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USA. The HEALing Communities Study: Using Science to Address the Opioid Crisis

By Nora D. Volkow, MD and Francis S. Collins, M.D., Ph.D., NIDA, Nora’s Blog, 19.09.2018

The public health emergency of opioid misuse, addiction, and overdose affects millions of Americans and requires innovative scientific solutions. Today, during “National Prescription Opioid and Heroin Awareness Week,” we are sharing news of an important step towards these solutions through the HEALing Communities Study – an integrated approach to test an array of interventions for opioid misuse and addiction in communities hard hit by the opioid crisis. 

https://www.drugabuse.gov/about-nida/noras-blog/2018/09/healing-communities-study-using-science-to-address-opioid-crisis

One size does not fit all – evolution of opioid agonist treatments in a naturalistic setting over 23 years.

Nordt, C., Vogel, M., Dey, M., Moldovanyi, A., Beck, T., Berthel, T., Walter, M., Seifritz, E., Dürsteler, K. M., and Herdener, M. (2018) 

Addiction, doi.org/10.1111/add.14442.

Abstract

https://onlinelibrary.wiley.com/doi/10.1111/add.14442

Primary Care and the Opioid-Overdose Crisis - Buprenorphine Myths and Realities.

Wakeman SE, Barnett ML.

N Engl J Med. 2018 Jul 5;379(1):1-4. doi: 10.1056/NEJMp1802741.

https://www.nejm.org/doi/10.1056/NEJMp1802741

Best Practices across the Continuum of Care for Treatment of Opioid Use Disorder.

Taha, S. (2018)

Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. 

http://www.ccsa.ca/Resource%20Library/CCSA-Best-Practices-Treatment-Opioid-Use-Disorder-2018-en.pdf

Moving Addiction Care to the Mainstream - Improving the Quality of Buprenorphine Treatment.

Saloner B, Stoller KB, Alexander GC.

N Engl J Med. 2018 Jul 5;379(1):4-6. doi: 10.1056/NEJMp1804059. 

https://www.nejm.org/doi/10.1056/NEJMp1804059

National trends and characteristics of inpatient detoxification for drug use disorders in the United States.

Zhu H, Wu LT.

BMC Public Health. 2018 Aug 29;18(1):1073. doi: 10.1186/s12889-018-5982-8.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5982-8

Heroin-dependent patient satisfaction with methadone as a medication influences satisfaction with basic interventions delivered by staff to implement methadone maintenance treatment.

Alcaraz S, Viladrich C, Trujols J, Siñol N, Pérez de Los Cobos J.

Patient Prefer Adherence. 2018 Jul 10;12:1203-1211. doi: 10.2147/PPA.S164181.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044354/

Long-Term Opioid Agonist Treatment Participation after First Treatment Entry is Similar across 4 European Regions but Lower in Non-Nationals.

Nordt C, Wiessing L, Kuijpers W, Wisselink J, Espelt A, Brugal MT, Mravčik V, Nechanská B, Seifritz E, Herdener M.

Eur Addict Res. 2018 Jul 17;24(4):173-183. doi: 10.1159/000490529.

Abstract

https://www.karger.com/Article/Abstract/490529

Integrating Responses at the Intersection of Opioid Use Disorder and Infectious Disease Epidemics: Proceedings of a Workshop.

National Academies of Sciences, Engineering, and Medicine. 2018. 

Washington, DC: The National Academies Press. doi.org/10.17226/25153.

https://www.nap.edu/catalog/25153/integrating-responses-at-the-intersection-of-opioid-use-disorder-and-infectious-disease-epidemics

Niederlande. Harm Reduction in Nederland

Inventarisatie van opiaatonderhoudsprogramma’s, gebruiksruimten en Harm Reduction binnen de (F)ACT-teams

In het rapport 'Harm Reduction in Nederland' is geïnventariseerd hoeveel Harm Reduction voorzieningen er zijn in Nederland. Het gaat dan om het aantal locaties waar vanuit de elf verslavingszorginstellingen methadon wordt verstrekt, het aantal locaties waar opiaatverslaafden worden behandeld met medische heroïne en het aantal drugs- en alcoholgebruiksruimten. Waar mogelijk zijn deze aantallen vergeleken met inventarisaties die in het verleden zijn uitgevoerd.

Naast het aantal locaties is er voor de relatief nieuwe Harm Reduction voorzieningen (alcoholgebruiksruimten, behandellocaties met medische heroïne en (F)ACT-teams) een aantal kenmerken van deze voorzieningen in kaart gebracht. Er is gekeken naar zowel organisatorische aspecten als zorginhoudelijke aspecten op het gebied van gezondheid en infectieziektepreventie. Een van de conclusies is dat er, door veranderend beleid en veranderingen in de doelgroep, meer aandacht zou moeten zijn voor het integreren en implementeren van Harm Reduction maatregelen en richtlijnen in bestaande (nieuwe) zorgstructuren rondom deze doelgroep. (Trimbos Instituut, Utrecht/Niederlande, 2018)

https://assets.trimbos.nl/docs/e9ad3758-4b3c-46aa-bc64-7f2410ee3882.pdf

Chronic Pain Opioid-Maintained Patients Receive Less Analgesic Opioid Prescriptions.

Delorme J, Chenaf C, Bertin C, Riquelme M, Eschalier A, Ardid D, Authier N.

Front Psychiatry. 2018 Jul 23;9:335. doi: 10.3389/fpsyt.2018.00335. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065119/

USA. Uninsured Opioid Users Admitted to Medication-Assisted Treatment (MAT) Program in Palm Beach County, Florida, Found to Be Using Many Drugs in Addition to Opioids 

Drug Outbreak Testing Service, July 2018, Issue 5 

https://ndews.umd.edu/sites/ndews.umd.edu/files/dots-bulletin-issue5-july2018-palmbeach-mat-final.pdf

Irland. 40% of those taking methadone are on it for 10 years

Four out of ten people on methadone, the legal substitute for heroin addiction, have been on the drug for at least 10 years.

That is according to HSE data, provided to Fianna Fáil TD John Curran, which shows that of the 10,316 people on methadone in the country, 4,069 have been taking it for a decade or more. (Irish Examiner, Irland, 23.08.2018)

https://www.irishexaminer.com/breakingnews/ireland/--863955.html

USA. It’s time for methadone to be prescribed as part of primary care

Opioid use disorder, which claims 115 lives a day by overdose in the United States, is a complex, chronic medical condition, but one that can be successfully treated with proven medications. And yet, one of the oldest and most effective medications to treat this disorder — methadone — is out of reach for many people, largely due to outdated federal laws.

Of the three medications approved by the Food and Drug Administration to treat opioid use disorder, federal law relegates only methadone to be dispensed in separate clinics apart from the general health care system. It’s not unusual for methadone clinics to be in out-of-the-way locations and often inaccessible by public transportation, especially in rural and suburban communities. When individuals trying to break an addiction to opioids can’t get to a methadone clinic on a daily basis, they can’t get treatment. (STAT, USA, 05.07.2018)

https://www.statnews.com/2018/07/05/methadone-prescribed-primary-care/

USA. At an Oakland Hospital, a New Way to Treat Opioid Addiction

So far, the opioid crisis hasn’t hit California as badly as many Eastern and Midwestern states. But with deadly synthetic fentanyl spreading there, Highland Hospital in Oakland is trying a new way of getting addicted patients into treatment. Those who come to its emergency room in withdrawal or with another medical problem are offered an initial dose of buprenorphine, a medication that staves off withdrawal symptoms and cravings. (New York Times, 20.08.2018)

https://www.nytimes.com/2018/08/20/us/california-today-opioid-addiction-treatment-oakland.html

USA. Research Summary: Buprenorphine Diversion Driven by Withdrawal Prevention, Abstinence Maintenance

 “Individuals who use diverted buprenorphine typically use it to prevent withdrawal symptoms or to maintain abstinence, according to research presented at the American Association of Nurse Practitioners 2018 National Conference.

Many users of diverted buprenorphine cited barriers to treatment access as a reason for not obtaining a prescription for the opioid partial agonist. Because recent legislation has extended buprenorphine waivers to qualified nurse practitioners and physician assistants, these clinicians may be able to help alleviate barriers to access. (Addiction Treatment Forum, USA, 09.07.2018)

http://atforum.com/2018/07/research-summary-buprenorphine-diversion-driven-by-withdrawal-prevention-abstinence-maintenance/

Improving wait time from referral to opiate replacement therapy in a drug recovery service.

Beattie M, Hookway G, Perera M, Calder S, Hunter-Rowe C, van Woerden H.

BMJ Open Qual. 2018 Jul 6;7(3):e000295. doi: 10.1136/bmjoq-2017-000295. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045695/

Methadone in Primary Care — One Small Step for Congress, One Giant Leap for Addiction Treatment

Jeffrey H. Samet, M.D., M.P.H., Michael Botticelli, M.Ed. and Monica Bharel, M.D., M.P.H.

N Engl J Med 2018; 379:7-8, DOI: 10.1056/NEJMp1803982

https://www.nejm.org/doi/full/10.1056/NEJMp1803982

Norwegen. Norwegen testet Heroin auf Rezept

Oslo – Norwegen plant einen Test mit Heroin auf Rezept für besonders schwer Süchtige. Ziel sei es, „denjenigen Drogenabhängigen zu einer besseren Lebensqualität zu verhelfen, die wir bislang nicht mit Hilfsprogrammen erreichen“, schrieb Gesundheitsminister Bent Höie auf Facebook. (aerzteblatt.de, 10.08.2018)

https://www.aerzteblatt.de/nachrichten/97081/Norwegen-testet-Heroin-auf-Rezept

Piloting online self-audit of methadone treatment in Irish general practice: results, reflections and educational outcomes.

Van Hout MC, Crowley D, McBride A, Delargy I.

BMC Med Educ. 2018 Jun 27;18(1):153. doi: 10.1186/s12909-018-1259-2.

https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1259-2

Norwegen. Norway to give free heroin to 400 addicts: report

Norway's government is to start providing free heroin to up to 400 hardened addicts as it pushes forward with its drug policy reforms. (The Local, Norwegen, 09.08.2018)

https://www.thelocal.no/20180809/norway-to-give-400-addicts-free-heroin

A Randomized Pilot Trial of Contingency-management Intervention for Patients in during Methadone Maintenance Treatment, Cash vs. Vouchers.

Pirnia B, Soleimani A, Taherinakhost HR, Pirnia K, Malekanmehr P, Zahiroddin A.

Iran J Public Health. 2018 Apr;47(4):618-619.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996323/

Russland. Russia calls to abandon doubtful methods in drug addiction treatment

MOSCOW, August 6. /TASS/. Russia recommends international experts to abandon doubtful methods in the treatment of drug addiction and search for truly effective methods in the fight against this threat, Russian Deputy Foreign Minister Oleg Syromolotov said on Monday, answering a question about "harm reduction programs." (TASS, Russland, 06.08.2018)

http://tass.com/society/1016222

Influence of social network on drug use among clients of methadone maintenance treatment centers in Kunming, China.

Shen L, Assanangkornchai S, Liu W, Cai L, Li F, Tang S, Shen J, McNeil EB, Chongsuvivatwong V.

PLoS One. 2018 Jul 3;13(7):e0200105. doi: 10.1371/journal.pone.0200105. 

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200105

USA. FDA takes new steps to encourage the development of novel medicines for the treatment of opioid use disorder

The U.S. Food and Drug Administration today issued new scientific recommendations aimed at encouraging more widespread innovation and development of novel medication-assisted treatment (MAT) drugs for the treatment of opioid use disorder (OUD). New draft guidance issued today outlines new ways for drug developers to consider measuring and demonstrating the effectiveness and benefits of new or existing MAT products. This new draft guidance is part of the FDA’s ongoing commitment to promote more widespread development, access to and adoption of MAT. (FDA, 06.08.2018)

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm615892.htm

Expanding the role of clinical pharmacists on interdisciplinary primary care teams for chronic pain and opioid management.

Giannitrapani KF, Glassman PA, Vang D, McKelvey JC, Thomas Day R, Dobscha SK, Lorenz KA.

BMC Fam Pract. 2018 Jul 3;19(1):107. doi: 10.1186/s12875-018-0783-9.

https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-018-0783-9

Change and variability in drug treatment coverage among people who inject drugs in 90 large metropolitan areas in the USA, 1993–2007

Barbara TempalskiCharles M. ClelandLeslie D. WilliamsHannah L. F. Cooperand Samuel R. Friedman

Substance Abuse Treatment, Prevention and Policy, 2018, 13:28, doi.org/10.1186/s13011-018-0165-2

https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-018-0165-2

Optimising treatment in opioid dependency in primary care: results from a national key stakeholder and expert focus group in Ireland

Marie Claire Van Hout, Des Crowley, Aoife McBride and Ide Delargy

BMC Family Practice2018, 19:103, doi.org/10.1186/s12875-018-0792-8

https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-018-0792-8

Australien. Medication Assisted Treatment for Opioid Dependence (MATOD) in Australia: A Better System for Better Outcomes

(Harm Reduction Australia and ScriptWise, 2018)

https://www.harmreductionaustralia.org.au/wp-content/uploads/2018/07/National-MATOD-Summit-Report-2018.pdf

USA. Methadone and buprenorphine reduce risk of death after opioid overdose - NIH research confirms effective treatments for opioid use disorder are underutilized. 

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. (NIH-NIDA, 19.06.2018)

https://www.nih.gov/news-events/news-releases/methadone-buprenorphine-reduce-risk-death-after-opioid-overdose

Access to opioid agonist therapy in Russia: time for reform.

Zelenev A.

Lancet HIV. 2018 Jul 19. pii: S2352-3018(18)30170-X. doi: 10.1016/S2352-3018(18)30170-X.

https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(18)30170-X/fulltext