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? What factors are considered in this genetic test for opioid addiction? 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.
A monthly injection of buprenorphine BUP-XR is more effective than a 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 and Treatment for Opioid AddictionBuprenorphine 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 SublocadeThe 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 ConductedResearchers 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 opioid withdrawal symptoms and control from cravings for opioids without having to take medication on a daily basis.
Researchers at Indiana University’s School of Medicine have developed a blood test that identifies biomarkers in the blood which can help to determine the severity of a patient’s pain. The results could potentially help doctors to accurately measure pain on a scale. Some people believe this breakthrough in measuring pain may help reduce opioid addiction and ultimately the opioid crisis. Currently, doctors must rely on their patients’ accounts of the amount of pain they are experiencing and suggest a treatment plan accordingly. A more accurate way to measure pain could lead to better treatment options for patients.
Breakthrough in Measuring Pain: Researchers Developed Prototype for Blood Test for PainThe study was led by Alexander Niculescu, MD, Ph.D., a psychiatry professor, and was published in the Nature journal Molecular Psychiatry. Hundreds of participants were tracked to find biomarkers in the blood to that can help doctors to objectively determine how much pain a patient is experiencing. This blood test, which is the first of its kind, would also help doctors to understand a patient’s long-term prognosis. The blood test can objectively tell doctors whether a patient is experiencing pain and how severe the pain is. It’s important to have an objective way to measure this symptom since until now the feeling of pain has been subjective. Physicians have to rely on what patients tell them about their pain or whatever clinical observations they can make to determine their patients’ pain levels. This blood test promises to give doctors a tool to treat and prescribe medications more appropriately for people experiencing pain.
Biomarkers in Blood Help Doctors Assess Pain LevelsThe researchers looked at biomarkers in the blood. These biomarkers work in a similar manner to the way glucose is a biomarker to diabetes; they let doctors assess the severity of their patient’s pain and then provide appropriate treatment. It’s hoped this prototype may alleviate the problems that have contributed to the current opioid crisis. The goal of pain management is to match the patient with the medication that is going to provide the best level of relief with the fewest side effects. Dr. Niculescu points out that through precision health, by having “lots of options geared toward the needs of specific patients, you prevent larger problems, like the opioid epidemic, from occurring.” The study experts on the team found biomarkers that match with non-addictive drugs for treating pain and can also help to predict when patients may experience pain going forward. They will assist doctors in determining if a patient is experiencing chronic pain which may result in future Emergency Room visits. Further research will focus on establishing whether there are some markers for specific conditions, such as headaches or fibromyalgia, or for ones that work better for men or women.
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 DonorsIn 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.
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 SurveyTwo 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 ProblemsThe 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. Survey Methodology 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.
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 TreatmentThe 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 InitiativesThe 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 FocusWhat 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.
Reports about the opioid crisis and drugs fentanyl, carfentanil and heroin have dominated recent headlines. During the years 200-2016, the number of lives lost to opioids has more than quadrupled. Though opioids have taken up a lot of our collective attention during the first part of the twenty-first century, it would be a mistake to ignore another addictive substances that have had a negative impact on people’s lives: alcohol. A new report released from the California Health Care Foundation looked at substance use disorders in California. It examined the impact of alcohol, opioid and other substance use over time. Although this particular report was specific to California, the figures are a fair representation for situations in Arizona and nationwide as well.
Key Findings from Substance Abuse ReportThe report, entitled “Substance Use in California: A Look at Addiction and Treatment," has several key findings, including:
- Alcohol use disorder was the most common type of substance use disorder among California residents. Approximately six percent of Californians met the criteria for alcohol dependence. Three percent of state residents met the criteria for dependence on illicit drugs.
- Experimenting with drugs and alcohol is likely to start during the adolescent years. By the time they reach Grade 11, over half of students in California have tried alcohol and close to 40 percent have tried marijuana.
- Young adults (aged 18-25) were most likely to develop substance use disorders, with the likelihood close to twice the state average.
- The number of Emergency Department visits related to heroin in California has tripled during the years between 2006-2017.
- Alcohol was responsible for more nonfatal Emergency Department visits in California than all other drug diagnoses combined.
Substance Abuse Disorders TreatableSubstance use disorders, including alcohol use disorder, can be treated and managed. Like other chronic illnesses, the risk of relapse is a real and ongoing one. Behavioral therapy helps people with substance use disorders change unhealthy coping mechanisms for new ways of dealing with destructive behaviors. Medications can be used to control cravings for opioids and alcohol and reduce the physical reward a user experiences when they are ingested. Naltrexone is among the most common medications, which is used in many different forms. Vivitrol is an monthly injectable version of naltrexone that is often used to help fight cravings.
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 IssuesOpioid 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 PregnancyThe 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.
With all eyes on the opioid problem in America, many people are missing the fact that millions of people are also abusing other prescriptions, such as Xanax. These anti-anxiety drugs have a very high potential for abuse and addiction and there is evidence that it is becoming even more prevalent.
Xanax Seen as Safer than Other DrugsAddiction specialists are expecting a continued increase in the number of teens and young adults addicted to Xanax and other sedatives belonging to a class of anti-anxiety drugs called benzodiazepines (“benzos”). A number of young people feel that Xanax is safer and more readily available than other drugs, but it is certainly just as dangerous. The drug is abused by itself and also commonly taken with other substances, such as painkillers or alcohol. Like most other substances, people can develop a tolerance over time, requiring more of it to achieve the same effect. This can lead people who have legitimate prescriptions for the drug to eventually become dependent and sometimes even farther down the path toward addiction. Often, teens are finding the pills in their parents’ or grandparents’ medicine cabinets, not realizing they can be just as dangerous as opioids or illicit drugs. The risk to health and life increases when Xanax is taken with other drugs and/or alcohol.
Risk of Addiction Higher with Younger StartWhen Xanax use starts early in life, the risk of addiction increases. A recent US Surgeon General’s report on drugs and indicated that close to 70 percent of young people who experiment with an illicit drug before the age of 13 will become addicted within the next seven years. Waiting to try illicit drugs until after the age of 17 lowers the risk of addiction to 27 percent. Addiction professionals are seeing a significant increase in the number of teens and young adults who are addicted to Xanax. Many of them are taking high doses of the drug on a daily basis, sometimes in combination with opioids and alcohol. Sharon Levy, the director of adolescent addiction treatment at Boston Children’s Hospital, explained that hospitals see trends first. She stated that benzo use among adolescents has “skyrocketed” and that more young people are being admitted to hospitals for withdrawals due to the possibility of dangerous seizures. At the same time, fewer teens are seeking help for prescription opioid addiction.
The opioid epidemic continues to rage through North America, and experts in East Tennessee are looking into the source of the problem. Many of them have determined that it can start with a trip to the dentist’s office. Dr. Turner Emery, an oral surgeon on Knoxville, explained that doctors have been blamed for a lot of patients getting started on opioids. However, dentists also prescribe this class of medications to their patients, who are also put at risk for addiction.