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
In a growing number of states, patients who get opioids for serious pain may leave their doctors’ offices with a second prescription — for naloxone, a drug that can save their lives if they overdose on the powerful painkillers.
New state laws and regulations in California, Virginia, Arizona, Ohio, Washington, Vermont and Rhode Island require physicians to “co-prescribe” or at least offer naloxone prescriptions when prescribing opioids to patients considered at high risk of overdosing. Patients can be considered at high risk if they need a large opioid dosage, take certain other drugs or have sleep apnea or a history of addiction.
Such co-prescribing mandates are emerging as the latest tactic in a war against an epidemic of prescription and illegal opioids that has claimed hundreds of thousands of lives over the past two decades.
Full story at Kaiser Health News
The National Institute on Drug Abuse (NIDA) today announced the availability of informational resources for clinicians interested in initiating buprenorphine treatment in emergency department settings. Buprenorphine is one of several medicines available for use in many emergency departments to treat opioid use disorders (OUD). The materials were developed by emergency department specialists at Yale University with grant support from NIDA, and contract support from NIDA’s Clinical Trials Network. NIDA is part of the National Institutes of Health.
Emergency department clinicians face unique challenges when faced with patients suffering from opioid overdoses or other effects of OUD. They can often reverse overdoses using the medication naloxone, however, that medication alone does not constitute treatment for the addiction itself. This makes the emergency setting an ideal place for clinicians to begin treatment conversations with patients, however, there have been few tools available to guide them. Since 2002, emergency clinicians have been able to administer buprenorphine to help patients manage opioid withdrawal symptoms, but the practice is still new in many emergency department settings.
Full story at drugabuse.org
U.S. Surgeon General Jerome M. Adams released a report Thursday that recommends ways families, doctors, educators and business leaders can talk about and prevent addiction, according to The Washington Times.
The “Spotlight” report urges companies to reduce work-related injuries that could lead to opioid misuse, and encourages family members to carry naloxone and be trained on how to use it. “Be supportive (not judgmental) if a loved one has a problem,” the report advises.
Full story at drugfree.org
At a time when drug overdoses are becoming more prevalent and lethal, a new report provides a snapshot of regional illicit drug use and, for the first time, highlights the complexity of detecting and treating patients at hospital emergency departments for a severe drug-related event.
The objective of the study, which began in 2016, was to identify illicit drugs that caused overdoses in patients at two hospital emergency departments in Maryland.
Emergency physicians were battling a spike in accidental drug overdoses and related deaths, thought to be linked to a group of designer drugs called synthetic cannabinoids that mimic the chemicals in marijuana, known on the street as Spice or K2. One doctor described “atypical overdoses,” patients with breathing difficulties and constricted pupils who responded well to the opioid overdose-reversing drug naloxone, and then required sedation for acute agitation, violence and hyperactivity, all unrelated to opiate withdrawal.
Full story at Science Daily