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Posts tagged as “opioids”

Reports Show Challenges Remain In Addiction Treatment Medication Access

Center for Disease Control and Prevention data indicate opioid overdose deaths in the Ohio Valley declined in 2018, the first time in nearly a decade. 

Researchers say this is cause for optimism. But two new studies warn that access to medication assisted treatment, or MAT, for people with opioid use disorders continues to be a challenge.

A Johns Hopkins University analysis of the 2017 National Survey of Substance Abuse Treatment Services published Friday in JAMA Psychiatry found problems with MAT availability and use in residential treatment facilities.

A little more than 60 percent of residential treatment facilities did not offer FDA-approved MAT drugs like methadone, buprenorphine and naltrexone on site that year. MAT is a key component for people reaching and sustaining addiction recovery, according to treatment specialists. 

Researchers found restrictions on prescribing MAT drugs as one possible cause for the limited availability.

“Prescriber restrictions include prior authorization to prescribe buprenorphine or extended release naltrexone, the requirement that buprenorphine be distributed by an opioid treatment program, or lifetime limits on doses of buprenorphine greater than 8 milligrams,” the authors wrote.

The solutions they offered included partnerships among local medical facilities and improvements in the accrediting and licensing of residential …

Rural Americans Increasingly Concerned About Opioid Addiction, Study Finds

Researchers at Harvard University and the Robert Wood Johnson Foundation found that rural Americans identified drug addiction and economic concerns as the most serious problems facing their communities. 

An open-ended survey of 2700 rural adults aimed to identify the major concerns of rural voters, and found that 25 percent of rural Americans said drug addiction was their biggest concern for their community, and 21 percent said the same about economic concerns. The striking illustrate the dramatic toll of addiction on rural communities, which have generally struggled to recover from the 2009 recession.

A higher share of respondents, about four in 10, ranking opioid addiction the most serious problem facing their community was significantly higher in Appalachia, where the opioid epidemic struck sooner and harder than in other parts of the country. That matches separate research from 2017, which found that the rate of overdose deaths per 100,000 people is higher in rural places than in metro areas. 

“When you ask an open-ended question question like that, the idea that four in 10 people would say the same thing is unheard-of,” said lead researcher Mary Gorski. 

The findings suggest that in rural parts of the United States, which have struggled to …

Study: Laws Limiting Opioid Prescriptions Have Mixed Results

A new study out in the Journal of the American Medical Society found that state laws limiting opioid prescriptions had mixed results.

The study looked at two states that implemented opioid prescribing deadlines – Massachusetts and Connecticut. Both have seven-day limits on initial opioid prescriptions with some exceptions.

Study authors from Emory University analyzed data from 16,281 patients who received an opioid prescription within three days of a surgery between June 2014 and November 2017.

In Massachusetts, patients were prescribed a lower dosage and for fewer days than before the law went into effect in 2016. There were no changes in Connecticut.

Study authors say doctors might be working around the laws and post-dating prescriptions so that patients still get opioids after that seven-day limit is up. The authors suggest hospitals could institute their own limits.

Kentucky passed a law in 2017 that is more restrictive than Connecticut and Massachusetts. Kentucky patients can only be prescribed three days of opioids for acute pain. A majority of opioids prescribed for use after surgery aren’t taken by the patient, putting them at risk of being diverted and abused

Thirty-one states have opioid prescribing laws that were implemented after the Centers for Disease …

Methadone Treatment A Long Haul For Many Rural Residents

New research shows just how difficult it is to access opioid treatment in rural areas in Kentucky, Indiana and surrounding states. 

The study from Yale University analyzed drive times to methadone treatment in every county in Kentucky, Indiana, Ohio, West Virginia and Virginia, which have the nation’s highest rates of opioid-related overdose deaths. The study was published in the Journal of the American Medical Association on Tuesday. 

Patients usually have to receive methadone in person six days a week. The findings show that the average drive time to a clinic from a rural county’s population center is about 49 minutes. That’s compared to a drive time of about eight minutes in large metro areas. And for a patient trying to get methadone treatment, time spent getting to appointments acts as a barrier to treatment. 

“If you need methadone and you live in a rural county, you’re in trouble in many places, that’s the issue,” said study author Paul Joudrey, a researcher and doctor at the Yale School of Medicine. ”For most health care, you might go to your doctor once a month, even less. In the case of methadone, it’s uniquely burdensome.”

Methadone isn’t the only medication-assisted treatment option for …

How One Indiana Hospital Drastically Cut Opioid Prescriptions

As the opioid epidemic continues, hospitals are looking for new ways to treat pain and combat addiction. At Indiana University Health, which has 16 hospitals across the state, that means change. They’re cutting back on opioid prescriptions and giving more advice to patients.

In January 2017, IU Health officials began monitoring when, where, and by whom every opioid was prescribed.

Chief Medical Officer Jonathan Gottlieb said the results were eye opening for his fellow doctors.

“You know, I think no one really knows when they’re operating independently, am I in the middle of the bell curve, am I at one end or the another?” he said. “Just showing the data caused a dramatic reduction in the number of pills prescribed.”

Comparing the first month of monitoring to one of the most recent, this April, nearly 440,000 fewer opioid pills were prescribed.

And that’s important because many people feed an addiction by getting pills from friends and relatives.

IU surgeon Amy Krambeck cut back opioid prescriptions for other reasons. She specializes in removing kidney stones.

“So we use a small scope and go up into the ureter, break up a stone and pull out the pieces,” she said. “So it can …

Beshear Sues Another Opioid Company Over Marketing Practices

Attorney General Andy Beshear has filed a lawsuit against another painkiller manufacturer, saying that the company fueled Kentucky’s drug epidemic through aggressive marketing and fraud.

The suit claims that Arizona-based Insys Therapeutics gave kickbacks to doctors who prescribed its products and used fraudulent tactics to get more people prescribed, including falsifying medical histories.

Beshear said the company’s fentanyl-based mouth spray Subsys was only approved for cancer patients but the company aggressively marketed the pain medication to get more patients prescribed.

“Insys sought to line their pockets by fraudulently acquiring insurance coverage approvals, giving kickbacks to doctors and incentivizing its sales force to engage in fraudulent and deceitful conduct,” Beshear said.

Inysys has been scrutinized for its marketing and promotion tactics for years and was the subject of a U.S. Senate report about aggressive opioid sales tactics.

This summer, the company also reached a $150 million settlement with the U.S. Department of Justice over its sales practices.

The lawsuit is the ninth Beshear has filed against an opioid distributor or manufacturer over the last year as Kentucky’s drug overdose death rate continues to climb every year.

In 2017, 1,565 people died of drug overdoses in the state, up from 1,404 in …

Surgeon General Says Opioid Crisis Requires Fight Against Stigma

In a comprehensive new report on the opioid crisis, the U.S. surgeon general writes that stigma remains a major barrier to treatment and urges a more supportive approach to those in need.

Surgeon General Jerome Adams wrote in his Spotlight on Opioids report that stigma has prevented people with opioid use disorders from seeking treatment.

“The way we as a society view and address opioid use disorder must change,” Adams wrote. “Individual lives and the health of our nation depend on it.”

The report released Thursday suggests people be supportive, not judgmental, if a loved one has a problem.

Adams with Jody Jaggers, Director of Kentucky’s Pharmacy Emergency Preparedness Program.

Communities can contribute to combating the epidemic by building awareness of substance use as a public health problem.

He recommends that educators teach up-to-date scientific information about substance use disorders as medical conditions.

This follows a study from researchers at the University of Pennsylvania in August that found people hold negative bias toward people referred to as “addicts” or “abusers.” More positive terms such as “someone with a substance use disorder” would encourage a culture of support for those seeking help.

The surgeon general’s report also provided a comprehensive …

Senate Opioids Bill Takes Aim At Fentanyl Imports

The U.S. Senate has approved a bipartisan package to address the nation’s opioid crisis with more resources for addiction treatment and recovery and an emphasis on stopping the flow of the the deadly synthetic opioid fentanyl.

The Senate approved the Opioid Crisis Response Act of 2018 by a 99-1 vote Monday night including a version of Ohio Republican Sen. Rob Portman’s Synthetics Trafficking and Overdose Prevention, or STOP, Act. Portman said he hopes to address the impact fentanyl has had on his constituents. Ohio has some of the nation’s highest overdoses death rates.

“Coroner’s reports from around the state indicate that fentanyl was involved in about two-thirds of our state’s overdose deaths last year,” Portman said in a press call. “And our STOP Act is very simple in that it closes a loophole that will require now more screening to keep these drugs from coming in through the mail, which is where most of them come from, mostly from China.”

Data from the the federal government’s recent National Survey on Drug Use and Health show the number of heroin users last year was down from 2016. But the number of opioid overdose deaths was higher, which officials attribute to fentanyl. …