Opioid Dose Variability Associated with Overdose

As health care providers lower opioid doses for pain patients to minimize the risk of addiction; increase doses to manage worsening pain; or re-start dosing after a period of time without opioid pain relievers, patients could be getting confused about safe dose levels, putting them at risk for overdose. A new study funded by the National Institute on Drug Abuse found that high dose variability increases the odds for an opioid overdose independent of dose alone. Even among patients receiving low doses of opioids, dose variability increases the risk of overdose.

The study followed long-term opioid therapy patients enrolled in Kaiser Permanente Colorado, from January 1, 2006 to December 31, 2017. The study matched 228 patients who had experienced an opioid overdose with 3,547 control patients who had not experienced an opioid overdose.

Results suggested that more dose variability correlates with a more than three-fold increase in overdose risk. The authors suggested patients in long-term opioid therapy are exposed to changes in dose for a variety of reasons, including worsened pain, practitioner-initiated tapers, changing physicians, missed appointments, poor adherence to urine toxicology screening, or travel. The periods of greatest risk could follow abrupt changes in dosage, such as resuming opioid use after a period with no pain reliever use, prompting patients to seek a dose that may heighten their risk for overdose. Alternatively, a dose reduction may cause patients to seek pharmaceutical opioids from other sources.

Full story at drugabuse.gov

Experimental drug may ease opioid withdrawal symptoms

A drug that scientists originally developed to treat depression may have promise for the treatment of opioid withdrawal, researchers say.

Opioid withdrawal is a challenging experience, and although there are medications already on the market that can help curb the symptoms of withdrawal, these drugs cause negative side effects.

Current withdrawal medications also often require people to take them for a prolonged period, which is not ideal and could lead to a relapse.

Full story at Medical News Today

Meth Seizures on the Rise: DEA

Methamphetamine seizures by law enforcement are on the rise, according to the Drug Enforcement Administration (DEA).

The DEA is concerned about an increase in meth trafficking and related deaths around the United States, The Wall Street Journal reports. Meth is becoming more common in areas such as the Northeast. According to the DEA, 347,807 law-enforcement meth seizures were submitted to labs in 2017, up 118 percent from 2010.

“Everybody’s biggest fear is what’s it going to look like if meth hits us like fentanyl did,” said Jon DeLena, second-in-command at the DEA’s New England office.

Full story at drugfree.org

Many Heroin Users Unprepared for Fentanyl OD

Though they know that nearly all heroin is laced with the dangerous synthetic opioid fentanyl, many Baltimore users aren’t prepared to prevent or treat fentanyl-related overdoses, a new study finds.

Baltimore has a thriving heroin trade and 1,000 opioid overdose deaths a year.

The study, by researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore, included 316 people who admitted recent illicit opioid use. All had heard of fentanyl and about 56 percent suspect most or all of Baltimore’s heroin is laced with it.

Nearly 75 percent said they were “quite a bit” or “very worried” about acquaintances overdosing on fentanyl, which is 30 to 50 times more potent by weight than heroin. Fentanyl and related synthetic opioids are the leading cause of drug overdose deaths in the United States — more than 70,000 in 2017 alone.

Full story at Health Day

Drinking and drug-use dreams in recovery tied to more severe addiction history

Vivid dreams involving drinking and drug use are common among individuals in recovery. A study from the Massachusetts General Hospital (MGH) Recovery Research Institute, published in the January issue of the Journal of Substance Abuse Treatment after online release in October 2018, finds these relapse dreams are more common in those with more severe clinical histories of alcohol and other drug problems.

“Anecdotally, the occurrence of drinking and drug-using dreams is a known phenomenon among people in recovery, but very little is known from an epidemiological standpoint about the prevalence of such dreams, their relation to relapse risk, and how they decay with time in recovery,” says lead author John F. Kelly, PhD, founder and director of the Recovery Research Institute. “Given that these dreams can be deeply unnerving, more information could help treatment providers, those in recovery and their families know what to expect going forward.”

Recovery from every kind of substance use disorder — alcohol, heroin, cocaine, cannabis — has been characterized by dreams that follow a common pattern: in the dream the person has a drink or ingests their primary substance. They experience disbelief and are overcome with fear, guilt and remorse until they wake up, relieved to realize it was only a dream.

Full story at Science Daily