Co-prescribing naloxone in Medicare Part D increases

The practice of co-prescribing the opioid overdose reversal drug naloxone to Medicare Part D patients who take opioids for chronic pain increased between 2016 and 2017, though such co-prescriptions were provided to only a small minority of patients who might benefit, according to research led by scientists at the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Office of the Assistant Secretary for Health, all within the U.S. Department of Health and Human Services (HHS). The study found that overall national rates for naloxone co-prescription along with any opioid among Medicare Part D patients increased from 1.5 per 1000 patients receiving opioid prescriptions in 2016 to 4.6 per 1000 in 2017.

In 2016, CDC released a guideline advising clinicians to consider co-prescribing naloxone to patients at increased overdose risk, such as those taking higher doses of opioids or those who also have prescriptions for benzodiazepines to treat anxiety. Consistent with these recommendations, the highest rates of co-prescribing were among patients receiving opioids at doses of more than 90 morphine milligram equivalents per day and benzodiazepines for more than 300 days. In addition, two states that mandated naloxone co-prescribing (Vermont and Virginia) have the highest rates of all U.S. states for co-prescribing.

Full story at National Institute of Drug Abuse

Music may replace sedatives for treating pre-op anxiety

Before undergoing an operation, most people experience some form of anxiety. Although this response is common, it is not unproblematic, and treatment often involves a sedative with a whole host of possible side effects. But new research may have found an alternative.

The biggest issue with preoperative anxiety is its ability to affect recovery, including wound healing.

Typically, people receive benzodiazepines — drugs that act as sedatives — to lower anxiety levels before receiving anesthesia.

Full story at Medical News Today

Rising Number of Benzodiazepine Prescriptions a Hidden Epidemic: Expert

Doctors are prescribing large amounts of benzodiazepines such as Xanax and Ativan, which can cause deadly complications, an expert tells NBC News.

Dr. Anna Lembke, Chief of Addiction Medicine at Stanford University Medical Center, said complications from benzodiazepines, such as dependency and addiction, are fueling a hidden epidemic. The drugs are primarily used to treat anxiety and sleeplessness.

“Medical students, residents and even doctors in practice don’t recognize the addictive potential of benzodiazepines,” Dr. Lembke said. “There’s been all this awareness on opioids but very little focus on benzodiazepines and yet people are dying from them.”

Full story at drugfree.org

Featured News: Methadone Appears Safe and Effective in Treating Fentanyl Addiction: Study

Methadone appears safe and effective in treating people who use fentanyl, suggests a study presented at the recent annual meeting of the American Society of Addiction Medicine.

“Highly potent fentanyl – often in combination with other substances including alcohol and benzodiazepines – is highly dangerous and responsible in large part for the enormous spike in preventable drug overdose deaths,” said lead researcher Andrew Stone, M.D., Medical Director of Discovery House CTC of Northern Rhode Island. “We conducted this study to see if medication-assisted treatment is effective in treating those who use fentanyl, given its unique properties and extreme potency.”

Stone and colleagues performed urine drug screens on patients admitted to a methadone maintenance treatment program over a 10-month period. Patients were screened for substances including illicit fentanyl, opiates and methadone. Those who tested positive for fentanyl when entering the program appeared to require a slightly higher dose of methadone to reach abstinence. The relapse rate for those who did not test positive for fentanyl was 15 percent, compared with 41 percent for those who tested positive. Most relapses while in treatment involved fentanyl, regardless of which substances were found in the initial drug screen. “The greater relapse rate may be due to the inability of methadone to completely block the ‘high’ users experience with fentanyl,” Dr. Stone said.

Full story at drugfree.org

People Who Become Addicted to Drugs Later in Life More Likely to Relapse: Study

A new study finds people who become addicted to drugs later in life are more likely to relapse during treatment, compared with those whose addictions started earlier. For every year increase in the age of starting to abuse opioids, there is a 10 percent increase in relapse, according to Science Daily.

The study of people being treated with methadone for their opioid use disorder found those who injected drugs were more than twice as likely to relapse by using opioids while on treatment, compared with those who did not inject drugs.

Use of benzodiazepines also increased the risk of relapse, the study found. For every day of benzodiazepine use in the previous month, the researchers found a 7 percent increase in relapse.

Full story of addiction to drugs later in life at drugfree.org