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

Newly discovered pathway for pain processing could lead to new treatments

The discovery of a new biological pathway involved in pain processing offers hope of using existing cancer drugs to replace the use of opioids in chronic pain treatment, according to scientists at McGill University.

Because many therapeutic options, such as opioids, for patients with chronic pain carry the risk of addiction and undesirable side effects, this breakthrough offers promising lines of research into chronic pain treatment, says Luda Diatchenko, professor at McGill’s Faculty of Dentistry and co-lead author of the new study

The scientists discovered that EGFR blockers, routinely given to lung cancer patients to inhibit tumour growth, were as potent analgesics as morphine in mouse models of inflammatory and chronic pain.

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

Using science to combat addiction

In this Policy Forum, Keith Humphreys and colleagues highlight the need for science, and particularly neuroscience, to inform policies that address addiction. Their recommendations are timely given that on 27 June, a U.S. presidential task force is slated to present policy recommendations to combat opioid addiction. On average in the U.S., 91 people per day die of opioid overdose.

Over the course of recent history, technological advances have enabled addictions to become more prevalent and overpowering, the authors say. For example, in the mid-nineteenth century it took a factory worker about one minute to roll a cigarette, and the resulting product was so harsh that few people could inhale it deeply enough to become addicted to nicotine.

Now, in one minute a machine can roll 20,000 cigarettes, which are sweetened and blended to allow deep inhalation that promotes nicotine addiction. Although technological advances have contributed to increasing rates of addictions, science can also be used to counteract addictions. Humphreys et al. cite ways in which science can inform better drug regulation, for example in the context of marijuana.

Full story of using science to combat addiction at Science Daily