Medications underutilized when treating young people with opioid use disorder

Only one in four young adults and teens with opioid use disorder (OUD) are receiving potentially life-saving medications for addiction treatment, according to a new Boston Medical Center (BMC) study published online in JAMA Pediatrics.

Buprenorphine and naltrexone are medications used to treat OUD that help prevent relapse and overdose when used appropriately. In late 2016, the American Academy of Pediatrics recommended, for the first time, that providers offer medication treatment to adolescents with OUD.

Prior studies have shown that among all adults in treatment for opioids, one-third started using opioids before age 18, and two-thirds started before age 25. Unlike methadone, buprenorphine and naltrexone can be offered in the primary care setting. However, few teens receive medication due, in part, to a widespread shortage of physicians who have received a waiver certification required to prescribe buprenorphine. And, as researchers note, of all of the physicians who are certified in the United States, only one-percent are pediatricians.

Full story of treating young people with opioid use disorder at drugfree.org

The cost of opioid use during pregnancy

A new study published today by the scientific journal Addiction reveals that the incidence of neonatal abstinence syndrome — often caused by mothers using opioids during pregnancy — is increasing in the United States, and carries an enormous burden in terms of hospital days and costs. The number of US hospital admissions involving neonatal abstinence syndrome increased more than fourfold between the years 2003 and 2012. In 2012, neonatal abstinence syndrome cost nearly $316 million in the United States.

Neonatal abstinence syndrome (NAS) is a constellation of symptoms that occur in newborn infants exposed to addictive illegal or prescription drugs in utero. Infants affected by NAS typically show a number of neurological symptoms and behaviors (e.g., tremors, seizures) as well as poor feeding and gastrointestinal dysfunction. Standard management of NAS involves the administration of opioids for opioid withdrawal, with additional medications for stubborn cases or instances of multi-drug exposure. This drug administration has been performed traditionally in the hospital setting, consuming valuable and finite hospital resources.

Full story of opioid use during pregnancy at Science Daily

Families Say Trump’s Budget Cuts Run Counter to His Promises to Battle Addiction

Family members of young people who have struggled with or died from opioid addiction say President Trump’s budget proposal, which would reduce funding for addiction treatment, runs counter to his promises to help solve the problem, the Associated Press reports.

The proposed budget would shrink spending for Medicaid, which covers an estimated three in 10 adults with opioid addiction. The budget is unlikely to be approved as written, the article notes.

Full story of Trump’s budget cuts and addiction promises at drugfree.org

Opioid abuse following urologic surgery documented

About 1 in 1,111 patients who undergo urologic surgery for conditions such as prostate cancer and kidney stones experience opioid dependence or overdose (ODO), a Loyola Medicine study has found.

Patients at highest risk for ODO were younger, underwent inpatient surgery, had longer hospital stays, were on Medicaid or Medicare or had a history of depression or chronic obstructive pulmonary disease.

The study by co-first authors Arpeet Shah, MD, and Robert Blackwell, MD, and senior author Gopal Gupta, MD, is published in the Journal of Urology.

Full story of opioid abuse after urologic surgery at Science Daily

Cost-effective ways to combat HIV risk among intravenous drug users identified

With the abuse of opioids on the rise in the United States, Stanford University researchers are concerned that increased HIV transmission from shared needles won’t be far behind.

“There’s an opioid epidemic in our country, and there’s a real public health crisis associated with injecting,” said Cora Bernard, a graduate student in management science and engineering. “We think it’s important to understand what investments give highest value because HIV prevention programs, and especially programs that reduce the prevalence of injection drug use, can have outsized, positive impact on individuals, families and public safety.”

Bernard is the lead author of a study on prevention programs that could head off a resurgence of HIV and perhaps decrease the effects of the opioid crisis. The study will be published online May 24 in PLOS Medicine. The senior author is Margaret Brandeau, PhD, professor of management science and engineering.

Full story of cost effective ways to combat HIV risk at Science Daily