Starting opioid addiction treatment in the ED is cost-effective

The most cost-effective treatment for people with untreated opioid addiction who visit the emergency department (ED) is buprenorphine, a medication to reduce drug cravings and withdrawal, say Yale researchers. Their study found that among patients who came to the ED, the ED-initiated medication strategy was most likely to be cost-effective compared to referral alone or a brief intervention with facilitated referral, the researchers said.

The study was published in the journal Addiction.

Nationally, only about one in five individuals who needed treatment for opioid addiction received treatment in the past year, and fewer received the most effective treatments, such as buprenorphine. Yet studies have shown that treating individuals with such medications is effective. In an earlier analysis of this study, Yale researchers found that when patients are screened for opioid addiction, receive ED-initiated buprenorphine, and a referral for ongoing treatment, the treatment was more effective than a standard referral or brief intervention with referral.

Full story at Science Daily

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.

Full story at drugfree.org

Why are doctors underusing a drug to treat opioid addiction?

A drug approved for private physicians to treat opioid addiction is being underprescribed, and a survey of addiction specialists suggests that many of them are not willing to increase their use of it, despite an expanding opioid addiction epidemic in the United States, according to research presented at the 125th Annual Convention of the American Psychological Association.

Two opioid replacement medications are currently approved for opioid use disorder: methadone, which under federal law must be dispensed from authorized clinics, and buprenorphine, which can be used to treat opioid addiction in the privacy of a physician’s office, so long as the physician has the proper waivers.

Full story at Science Daily

Clinical trial looks at tramadol for opioid withdrawal

A randomized clinical trial published by JAMA Psychiatry compared tramadol extended-release with clonidine and buprenorphine for the management of opioid withdrawal symptoms in patients with opioid use disorder in a residential research setting.

Opioid use disorder is a public health problem that has contributed to unprecedented levels of overdose deaths. Detoxification – or medically supervised withdrawal – is a widely used treatment for opioid use disorder. However, failing to adequately manage opioid withdrawal symptoms can contribute to people leaving treatment.

Clonidine and buprenorphine are two medications widely used to manage opioid withdrawal. Tramadol hydrochloride is a promising alternative option for effective opioid use disorder treatment, according to the article.

Full story of tramadol and opioid withdrawal at Science Daily

Inadequate Access to Addiction Treatment Leads to Suboxone Black Market

Inadequate access to opioid addiction treatment programs has led to a thriving black market for Suboxone, the drug that helps patients overcome their addiction, experts tell The Wall Street Journal.

More than 36,000 doctors are certified in the United States to prescribe Suboxone and other buprenorphine-based medications. Until last year, those doctors were limited to prescribing the drugs to 100 patients each. Last year, the Obama Administration increased that number to 275, and began allowing physician assistants and nurse practitioners to prescribe the drugs.

Full story of Suboxone thriving on the black market at drugfree.org