If you could order a genetic test that could tell you whether you were at risk for opioid abuse later in life, would you take it? The test would be something like the one available from companies currently offering health predisposition information along with DNA testing. Instead of indicating whether someone has a higher-than-average risk of developing heart disease, the proposed test would tell who is at risk for opioid addiction.
A New Jersey research institute is working with leaders in the medical community, scientists and academics to unravel the genetic code as it pertains to opioid dependency.
Team Investigates Factors Contributing to Opioid Abuse
The Coriell Institute for Medical Research, Rowan University’s Cooper Medical School and Cooper University Health Care have come together to launch the Camden Opioid Research Initiative (CORI). This team will investigate “genetic and biological factors that contribute to opioid abuse.”
One key part of the study will involve collecting and testing tissue samples from people who have lost their lives from an opioid overdose. The researchers will also be studying people currently in treatment for opioid addiction, along with patients who are receiving prescription opioids for chronic pain treatment but have not become addicted. The findings from the two groups will be compared.
Stefan Zajic, the principal scientist and scientific lead for CORI, explained that the dream for scientists would be to have access to a profile or algorithm that would provide doctors and patients with information about genetic factors that may influence their susceptibility to opioid addiction.
Genetic Test Could Influence Future Prescribing Habits
If a genetic test were available to indicate to healthcare providers which patients are at higher risk for opioid addiction, a doctor could take that factor into consideration when making decisions about which medications to prescribe. The doctor may choose to prescribe a non-opioid, adjust the dose if he or she decides to prescribe an opioid medication or prescribe a smaller number of pills so that the patient can be monitored more closely for follow-up.
The research team will work with the medical examiner’s office to establish a biobank of the tissue samples (with the respective families’ permission). Zajic believes it will be the first one of its kind in the country. The tissue samples will be made available to researchers in the field of opioid abuse going forward.
A monthly injection of buprenorphine BUP-XR is more effective than placebo for treating opioid addiction, according to the results of a new study. This formulation is the extended release version.
A daily dose version of buprenorphine was approved by the FDA (US Food and Drug Administration) in 2002. It has been an effective treatment for opioid use disorder. Daily doses mean patients must commit to taking it each day; they may start to experience cravings for opioids once they get close to the end of the 24-hour cycle when they can take more medication.
Medication Assisted Therapy for Opioid Addiction
Buprenorphine and methadone are both used in MAT (Medication Assisted Therapy) to treat opioid addiction. These medications are used in combination with behavioral counseling as part of a “whole patient” approach. The medications are used to control cravings and clients work with a counselor to develop new ways of thinking and responding to life stresses.
Extended Release Buprenorphine Called Sublocade
The extended-release version of buprenorphine was approved by the FDA in November 2017, which is being marketed under the brand name Sublocade. Approval was based on positive results in a Phase III human subjects study. The study has been published in The Lancet to make it available to the wider scientific community.
Double Blind Study Conducted
Researchers divided 200 participants in the randomized, double-blind study into three groups. All of them had a mean duration of opioid use of between 11 and 12 years. Two of the groups were given different monthly doses of BUP-XR and one was given a placebo.
Both groups who were given BUP-XR reported “substantial portions of participants” abstaining from opioids. They also experienced relief from withdrawal symptoms and control from cravings for opioids without having to take medication on a daily basis.
The opioid epidemic has triggered a hardship that most people likely haven’t thought of: A higher number of donated organs are infected with the hepatitis C virus.
Dr. Winston Abara, a hepatitis researcher at the Centers for Disease Control and Prevention (CDC), explains that as the number of drug overdose deaths and acute hepatitis infections increases, young people are most affected. These are the people who are most likely to be eligible organ donors.
Opioid Users Considered Increased Risk Donors
In the years 2010-2017, the number of organs obtained for transplant obtained from “increased risk” donors (people at risk of hepatitis due to drug abuse) tripled, according to the results of a new study published in the January 25 edition of CDC’s Morbidity and Mortality Weekly Report.
In 2010, approximately nine percent of donor organs came from people in this category. By 2017, that number had jumped to over 26 percent, according to Dr. Abara’s team.
The number of organs obtained from people who died as the result of “drug intoxication” tripled as well. They climbed from just over four percent in 2010 to over 13 percent by 2017, according to CDC researchers. Organ donor deaths linked to injected drugs like heroin increased fivefold during the same period.
This is concerning, since tainted needles are a prime source of infection with hepatitis C, which can lead to liver disease, a potentially fatal condition, over time. Due to advances in medical care, donor kidneys, along with livers and other organs can now be used for transplant and may save potentially save the lives of the thousands of people on waiting lists.
Medications Available to Treat Hep C in Transplant Recipients
Powerful new medications exist to rid the body of hepatitis C and render the transplant viable. The transplant recipient would be screened after receiving the donor organ. If a hepatitis C infection is diagnosed, the donor organ recipient is offered antiviral treatment.
Dr. David Bernstein, a liver specialist, stated that understanding whether an organ donor has a history of addiction is essential. He said that when that knowledge is available, organ recipients and their doctors can be notified and screened after transplant surgery.
It was the late 1990’s when big pharma was making promises to the medical community that addiction would not occur in patients prescribed opioid pain relievers. A few short decades later and the Department of Health and Human Services declared a public health emergency for the ensuing opioid crisis. Opioid withdrawal, abuse, and treatment have since become the focus of Arizona opioid rehab centers statewide.
A combination of factors has led to the explosion of opioid addiction. Many of the reasons lead back to the over prescribing of painkillers, ease of access to medication, and increased availability of street versions of opioid-based drugs. One factor not mentioned enough, however, is the impact opioid withdrawal symptoms have on a patient’s ability to break their addiction.
What are Opioids?
Opioids, also known as opiates, are a class of drugs made from the opium poppy plant. The opium is used to make medications which in turn are prescribed for treating pain. Examples of opioid medications include codeine, morphine, amphetamine, oxycodone, hydrocodone, and fentanyl.
Heroin, an illegal opioid drug, is also derived from a natural substance found in the opium plant called morphine. Both prescription and illicit opioids are highly addictive and can easily cause dependency. The abuse of prescription and “street” opioids are largely responsible for the rise in the drug addiction statistics in the US.
How Common is Opioid Addiction?
Opioid addiction is a serious problem that affects millions of men and women in the US. The rise in abuse of both illicit and prescription opioids and the rate of overdose lead to the opioid crisis. According to the Centers for Disease Control and Prevention (CDC), 66% of drug overdose deaths in 2016 involved opioids. Due to its addictive nature, comprehensive clinical treatment is usually required.
Opioid addiction treatment involves detoxification followed by therapy. Cognitive Behavioral Therapy as part of rehabilitation has proven effective in reducing the risk of relapse. However, overcoming opioid addiction can be one of the toughest parts of rehab because the process is accompanied by severe withdrawal symptoms.
Why is Opioid Withdrawal Challenging?
The National Institute on Drug Abuse refers to drug addiction as a complex disorder. The disorder affects brain functions making it very difficult for users to simply quit drug abuse. The brain is made up of natural opioid receptors that help in the release of dopamine and endorphins. These two hormones are responsible for feelings of pleasure.
Smoking, snorting, or injecting opioids frequently activates these receptors and make the brain want more and more of this euphoria. Over time, the receptors build a tolerance and require higher dosages of the drug. Eventually, sufferers begin to compulsively seek out the addictive substance despite of its effects on their health, relationships, or career.
Arizona Opioid Rehab and Detoxification
Opioid withdrawal starts with detoxification, or detox. Detox is a medically-assisted process of removing the drug and toxins from the body. During this time, the addicted individual will experience various physical, psychological, and emotional symptoms.
Some of them can be severe enough to make him or her want to quit rehab more than quitting their addiction. The severity of withdrawal symptoms has led many treatment centers to adopt a new approach involving the administration of one or more FDA-approved drugs to help reduce the effects of withdrawal symptoms.
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Opioid Withdrawal Timeline
The length of time it takes to withdraw from opioid varies from person to person. The withdrawal timeline usually depends on the type of opioid abused, level of addiction, dosage, frequency of use, and the body’s response to detoxification. It can take about 2 weeks to several months before the client stabilizes. In general, the first 7 days of detox is the worst for the patient seeking treatment.
Various physical and psychological symptoms may be experienced during this time, some of which can be severe. Symptoms usually set in between 6 to 30 hours after the last dose taken. Symptoms that become very intense at the 72-hour mark are known as post-acute withdrawal symptoms (PAWS).
The general withdrawal stages and time-frames are as follows:
Days 1-2: Restlessness, anxiety, runny nose, excess sweating, muscle aches, and trouble sleeping are symptoms that typically begin within the first 6 to 30 hours after the last dose. Patients may experience strong cravings and drug-seeking behaviors.
Days 3-5: Symptoms reach their peak and cravings can be overpowering. Post-acute withdrawal symptoms may appear during this time-frame. Patients may experience body tremors, nausea, vomiting, rapid heartbeat, abdominal cramps, or high blood pressure. Some other symptoms include chills, diarrhea, dilated pupils, stomachache, or blurred vision.
Days 6-7: Physical symptoms begin to improve, but psychological symptoms such as depression, irritability, and insomnia begin to set in. However, cravings are not as powerful as before. At this point in the detox process, patients first begin to stabilize.
Day 8 and later: Patients usually become remorseful and emotional during this stage. They may think or act irrationally and may feel hopeless. With emotional and psychological support from a therapist or counselor, you can better cope and overcome this phase.
Seeking the Right Treatment
Opioid rehab in Arizona treatment centers have evolved to treat the physical, mental, and emotional hurdles sufferers face when detoxifying from opioid abuse. The comprehensive approach yields higher success rates than individuals who only receive treatment for the physical symptoms of opioid withdrawal.
If you or someone you know is struggling with opioid addiction, let them know friends and family are there to support them along with specially trained experts who can help them break the addiction. The first step toward recovery is only a phone call away.
The results of a survey conducted by The Hartford, a leading property and casualty insurance company, have found the current opioid epidemic is having a “tangible and growing impact” on employers across the US. The survey also found that a majority of Human Resources (HR) professionals and workers feel they don’t have the knowledge or resources necessary to deal with addiction.
Companies of All Sizes Participated in Opioid Survey
Two thousand workers and 500 HR leaders participated in the national survey, which collected responses from companies of all sizes.
• Two-thirds of HR professionals (67 percent) said their company is being impacted by opioid use today, or will be in the future. • Just under two-thirds of the HR professionals (65 percent) revealed that opioid addiction is impacting their company financially.
Employees, HR Staff Feel Unprepared for Substance Use Problems
The Hartford survey is an opportunity for employers to provide addiction education materials to workers, as well as develop and implement consistent policies and procedures regarding drug misuse.
• Many employees (76 percent), as well as HR professionals (64 percent), don’t feel they are well trained when it comes to helping co-workers who have an opioid addiction issue. • When asked if they could spot the signs of an opioid addiction, 24 percent of HR professionals and 18 percent of employees felt extremely or very confident they could. • Nineteen percent of HR professionals and employees feel they are extremely or very knowledgeable about how to reduce the risk of opioid addiction.
The Opioids in the Workplace survey was conducted with an online research panel on August 9-15, 2018. A representative sample of 2,500 US adults from across the nation was divided into two groups. Two thousand full and part-time workers and 500 participants with an HR role answered questions.
The margin of error for the first group is +/-2.2 percent at the 95 percent confidence level. For the second group, the margin of error is +/-4.4 percent at the 95 percent confidence level.
Ibogaine treatment has seen a rise in popularity in recent years, specifically when it comes to opioid addiction treatment. There are many claims made regarding the success rates of Ibogaine treatment, which uses a psychoactive compound found in several different plants to facilitate a detox experience for patients addicted to a wide-range of substances. While this treatment seems to show promise, it is important to be aware of the potential risks involved in undergoing this largely unproven and untested form of addiction treatment. Before diving into this treatment method, it’s important to answer the question: is Ibogaine safe?
The Trap of the Magic Pill Mindset
In the battle to overcome addiction, it can be tempting to believe that a simple magic pill or treatment will be the answer to the problem. Unfortunately, addiction is often the result of many factors in one’s life. Whether it be trauma, a genetic predisposition to certain substances, social influences, or other co-occurring disorders, addiction can stem from many root causes, something which a simple treatment modality such as Ibogaine will not fully address.
To quote from Harvard Medical School professor Dr. Bertha Madras: “People think there is going to be a magic pill that’s going to erase addiction, and that’s just not reality. What they should not be desperate for is a quick fix.” While certain treatment methods can be useful in the process of overcoming addiction, a holistic, multi-faceted approach is the recommended way to address an addiction, as it will incorporate each issue which is contributing to the dependence.
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The Dangers of Ibogaine Treatment
Ibogaine has been promoted recently as an alternative therapy to traditional methods, specifically as an option for opioid addiction treatment. Some medical professionals believe that Ibogaine inhibits the reuptake of serotonin, and that it can not only prevent a person from experiencing dangerous withdrawals, but that it can also reduce a person’s desire to use the substance again.
It is claimed that the spiritual aspects of this substance induce a sense of introspection which also leads to relief from addictive cravings, as a person will have an increased degree of perspective after their Ibogaine experience. This is the result of the fact that Ibogaine is an intense, hallucinogenic drug that can last up to 24 hours. Ibogaine can cause physical responses such as dry mouth, nausea and vomiting, muscle coordination issues, as well as extreme levels of dehydration.
In addition to the physical symptoms a person may experience as a result of taking Ibogaine, the drug can also bring on intense emotional reactions, many of which can be difficult for some individuals to process. If a practitioner is not able to effectively help guide a patient through their experience, Ibogaine can become a terrifying experience, fraught with uncertainty and unclear solutions.
An Uncertain, Unproven Treatment for Addiction
While Ibogaine seems to show promise as a treatment option for addiction, there is simply not enough data to say for sure whether this is a reliable and effective modality. A patient who decides to take the chance and try Ibogaine as a method for curing their addiction must rely on a certain degree of faith, as there is an absence of proven, time-tested evidence to fall back on in terms of how effective this drug is.
Because Ibogaine is listed as a schedule 1 drug in the United States, there are no Ibogaine clinics available stateside where a person can seek treatment. Instead, individuals are forced to go to Mexico and other countries where Ibogaine is allowed, but still not has heavily regulated as it would be in the US. While some clinics may claim to offer a trusted, safe environment for patients to detox within while using Ibogaine, this process is undoubtedly risky and involves a great level of inconvenience for the person who decides to go this route.
In order to answer the question: is Ibogaine safe, we must look at the potential risks inherent in this treatment option. According to a study conducted by the National Institutes of Health, Ibogaine affects the cardiovascular system and there have been alarming reports of life-threatening complications, as well as sudden death cases associated with the administration of Ibogaine. The most likely cause of these sudden death cases was cardiac arrhythmias, showcasing the potential downsides which can impact a patient if they don’t consider all of their current health conditions.
Is Ibogaine Safe?
Ibogaine is an unknown, mostly untested treatment option which has a long way to go before it can be considered a safe option for patients seeking relief from their drug addiction. The most effective treatment options are always those that address the confluence of factors which can make up the reasons for why a person becomes addicted. Magic pills are an intriguing idea to entertain, but the truth is that they are simply not a realistic outcome for people seeking relief from their addiction.
After declaring the US in the midst of a public health emergency in 2017 due to the opioid crisis, The President signed a bill into law that experts believe will help to curb the opioid crisis. The new legislation is called the SUPPORT for Patients and Communities Act.
More Funding for Addiction Treatment
The new law provides funding to federal agencies and states so that they can provide increased access to addiction treatment. It also puts measures in place to help alleviate the crisis, such as:
• Preventing overprescribing • Training law enforcement agencies to intercept drug shipments at US borders
The bill signing was the culmination of a 12-month effort by the legislative and executive branch to react to the opioid crisis. While lawmakers said the bill was a step in the right direction, although many of them said it didn’t go far enough to deal with the epidemic. Rep. Frank Pallone of New Jersey cautioned of ramifications of talk of reducing access to publicly-funded treatment programs.
Congress and the White House entered into discussions for making a plan for confronting the epidemic in October 2017. This was before several congressional hearings by the House and the Senate on the same subject.
Public health experts have spoken out in favor of the bill, since it increases access to treatment. They say this is a critical step to controlling the epidemic. One of the measures in the legislation removes an old measure that didn’t allow clients with substance abuse issues get treatment in mental health facilities with more than 16 beds under Medicaid.
Private Companies on Board with New Initiatives
The White House has also pointed to new initiatives from private companies:
• Amazon has programmed its Alexa voice service to answer consumers’ questions about opioids and addiction. • Blue Cross Blue Shield, the major insurance provider, will establish a national toll-free phone number to help US residents locate drug and alcohol treatment centers. • Biopharmaceutical company Emergent BioSolutions will offer free Narcan nasal sprayers at over 16,500 public libraries and 2,700 YMCAs. Narcan, when administered to someone experiencing an opioid overdose, can help reverse the condition.
Treatment Still the Main Focus
What this new law and other efforts do is to help continue to focus on the need for treatment at all levels. This current drug crisis won’t subside until there are enough people seeking and receiving quality treatment for their substance use disorders. Desert Cove Recovery is proud to be a leader in rehabilitation for people both in Arizona and from all over the country.
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 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.
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.
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.