Public Health Association.

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Millions of Dollars Needed for Trump’s Anti-Opioid Ad Campaign, Advocates Say

Millions of Dollars Needed for Trump’s Anti-Opioid Ad Campaign, Advocates Say

The anti-drug ad campaign advocated by President Trump’s opioid commission will need millions of dollars in funding, advocates tell The Hill.

It is not clear how such a campaign would be funded, the article notes.

New Jersey Governor Chris Christie, who chaired the commission, said the campaign should be paid for by the federal government, with private sector partners. The report, released recently, included 56 recommendations, including an aggressive multimedia campaign to fight the opioid epidemic.

An ad campaign must be part of a more comprehensive approach that includes strengthening treatment and changing opioid prescribing patterns, advocates say.

In order to be effective, a campaign must be based on evaluations of what has been effective in the past, and must frequently test the ad’s message with the target audience, they note. “We’ve learned a lot about how to communicate about these issues in the past three decades or so. There’s a lot of really good science on this right now,” said Marcia Lee Taylor, Chief Policy Officer of the Partnership for Drug-Free Kids.

Original linkOriginal author: Ezra
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Combo of Acetaminophen and Ibuprofen as Effective as Opioids for Acute Pain

Combo of Acetaminophen and Ibuprofen as Effective as Opioids for Acute Pain

A study of patients who went to the emergency room suffering from acute pain found those given a combination of ibuprofen and acetaminophen reported as much pain relief as those who were given opioids.

The 416 patients in the study had acute pain in their shoulders, arms, hips or legs, the Los Angeles Times reports.

About 20 percent of the patients had a bone fracture, the researchers wrote in the Journal of the American Medical Association. Other patients had injuries such as a sprained ankle or dislocated shoulder.

Patients were assigned to one of four groups. One group received a combination ibuprofen/acetaminophen tablet (containing the medications found in Advil and Tylenol. The other groups received a drug containing a prescription opioid, such as Percocet (a combination of oxycodone and acetaminophen), Vicodin (hydrocodone and acetaminophen) or Tylenol No. 3 (codeine and acetaminophen).

Patients were asked to rate their pain when they arrived at the hospital and two hours after they received their medication. Those who took the acetaminophen/ibuprofen tablet reported pain relief similar to those who received an opioid.

Original linkOriginal author: Ezra
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Drug Overdose Deaths Rose More Than 17 Percent Last Year: CDC

Drug Overdose Deaths Rose More Than 17 Percent Last Year: CDC

 Drug overdose deaths increased more than 17 percent between 2015 and 2016, according to a new report by the Centers for Disease Control and Prevention (CDC).

The overdose death rate rose to almost 20 people per 100,000, up from 16.3 per 100,000 the previous year, The New York Times reports.

Drug overdoses are now the leading cause of death for Americans under age 50, the CDC found.

Recently, these deaths have been driven by overdoses of fentanyl and other synthetic opioids, according to Dr. Robert Anderson, Chief of the CDC mortality statistics branch. “The main message is the drug rate went up a lot again, and of course we’re worried about it,” he said.

Original linkOriginal author: Ezra
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Hospitals Overwhelmed With Treating Diseases Resulting From IV Drug Use

Hospitals Overwhelmed With Treating Diseases Resulting From IV Drug Use

Hospitals are struggling to deal with an overwhelming number of cases of diseases that result from intravenous opioid use, including hepatitis C, endocarditis and the antibiotic-resistant infection MRSA.

Hepatitis C is the most common infectious disease that affects people with opioid use disorder, USA Today reports.

Reported cases of the disease almost tripled between 2010 and 2015.

Endocarditis—a condition in which the heart’s inner lining is inflamed—is a side effect of opioid addiction. Hospitalizations for endocarditis rose almost 50 percent from 2002 to 2012, at an average cost of $50,000 per patient.

MRSA is the second most common co-occurring condition with opioid use disorder, the article notes. The cost of treating the infection is about $60,000 per patient.

Original linkOriginal author: Ezra
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Teens Bring Juul E-Cigarette Device, Which Looks Like USB Flash Drive, to School

Teens Bring Juul E-Cigarette Device, Which Looks Like USB Flash Drive, to School

School officials report a growing number of teens are bringing a new e-cigarette device called a Juul vaporizer to school.

The device looks like a USB flash drive, and charges when plugged into a laptop, USA Today reports.

Juul is small enough to fit inside an enclosed hand. It comes with pods of e-liquid in sweet flavors such as mango, fruit medley and crème brulee. The devices and flavored pods can be ordered online.

U.S. Senator Chuck Schumer of New York wrote a letter to the Food and Drug Administration (FDA), asking it to reverse a recent decision to delay the regulation of e-cigarettes popular among teens, such as Juul.

“To know that New York kids are much more likely to be using these new-age e-cig devices, like Juul, is not only concerning, but it could be dangerous,” Schumer said in a statement. “Up until now, the FDA was on track to reign in e-cigs and regulate them like any other tobacco product, but this recent delay, coupled with the new numbers showing a rise in the use of gadgets like Juul, which can fool teachers and be brought to school, demands the FDA smoke out dangerous e-cigs and their mystery chemicals before more New York kids get hooked.”

Original linkOriginal author: Ezra
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NIAAA Alcohol Treatment Navigator: Pointing the Way to Quality Care

NIAAA Alcohol Treatment Navigator: Pointing the Way to Quality Care

 

Source: Blog by George F. Koob, PhD. NIAAA Director

Welcome to my first-ever NIAAA Director’s Blog. I look forward to using this space to discuss significant advances in alcohol research and to highlight work supported by NIAAA. In this first installment, I would like to introduce you to an exciting and important new online resource developed by NIAAA – the Alcohol Treatment Navigator. In any given year, more than 15 million adults in the US meet the diagnostic criteria for alcohol use disorder (AUD), but less than 10% of them receive treatment. Meanwhile, many of those in treatment may not receive the care that best fits their needs.

What accounts for this alcohol “treatment gap?”

Often, finding quality AUD care can be complicated, and many people aren’t aware of the full range of available treatment options. It can also be difficult to tell if a provider is offering good quality treatment – what we call “evidence based care” – that is, treatment that is grounded in clinical and health services research that demonstrates positive treatment outcomes.

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DEA Collects Record Number Of Unused Pills As Part Of Its 14th Prescription Drug Take Back Day

DEA Collects Record Number Of Unused Pills As Part Of Its 14th Prescription Drug Take Back Day

The public returns record number of potentially dangerous prescription drugs

Americans nationwide did their part to reduce the opioid crisis by bringing the DEA and its more than 4,200 local and tribal law enforcement partners a record-setting 912,305 pounds-456 tons-of potentially dangerous expired, unused, and unwanted prescription drugs for disposal at more than 5,300 collection sites. That is almost six tons more than was collected at last spring's event.This brings the total amount of prescription drugs collected by DEA since the fall of 2010 to 9,015,668 pounds, or 4,508 tons.

Now in its 8th year, National Prescription Drug Take Back Day events continue to remove ever-higher amounts of opioids and other medicines from the nation's homes, where they could be stolen and abused by family members and visitors, including children and teens. The DEA action comes just days after President Donald J. Trump announced the mobilization of his entire Administration to address drug addiction and opioid abuse by directing the declaration of a Nationwide Public Health Emergency to address the opioids crisis.

"More people start down the path of addiction through the misuse of opioid prescription drugs than any other substance. The abuse of these prescription drugs has fueled the nation's opioid epidemic, which has led to the highest rate of overdose deaths this country has ever seen," said Acting Administrator Robert W. Patterson. "This is a crisis that must be addressed from multiple angles. Educating the public and removing these medications from households across the Unites States prevents misuse where it often starts."

This year, DEA worked with its tribal law enforcement partners to set up 115 collection sites on tribal lands. Opioid addiction impacts Native American communities just as it does all parts of American society. By partnering with FBI, BIA, and tribal law enforcement, the DEA was able to greatly expand tribal participation in the Take Back program. DEA remains committed to supporting public safety in American Indian and Alaska Native communities.

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NIDA Launches Two Adolescent Substance Use Screening Tools

NIDA Launches Two Adolescent Substance Use Screening Tools

The National Institute on Drug Abuse (NIDA) has launched two evidenced-based online screening tools that providers can use to assess substance use disorder risk among adolescents 12-17 years old.

These tools can be self-administered or completed by clinicians in less than two minutes. They are being offered through the NIDAMED Web Portal.

The American Academy of Pediatrics recommends universal screening in pediatric primary settings, and these tools help providers quickly and easily introduce brief, evidence-based screenings into their clinical practices. Providers can select the tool that best fits their practice.

The screening options are:

For more information on adolescent substance use screening tools, click here.

Original linkOriginal author: Ezra
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Patients Treated with Naloxone Continue to be at High Risk of Overdose: Study

Patients Treated with Naloxone Continue to be at High Risk of Overdose: Study

A new study finds 10 percent of people saved by the opioid overdose antidote naloxone die within a year of treatment.

“Patients who survive opioid overdoses are by no means ‘out of the woods,'” lead study author Scott Weiner, MD, Director of the Brigham Comprehensive Opioid Response and Education Program at Brigham and Women’s Hospital, said in a news release. “These patients continue to be at high-risk for overdose and should be connected with additional resources such as counseling, treatment and buprenorphine.”

The study, presented at the annual meeting of the American College of Emergency Physicians, found half of patients who died within a year of naloxone treatment died within one month of treatment, HealthDay reports.

Original linkOriginal author: Ezra
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