Text Messaging Program Could Increase Adherence to Buprenorphine Treatment


Researchers are testing whether a text messaging system can increase patient adherence to buprenorphine treatment for opioid addiction. “We use text messaging in our society for so many things, but for something as critical as opioid treatment, we really didn’t have any text messaging system to support patients,” said lead researcher Babak Tofighi, M.D. Assistant Professor in the Department of Population Health at NYU Langone Medical Center. Dr. Tofighi works with patients at Bellevue Hospital, many of whom do not have access to smartphones. “Text messaging can reach people at all income levels, with all sorts of phones, even basic ones,” he said. “The patient population we are targeting may not have iPhones, but they can receive texts. Even a simple reminder hopefully could increase adherence to treatment and reduce overdoses and relapses.” About half of patients drop out of buprenorphine programs because of administrative issues – ranging from lack of...

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Could Naltrexone Be Used to Treat Pregnant Women with Opioid Addiction?


Of the three medications currently approved to treat opioid addiction, the long-acting antagonist naltrexone, which blocks opioids from attaching to the mu-opioid receptor, is the newest and the least studied. The research gap is closing, however: A recent study published in Lancet found that extended-release naltrexone was equally effective at reducing illicit opioid use as the partial agonist buprenorphine if patients could be successfully initiated on naltrexone. Initiation requires detoxification from opioids first (since naltrexone elicits withdrawal symptoms in opioid-dependent users), which can be an impediment for some patients. Still, this finding pointed to the promise of naltrexone as an effective treatment approach, as well as the need for research on how to overcome the “detox hurdle” when using an antagonist medication to treat opioid use disorder. As naltrexone becomes more widely used in the treatment of opioid use disorders, we need to learn more about whether it could be safe...

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DEA Announces Step to Increase Opioid Addiction Treatment


The United States Drug Enforcement Administration announced a deregulatory measure that will make it easier for residents of underserved areas to receive treatment for opioid addiction. As published in the Federal Register, nurse practitioners and physician assistants can now become DATA-Waived qualifying practitioners, which give them authority to prescribe and dispense the opioid maintenance drug buprenorphine from their offices. Prior to the enactment of the Drug Abuse Treatment Act of 2000, only physicians could treat opioid addicts and had to register with DEA as both physicians and operators of Narcotic Treatment Programs. Waiving this second registration prompted more physicians to offer treatment services. The Federal Register notice is available here: This action brings DEA regulations into conformity with the Comprehensive Addiction and Recovery Act passed by Congress and signed into law in 2016. Because the vast majority of DATA-Waived physicians prior to CARA served urban areas, rural parts of the United...

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Veterans Especially Hard Hit by Opioid Epidemic


The opioid epidemic has taken an especially heavy toll on U.S. veterans, Reuters reports. Veterans are twice as likely as non-veterans to die from accidental overdoses of opioid painkillers. Veterans of the wars in Iraq and Afghanistan are at the highest risk of opioid addiction, federal data indicates. Senator John McCain has sponsored the Veterans Overmedication Prevention Act, which would fund research to help Veterans Administration (VA) doctors rely less on opioids in treating chronic pain. The bill is stalled in Congress, the article notes. “The Veterans Administration needs to understand whether overmedication of drugs, such as opioid painkillers, is a contributing factor in suicide-related deaths,” said McCain, a Vietnam veteran. The VA system has treated 68,000 veterans for opioid addiction since March, according to a department spokesman. The Louis Stokes VA Center in Cleveland has started testing alternative treatments, including acupuncture and yoga, to reduce use of and dependency on...

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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.

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FDA Encourages Use of Medication-Assisted Treatment for Opioid Addiction


The Food and Drug Administration (FDA) will encourage widespread use of medication-assisted treatment for opioid addiction, the agency’s commissioner said recently. The FDA has approved three medication-assisted treatment drugs: buprenorphine, methadone and naltrexone. A report issued last year by Pew Charitable Trusts concluded that medication-assisted treatment is the most effective way to deal with opioid use disorder. FDA Commissioner Scott Gottlieb, appearing before the House Committee on Energy and Commerce, said, “Unfortunately, far too few people who are addicted to opioids are offered an adequate chance for treatment that uses medications. In part, this is because insurance coverage for treatment with medications is often inadequate.” In his remarks, Gottlieb noted that some people may need medication-assisted treatment for years, if not for their entire lives. He said the FDA will issue guidance to drug manufacturers to promote the development of new addiction treatments, The Washington Post reports.

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FDA: Don’t Mix Opioid Addiction Medication with Anti-Anxiety Drugs


The Food and Drug Administration (FDA) issued a new warning about mixing medication to treat opioid addiction with anti-anxiety drugs. Both types of drugs slow breathing and brain activity. Combining opioid addiction medications with anti-anxiety drugs can lead to difficulty breathing, coma or death, the agency said. In addition to anti-anxiety drugs such as Valium and Xanax, other drugs that should not be combined with opioid addiction medication include Ambien and Lunesta for insomnia, muscle relaxers Soma and Zanaflex, and antipsychotic drugs Abilify, Invega, and Saphris, the Associated Press reports. Buprenorphine and methadone, also known as medication-assisted treatment, reduce opioid cravings and withdrawal without producing a high. The FDA is requiring changes to medication-assisted treatment drug labels. The new labels recommend that health care providers develop a treatment plan that closely monitors any simultaneous use of these drugs.

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Survey Finds Many Doctors Underprescribing Buprenorphine


Doctors are underprescribing the opioid addiction medicine buprenorphine, according to a new survey of addiction specialists. Buprenorphine can be used to treat opioid addiction in the privacy of a doctor’s office. Doctors who prescribe the medication must have a waiver allowing them to do so. Until recently, doctors with waivers could prescribe buprenorphine to 100 patients. This year, the cap was raised to 275, HealthDay reports. More than half of the doctors with a waiver said they were not currently prescribing the buprenorphine to capacity, according to the survey, which was presented at the American Psychological Association annual meeting.Doctors who have a waiver but are not using it to capacity said they regularly turn away one to three patients a month who approach them for buprenorphine treatment.

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Justice Department Announces Program to Combat Opioid-Related Health Care Fraud


Attorney General Jeff Sessions announced a program aimed at combating opioid-related health care fraud, the Associated Press reports. Twelve federal prosecutors will be sent to cities hit hard by opioid addiction. They will analyze data to identify and prosecute individuals that are contributing to the prescription opioid epidemic, Sessions said. They will aim to find “pill mills” and track down physicians and pharmacies that illegally prescribe or distribute opioid painkillers. In a statement, Sessions said the Opioid Fraud and Abuse Detection Unit “can tell us important information about prescription opioids—like which physicians are writing opioid prescriptions at a rate that far exceeds their peers; how many of a doctor’s patients died within 60 days of an opioid prescription; the average age of the patients receiving these prescriptions; pharmacies that are dispensing disproportionately large amounts of opioids; and regional hot spots for opioid issues.”

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Foster Care Systems Overwhelmed by Opioid Crisis


Foster-care systems throughout the United States are being overwhelmed by children whose parents are addicted to opioids, according to The Washington Post. The problem is most acute in rural areas. “It’s pretty much every state — except maybe four or five — that have seen an increase in the number of children in foster care,” said John Sciamanna, Vice President of Public Policy at the Child Welfare League of America. “What you are seeing now is just a straining of the system.” In 2012 there were 397,000 children in foster care. By 2015, there were 428,000 children – an increase of 8 percent. Experts say since then, the number has increased dramatically, although concrete numbers are not yet available. The increase in foster children is stretching state budgets, the article notes. There are not enough families willing to take in foster children, and the caseloads of social workers are overloaded.

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