Opioids without the risk of addiction?

Scientists are working to develop medicines that have the pain-relieving effects of opioids without the high risk of misuse and addiction. Since misuse is linked to the euphoric effects of the drug, investigators led by scientists at NIDA’s intramural labs are studying methadone, a drug used to manage opioid addiction that does not have euphoric effects as strong as many other opioids.

Animal studies show that mu opioid receptors in the brain play a key role in the reinforcing effects of opioid drugs, whereas the neuropeptide galanin counteracts the effects of mu opioid receptors. In a recently published study, investigators found a significant difference in the mechanisms of action between methadone and morphine that is determined by the activation of opioid receptor complexes (heteromers) composed of both mu-opioid receptors and one of the galanin receptor subtypes; differences that are key to their subsequent effects on the brain’s dopamine system.

Full story at drugabuse.org

Too Few People Who Survive Opioid Overdose Get Medication-Assisted Treatment

A new study concludes too few people who survive an opioid overdose receive medication-assisted treatment that will reduce the chance of another overdose.

The study included more than 17,500 adults who survived an opioid overdose and found only about one-third received either buprenorphine (Suboxone), methadone or naltrexone (Vivitrol), HealthDay reports.

Among people who did receive one of these medications, most did not stay on the drug for a long time, the researchers report in the Annals of Internal Medicine. The researchers found 17 percent used buprenorphine, with a median use of four months; 11 percent used methadone, with a median use of five months; and 6 percent used naltrexone, with a median use of one month.

Full story at drugfree.org

Methadone and buprenorphine reduce risk of death after opioid overdose

A National Institutes of Health-funded study found that treatment of opioid use disorder with either methadone or buprenorphine following a nonfatal opioid overdose is associated with significant reductions in opioid related mortality. The research, published today in the Annals of Internal Medicine, was co-funded by the National Institute on Drug Abuse (NIDA) and the National Center for Advancing Translational Sciences, both parts of NIH.

Study authors analyzed data from 17,568 adults in Massachusetts who survived an opioid overdose between 2012 and 2014. Compared to those not receiving medication assisted treatment, opioid overdose deaths decreased by 59 percent for those receiving methadone and 38 percent for those receiving buprenorphine over the 12 month follow-up period. The authors were unable to draw conclusions about the impact of naltrexone due to small sample size, noting that further work is needed with larger samples. Buprenorphine, methadone, and naltrexone are three FDA-approved medications used to treat opioid use disorder (OUD).

Full story at drugabuse.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

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