Category Archives: Drug News

Deep Brain Stimulation May Treat Severe Alcohol Addiction in the Future

Despite all the attention that has been paid to the current opioid crisis, alcohol addiction hasn’t gone anywhere. According to a study published in JAMA Psychiatry, rates of alcohol use disorder rose by just over 49 percent in the US population in the years 2001-2013. One in eight adults meets the diagnostic criteria for alcohol use disorder (AUD).

Mild Electrical Current Used

Researchers at Stanford University have found that deep brain stimulation (DBS) could be a possible treatment for even the most severe cases of alcoholism. The results of the study, which were published in the journal Neurosurgical Focus, involves sending a mild electrical current through the affected person’s brain.

How Body Responds to Alcohol

When alcohol is consumed, the brain naturally releases dopamine. This is the body’s “feel good” neurotransmitter, which is released during pleasurable activities, like watching a movie, eating a good meal, exercising or having sex. When the brain becomes overstimulated by drinking alcohol, it associates alcohol with pleasurable experiences.

If that person continues drinking regularly and consumes large amounts of alcohol, the brain becomes desensitized to the release of dopamine. Alcohol no longer provides the same level of enjoyment it once did. The person needs to drink more alcohol to feel pleasure from the experience.

The Slide Toward Addiction

The slope toward addiction starts at the point when the brain compensates for alcohol’s depressant effects by increasing its glutamate function. Glutamates cause cells to increase their level of activity. In the case of someone with AUD, being around alcohol feels exciting and this feeling continues when alcohol is no longer present. He has to continue drinking to feel normal and less excited.

The longer someone has been drinking, the harder it is to stop. Regular, high-level consumption of alcohol rewires the brain and affects the decision-making process that tells an alcoholic not to drink.

Deep Brain Stimulation Technique for AUD

Deep brain stimulation is already being used to treat Parkinson’s Disease and obsessive-compulsive disorder (OCD). Scientists have also noticed that this type of therapy also reduced alcohol cravings in patients.

Dr. Casey Halpern, an assistant professor of neurosurgery at Stanford University, stated that DBS is a minimally invasive form of brain surgery. When treating Parkinson’s, doctors place deep brain stimulators to restore normal functioning to dysfunctional parts of the brain. Patients improve right away when a small dose of current is applied to these areas. Dr. Halpern went on to say that a similar treatment should possibly be able to treat alcoholism.

This may sound like an extreme method of treating AUD. Researchers point out that DBS is one of the least invasive and safest procedures performed by neurosurgeons.

To date, DBS has not been approved as an AUD treatment by the US Food and Drug Administration. This status may change at a later date as more positive evidence is gathered by researchers.

Number of Pregnant Opioid Addicts Surged Over Last 15 Years

The results from a new report released from the Centers for Disease Control and Prevention (CDC) published in the CDC’s Morbidity and Mortality Weekly Report shed light on the continued effects of the opioid epidemic on a specific portion of the population: pregnant women. The researchers found that the number of women living with opioid use disorder at the time they went into labor and delivered their babies “more than quadrupled” during the 15-year period between 1999-2014.

Opioid Addiction Leads to Other Health Issues

Opioid addiction is responsible for a number of health problems. It can take a toll on a user’s physical and mental health, as well as her personal relationships. According to statistics collected by the CDC, opioids (which include prescription pain medications and illicit drugs such as heroin) were responsible for taking the lives of more than 42,000 people in 2016, a record level for fatalities.

Opioid use at addiction levels during pregnancy has been linked to several negative health consequences for mothers and babies. The drug use can lead to preterm birth, stillbirth and neonatal abstinence syndrome (NAS), a term describing a group of conditions caused when a fetus goes through withdrawal from certain drugs before birth.

National Database Analyzed

Researchers analyzed a national database collected on women from 28 states and discovered the rate of opioid use disorder jumped from 1.5/1000 delivery hospitalizations in 1999 to 6.5/1000 delivery hospitalizations in 2014. The rate increased by 0.39 cases per 1,000 during each year of the study.

Some geographical differences were noted during the study. The average annual increases were highest in West Virginia, Vermont, New Mexico and Maine. They were lowest in Hawaii and California.

Wanda Barfield, MD, Rear Admiral, US Public Health Service (USPHS), and the Director of the Division of Reproductive Health, explained that even in states with the smallest increases year over year, more pregnant women with opioid use disorder are being seen in labor and delivery.

Strategies for Dealing with Opioid Addiction in Pregnancy

The report included strategies for states to take on the issue of opioid addiction in pregnancy.

• Ensure opioid prescribing is in line with the CDC’s current guidelines
• Intensify prescription drug monitoring programs.
• Institute a policy of substance use screening at the first prenatal visit.
• Make certain that pregnant women with opioid use disorder have access to MAT (medication assisted therapy) and other addiction treatment services.
• Provide mothers with opioid use disorder with postpartum care that includes substance abuse treatment, mental health treatment, relapse prevention and family planning services.

How Meth Use During Pregnancy Affects Neonatal Outcomes

Methamphetamine addiction is on the rise again in many areas. Meth use by pregnant women resulted in a number of negative neonatal outcomes, according to results from a systemic review and meta-analysis published in the Journal of Addiction Medicine. The review indicated meth use during results in a measurable decrease in the following:

• Infant birth weight
• Head circumference
• Body length
• Gestational age at birth

The review also found that expectant mothers who were exposed to methamphetamine didn’t experience “excessive pregnancy complications” due to their illicit drug use.

Pregnant Women “Vulnerable Population” for Meth Use

Dr. Dimitrios-Rafail Kalaitzopoulos, from the Reproductive Endocrinology Unit, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, wrote that pregnant women are one of the “vulnerable populations” that use methamphetamine. Dr. Kalaitzopoulos stated that data about the effects of meth use during pregnancy is limited, since existing studies have involved only small samples and have not accounted for the participants using other drugs as well as methamphetamine.

The investigators examined several types of materials while conducting their review, including an orderly review of clinical literature and a deep dive analysis of case-control studies. They included studies which compared women who were exposed to methamphetamine during their pregnancy with a control group who didn’t use meth.

Multiple Studies Examined by Researchers

Eight studies involving a total of 626 participants who used methamphetamine during pregnancy and 2,626 women who didn’t use the drug during pregnancy (the control group) were examined and analyzed. The results showed no difference (statistically) between women who used meth during pregnancy and the control group on preeclampsia (high blood pressure during pregnancy) rates.

Dr. Kalaitzopoulos pointed out there was a limitation to this type of meta-analysis due to the methods used to identify pregnant women who used meth. The ones who were recruited into the methamphetamine users group were placed there through a combination of self-reporting and toxicological reports, such as maternal urine tests, meconium tests performed on the infant’s first bowel movement or neonatal urine toxicology. In some instances, self-reporting only was used or taking a urine sample from the infant only was used.

None of these methods is considered ideal. To determine the extent of maternal drug use, all these methods should be used together, according to Dr. Kalaitzopoulos.

New Research Examines at Link Between DNA and Opioid Addiction

Bentley University and Gravity Diagnostics have entered into a partnership to conduct research into whether a person’s DNA can predict susceptibility to opioid addiction. The results of this work could give doctors prescribing pain medication an indication of how likely a patient is to become addicted. It could also predict how well patients who already have an opioid addiction problem will respond to specific treatments.

From Prescription Opioid Use to Addiction

According to the National Institute on Drug Abuse (NIDA), between 21-29 percent of chronic pain patients don’t take their medications properly and more than 115 people lose their lives due to opioid overdose every day. The majority (80 percent) of heroin users began their slide toward this illicit drug by misusing prescription opioid pain relievers.

Researchers will examine individuals’ DNA to discover how susceptible this factor makes them to becoming opioid-dependent. For people who have already become addicted to opioids, the scientists will examine their DNA to determine whether they are likely to respond well to both opioid and non-opioid treatments.

The results of this work could have a significant influence on doctors’ decisions about whether to prescribe opioid to specific patients. When a physician does make the choice to prescribe an opioid pain medication, a patient’s DNA profile may influence how much of the medication he is prescribed. The research results can also influence how doctors treat patients with a history of addiction.

Partnership Includes Multiple Departments at Bentley

The partnership, which will last three years, will include faculty from several departments at Bentley: Natural and Applied Sciences, Sociology and Economics. A public health geneticist will also be on the team to provide assistance with research. Bentley students will enter and process data, and write computer scripts.

Gravity Diagnostics, a Northern Kentucky-based laboratory, is providing a $360,000.00 grant to finance the work. Bentley was selected as a research partner because, “[it is] doing successful research that is relevant to the world today.”

Data Analytics First Phase in Research

In the initial phase of the research, data analytics will be used to pinpoint the genetic features that are the best predictors for addiction and responses to treatment. Once they have been identified, these features and predictions will be tested by comparing them to DNA samples taken from active opioid addicts and those in recovery.

The goal is to discover why some people become addicted to substances quickly, while others can use the same drug and seem to be resistant to physical addiction for some time.

Brain Cell Changes Linked to Opiate Addiction, Narcolepsy

UCLA researchers have made two discoveries that provide new information on chemical messengers in the brain regulating addiction and sleep. One of the new findings involves the brain of people living with a heroin addiction and the other involves the brain of drowsy mice.

In 2000, scientists at the University of California Los Angeles found that narcolepsy (a sleep disorder whose symptoms include excessive sleepiness, sleep attacks, hallucinations and loss of muscle control) is caused by loss of approximately 90 percent of the brain cells that contain the neurotransmitter hypocretin. This chemical messenger is normally present in 80,000 brain cells.

Narcolepsy and Heroin Addiction

Narcolepsy is not a common disorder, affecting about one in 2,000-3,000 people. It can go undiagnosed for a number of years, with the patient usually starting to experience symptoms in childhood or adolescence.

The results of a new study have revealed that heroin addicts have 54 percent more hypocretin-secreting neurons that non-addicts, on average. Tests performed on mice have confirmed that opiate use is responsible for this increase. The jump in hypocretin cells lasted for up to four weeks after morphine treatment stopped, which is well after the morphine would have left the mice’s bodies.

The researchers thought morphine, which is the active ingredient in heroin, may restore the hypocretin-producing neurons which are missing in narcolepsy patients. To put this idea to the test, they gave narcoleptic mice morphine. The researchers found that morphine increased the number of hypocretin-producing cells, and the symptoms of narcolepsy disappeared.

Brain Neurotransmitter May Contribute to Opioid Cravings

The mice continued to produce hypocretin after they were taken off morphine. To the researchers, this observation led to a theory that humans may continue producing hypocretin after going through heroin detox (detoxification). The researchers thought the increase in hypocretin levels may be linked to opiate cravings and that bringing them close to “normal” levels might potentially reverse narcolepsy symptoms in humans.

More work will be needed with mice before this treatment approach can be recommended for human patients. Researchers would like to discover whether reducing the number of “excess” hypocretin cells could have a role in relieving withdrawal symptoms for long-term opiate users and preventing relapse once they are clean.

Study Finds Obstacles and Delays to Getting Help for Substance Abuse

When patients with substance abuse disorder visit their doctor’s office or the local emergency room seeking help, finding appropriate treatment for them is challenging in many instances. Physicians and treatment center administrators shared their thoughts about the obstacles and delays to getting help in the Journal of Addiction Medicine.

Several issues contribute to gaps in patients getting into treatment programs, according to the study conducted by researchers at Brown University and Butler Hospital. The opioid crisis has underlined the gap between the high need for substance abuse treatment and lack of availability to programs in the US.

SAMHSA Report Reveals Shortfall in Substance Abuse Treatment

A report released by the Substance Abuse and Mental Health Services Administration (SAMHSA) states that 21.7 million people living in the US need substance abuse treatment. Only 2.35 million of them receive the help they need at a facility specializing in providing this type of care. There hasn’t been much information gathered at the organizational level about the barriers to treatment for people seeking help for substance abuse disorders.

Major Obstacles and Delays in Getting Help for Substance Abuse

Researchers interviewed 59 people they referred to as “stakeholders in the treatment referral process”. These included emergency room doctors, addiction specialists, drug and alcohol treatment center staff and administrators. When the interviews were analyzed, four major ideas stood out:

1. Healthcare providers may not be fully aware of scope of treatment options.

Providers may not have the knowledge required to determine the best type of treatment for a patient. If a healthcare provider does determine the right treatment level for a patient, he must find a program that is a good match for the patient’s needs.

2. Healthcare providers have difficulty determining patient eligibility.

Each treatment center sets its own eligibility requirements, which may prevent a particular patient from receiving needed care.

3. Providers unable to find out whether treatment centers have space available.

Once a healthcare provider determines a patient needs treatment, it is challenging for the provider to find out whether the chosen center has a bed available.

4. Communication challenges make referrals from emergency room directly to a treatment bed difficult.

Often, there is a delay in starting treatment. Direct referrals, where the patient can be taken directly to the drug and alcohol treatment center, are the best approach, especially for patients needing help for opioid use disorders.

Generic Medications for Opioid Dependence

FDA Approves Two Generic Medications for Opioid Dependence Treatment

FDA Approves Two Generic Medications for Opioid Dependence Treatment

Mylan Technologies Inc. and Dr. Reddy’s Laboratories SA have received the go-ahead to market buprenorphine and naloxone sublingual film. These products will be made available to patients as generic versions of Suboxone, a medication used to treat opioid dependence.

Buprenorphine is used to reduce the severity of opioid withdrawal symptoms. Naloxone blocks their effects and reverses the same. The two medications can be used as part of an overall treatment program that includes counseling and prescription monitoring.

More Help Available for Opiate Addiction

Generic buprenorphine and naloxone sublingual film will be available in several dosage levels. These medications can only be prescribed by medical professionals certified by the Drug Addiction Treatment Act.

Dr. Scott Gottlieb, the FDA Commissioner, stated that the FDA is taking steps to “advance the development of improved treatments for opioid use disorder” and to ensure that these medications are available to patients who need them. He also said that includes “promoting the development of better drugs, and also facilitating market entry of generic versions of approved drugs to help ensure broader access.”

About Medication-Assisted Treatment

Medication-assisted Treatment (MAT) is a treatment option that uses FDA-approved medications (buprenorphine, methadone or naltrexone) along with counseling and other types of behavioral therapies, to treat opioid addiction. This form of treatment reduces the severity of withdrawal symptoms. The medications used for MAT don’t give participants the “high” or feeling of ecstasy normally associated with opioid abuse, although some of these medications can wind up being abused as well, so they alone are not a permanent solution.

At an appropriate therapeutic dose for a patient, buprenorphine is also supposed to reduce the pleasurable effects he would experience if he took other opioids. This effect would make continued use of opioids less attractive, therefore much less likely.

Patients who are receiving MAT for opioid use disorder benefit from this type of treatment in another way as well: they cut their risk of dying by 50 percent, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

opioid withdrawal symptoms

FDA Approves Non-Opioid Drug to Treat Opioid Withdrawal Symptoms

FDA Approves Non-Opioid Drug to Treat Opioid Withdrawal Symptoms

The US Food and Drug Administration (FDA) has approved Lucemyra (lofexidine hydrochloride) to treat opioid withdrawal symptoms in adults. This drug may lessen the severity of withdrawal symptoms; however, it may not prevent them.

Lucemyra is only approved for a treatment period of up to 14 days. The medication is not meant to be used as a treatment for opioid use disorder (OUD). It’s one part of a long-term treatment plan for patients with OUD.

Opioid Withdrawal Symptoms

When someone has been taking opioids over a period of time, he will develop a physical dependence on the drugs. This is to be expected, and doesn’t necessarily mean that a patient has become addicted to the medication. Withdrawal symptoms can occur in patients who have been using opioid pain medications as directed by their doctor and people with OUD.

These withdrawal symptoms include the following:

• Anxiety
• Cravings
• Diarrhea
• Difficulty sleeping
• Muscle aches
• Nausea
• Runny nose
• Sweating
• Vomiting

How Opioid Withdrawal is Typically Managed

For patients taking opioid pain medications as directed by a doctor, opioid withdrawal is typically managed by slowly tapering off the drug. This strategy is used to lessen the effects of withdrawal symptoms. Some patients are able to avoid experiencing withdrawal symptoms entirely.

In a patient with OUD, withdrawal is typically treated by substituting another opioid medication. In time, the dose is gradually reduced or the patient is switched to a maintenance therapy program. These medication-assisted therapy (MAT) treatments may use drugs like methadone, buprenorphine or naltrexone. Medications may be prescribed to treat specific symptoms, such as aches and pains or stomach upsets.

About Lucemyra

Lucemyra is taken orally and works by reducing the release of the brain chemical norepinephrine. Its actions are believed to play a role in several opioid withdrawal symptoms.

DEA Suspends Louisiana Pharmacy Distributor Over Suspicious Orders

The Drug Enforcement Administration (DEA) announced that it has issued and served a Suspension Order on Morris & Dickson Company. The wholesale pharmaceutical distributor is situated in Shreveport, Louisiana.

The DEA alleges that the distributor failed to identify “large suspicious orders for controlled substances.” These substances were sold to independent pharmacies that the DEA says had questionable need for the drugs.

Hydrocodone and Oxycodone Purchases

The investigation centered on purchases of hydrocodone and oxycodone. It revealed that in some instances, the pharmacies were allowed to buy six times as much as a normal order. Regulations are in place requiring distributors to identify orders which are out of the norm; the DEA is alleging that Morris & Dickson Company failed to identify these large orders. As a result, millions of hydrocodone and oxycodone pills were distributed, in violation of existing law.

DEA Acting Administrator Robert W. Patterson stated that pharmaceutical distributors have an obligation to make sure that all controlled substances being ordered are for legitimate purposes. Distributors have a duty to “identify, recognize and report” any suspicious orders to the DEA.

Company Failed to File Suspicious Order Reports

The DEA became aware of the high-volume orders involved in this investigation in October, 2017. The Agency’s records revealed that the company hadn’t filed any suspicious order reports on any of the pharmacies placing the large orders. On review, the purchases made weren’t in line with the pharmaceutical market:

• Independent retail pharmacies were buying more of the drugs than the largest chain pharmacies in the state.
• The pharmacies were buying more narcotics than several of the largest pharmacies in a single zip code.

The DEA states that more than four million people in the US are addicted to prescription pain medications. This figure includes 250,000 adolescents. Drug overdoses are the leading cause of death in the United States, surpassing deaths from motor vehicles accidents or deaths due to firearms.

S

Dentist Group Announces Policy to Cut Opioid Painkiller Prescriptions

The American Dental Association its members to reduce the number of opioid painkillers they are prescribing. The Association announced a new policy stating that members should “essentially eliminate” opioids from the list of remedies they have at their disposal, “if at all possible.”

Weekly Limits for Narcotics

The Association also wants to have a time limit put in place on prescriptions of no more than one week at a time. Under the new policy, dentists would be required to complete a mandatory education program that encourages use of other pain relievers.

Dentists Prescribe Most Opioids to US Teens

Dental practitioners are the leading source of opioid prescriptions for US teens, even though they write less than seven percent of opioid prescriptions in the US. During the period from 2010-2015, the most notable increase in dental prescriptions was for patients aged 11-18. The rate jumped from close to 100 per 1,000 patients to 165 per 1,000 patients. Among all age groups, the rate increased from 131 per 1,000 patients to 147 per 1,000 patients.

Other Options Shown to be Just as Effective

The number of opioid prescriptions written by dentists continues to rise even though evidence has shown that ibuprofen and acetaminophen control most dental pain effectively, according to an analysis conducted on five studies. The results were published in the Journal of the American Dental Association. These over-the-counter medications are less risky than opioids, which are addictive.

When dentists prescribe opioids, they tend to prescribe Vicodin or Percocet to relieve the short-term pain from procedures such as wisdom teeth extractions, dental implants and root canal work.

Dr. Paul Moore, Professor at the University of Pittsburgh’s School of Dentistry and the co-author of the analysis, said that the fact dentists are still prescribing opioids when other options are just as effective most of the time is “a little disturbing.”

The Association’s new policy supports requiring dentists to complete continuing education courses on limiting opioid use to retain their license. A number of states have already adopted this policy.