For Rural Patients, Opioid Treatment Centers Often Too Far Away

Methadone is often used in the fight against opioid addiction, but long travel times in rural areas may be hampering efforts to get more people treated, a new study finds.

If methadone for opioid addiction was available in primary care clinics, more people would have better access to treatment, researchers suggest.

In the United States, methadone is only available at clinics certified by the federal government as Opioid Treatment Programs, or OTPs. This restriction, along with state and local laws, limits the number of clinics that offer methadone for opioid addiction.

Full story at HealthDay

OxyContin Maker Files for Bankruptcy

Purdue Pharma, the company that makes the opioid painkiller OxyContin, has filed for bankruptcy, CNN reports.

The filing is part of the company’s plan to settle litigation involving more than 2,000 cases brought by states, counties, municipalities and Native American governments. The plaintiffs in those cases say Purdue Pharma fueled the opioid epidemic. Under the settlement, the company will provide more than $10 billion in funding to address the opioid crisis.

Purdue also plans to create a company called NewCo, which will produce medicines to reverse overdoses, and will continue to develop an over-the-counter version of naloxone at little to no cost to communities across the country, according to a company statement.

Full story at Partnership for Drug-Free Kids

Preference for fentanyl higher among young, white, frequent opioid users

A minority of people who use illicit opioids indicated a preference for fentanyl, the super-potent synthetic opioid that accounts for much of the recent rise in U.S. overdose deaths, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

The study, based on surveys of 308 people who use opioids in Baltimore, Maryland; Boston, Massachusetts and Providence, Rhode Island, found that 27 percent indicated a preference for opioids containing fentanyl, and that people who prefer fentanyl are more likely to be younger, white, and daily users. The median age of those who prefer fentanyl was 38 years compared to 45 years for those who don’t prefer fentanyl. Fifty-nine percent of fentanyl preferers identified as non-Hispanic white, compared to only 29 percent among the non-preferers.

The study, published online in the journal Drug and Alcohol Independence, is thought to be the first to characterize fentanyl-preferring opioid users.

Full story at Science Daily

Prescription size predicts persistent opioid use after cardiothoracic surgery

Prescription size is associated with increased new persistent opioid use among patients after cardiothoracic surgery, according to a study published online Aug. 22 in the Annals of Thoracic Surgery.

Alexander A. Brescia, M.D., from the University of Michigan in Ann Arbor, and colleagues identified opioid-naive Medicare patients undergoing cardiothoracic surgery between 2009 and 2015. They selected 24,549 patients who filled an opioid prescription between 30 days before surgery and 14 days after discharge and with continuous Medicare enrollment. The correlation for prescription size with new persistent opioid use was examined.

The researchers found that new persistent use was 12.8 percent overall and decreased annually, from 17 to 7.1 percent from 2009 to 2015. Associations with new persistent use were seen for prescription size, preoperative prescription fills, black race, gastrointestinal complications, disability status, open lung resection, dual eligibility (Medicare and Medicaid), drug and substance abuse, female sex, tobacco use, high comorbidity, pain disorders, longer hospital stay, and younger age. Among patients prescribed more than 450 oral morphine equivalents, adjusted new persistent use was 19.6 percent compared with 10.4 percent among those prescribed 200 oral morphine equivalents or less.

Full story at Medical Xpress

Adults who mix cannabis with opioids for pain report higher anxiety, depression

A researcher from the University of Houston has found that adults who take prescription opioids for severe pain are more likely to have increased anxiety, depression and substance abuse issues if they also use marijuana.

“Given the fact that cannabis potentially has analgesic properties, some people are turning to it to potentially manage their pain,” Andrew Rogers, said in describing the work published in the Journal of Addiction Medicine. Rogers focuses on the intersection of chronic pain and opioid use, and identifying the underlying psychological mechanisms, such as anxiety sensitivity, emotion regulation, pain-related anxiety, of these relationships. Rogers is a doctoral student in clinical psychology who works in the UH Anxiety and Health Research Laboratory and its Substance Use Treatment Clinic.

Under the guidance of advisor Michael Zvolensky, Hugh Roy and Lillie Cranz Cullen Distinguished University Professor of psychology and director of the lab and clinic, Rogers surveyed 450 adults throughout the United States who had experienced moderate to severe pain for more than three months. The study revealed not only elevated anxiety and depression symptoms, but also tobacco, alcohol, cocaine and sedative use among those who added the cannabis, compared with those who used opioids alone. No increased pain reduction was reported.

Full story at Science Daily