Focus points to reduce opioid overdose deaths identified

A new study identifies specific locations where medication and harm reduction services for people with opioid use disorder should be available in order to have the greatest impact on reducing opioid overdose deaths. Led by researchers at Boston Medical Center’s Grayken Center for Addiction, the data show that more than half of those who died of an opioid overdose in Massachusetts encountered the health care, public health and/or criminal justice systems within the 12 months prior to their fatal overdose. These results, published in Drug and Alcohol Dependence, provide a roadmap to better reach these individuals at high risk of overdose and provide treatment and harm reduction services in order to reduce the number of overdose deaths.

For this retrospective cohort study, researchers set out to determine how and where individuals encounter the health care, criminal justice and public health systems in the 12 months prior to their fatal overdose. In collaboration with Massachusetts Department of Public Health, researchers examined eight data sets for persons over the age of 11 in Massachusetts between January and December 2014 with health insurance, as identified in the All-Payer Claims Database.

Full story at Science Daily

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

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

FDA approves first medication to reduce opioid withdrawal symptoms

The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, is pleased to announce that lofexidine, the first medication for use in reducing symptoms associated with opioid withdrawal in adults, has been approved by the U.S. Food and Drug Administration. Lofexidine, an oral tablet, is designed to manage the symptoms patients often experience during opioid discontinuation. Opioid withdrawal symptoms, which can begin as early as a few hours after the drug was last taken, may include aches and pains, muscle spasms/twitching, stomach cramps, muscular tension, heart pounding, insomnia/problems sleeping, feelings of coldness, runny eyes, yawning, and feeling sick, among others. The product will be marketed under the brand name LUCEMYRATM.

In 2016, more than 42,000 people died from an opioid overdose, or approximately 115 people per day. Although effective treatments exist for opioid addiction, painful and difficult withdrawal is one of the reasons treatment fails, and relapse occurs. By alleviating symptoms associated with opioid withdrawal, LUCEMYRA could help patients complete their discontinuation of opioids and facilitate successful treatment. To date, no other medications have been approved to treat opioid withdrawal symptoms.

Full story at drugabuse.org