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USA. Top U.S. addiction researcher calls for broad deregulation of methadone

BOSTON — The U.S. government’s top addiction researcher is calling for broad deregulation of methadone, a key drug used to treat opioid use disorder.

American doctors should “absolutely” be allowed to prescribe methadone directly to patients, Nora Volkow, the director of the National Institute on Drug Abuse, said Wednesday. 

“There’s absolutely no reason why not,” Volkow said. “There are countries where physicians are providing methadone, and the outcomes are actually as good as those they get [at] methadone clinics.” (Stat, 16.11.2022)

https://www.statnews.com/2022/11/16/nora-volkow-nida-broad-deregulation-methadone/

USA. State Opioid Treatment Program Regulations Put Evidence-Based Care Out of Reach for Many 

Opioid treatment programs (OTPs) are the only health care facilities that can offer patients all three forms of medication for opioid use disorder: methadone, buprenorphine, and injectable extended-release naltrexone. No other setting is permitted to provide methadone. These facilities are critical to reducing overdose deaths and providing lifesaving addiction treatment.

But too often, access to high quality OTP care is curtailed by federal and state rules that are not based in evidence. Although debate over the future of federal methadone regulation is ongoing, state policymakers have the opportunity to act now to improve access to this medication and the quality of OTP services by removing rules that go beyond federal restrictions and limit access to care. (PEW Charitable Trusts, USA, 31.10.2022)

https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2022/state-opioid-treatment-program-regulations-put-evidence-based-care-out-of-reach-for-many

Afghanistan. Afghan Rehab Centers Failing Drug Addicts After Taliban Takeover (Video)

The director of a 1,000-bed rehabilitation center for drug addicts in Kabul says they don't have enough basic food, medicine, and clothes for patients. Many rehabilitation centers have closed or are struggling to remain open since international charities cut or reduced funding after the Taliban returned to power in August 2021. (Gandhara, RFE/RL's Radio Azadi, Tschechien, 25.10.2022, Video, 03:34)

https://gandhara.rferl.org/a/afghan-rehab-centers-drug-addicts-taliban/32124517.html

Performance Measurement for Opioid Use Disorder Medication Treatment and Care Retention. 

Williams AR, Mauro CM, Feng T, Wilson A, Cruz A, Olfson M, Crystal S, Samples H, Chiodo L. 

Am J Psychiatry. 2022 Oct 26:appiajp20220456. doi: 10.1176/appi.ajp.20220456. Epub ahead of print. PMID: 36285405.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20220456

USA. Ethnic and racial disparities found in buprenorphine treatment

A quartet of researchers, three with Harvard Medical School's Massachusetts General Hospital Institute for Technology Assessment, and the fourth with McGill University, has found that there are ethnic and racial disparities in the availability and duration of treatment for people with addictions prescribed the drug buprenorphine. (MedicalXpress, USA, 09.11.2022)

https://medicalxpress.com/news/2022-11-ethnic-racial-disparities-buprenorphine-treatment.html

Stage-of-change Assessment Predicts Short-term Treatment Engagement for Opioid Use Disorder Patients Initiated on Buprenorphine. 

Reuter Q, Larkin GL, Dubé M, Vellanki S, Dos Santos A, McKinnon J, Jouriles N, Seaberg D. 

West J Emerg Med. 2022 Jun 29;23(5):684-692. doi: 10.5811/westjem.2022.3.53197. PMID: 36205682; PMCID: PMC9541985.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541985/

Analysis of US County Characteristics and Clinicians With Waivers to Prescribe Buprenorphine After Changes in Federal Education Requirements. 

Nguyen T, Andraka-Christou B, Arnaudo C, Bradford WD, Simon K, Spetz J. 

JAMA Netw Open. 2022 Oct 3;5(10):e2237912. doi: 10.1001/jamanetworkopen.2022.37912. PMID: 36269358; PMCID: PMC9587475.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797551

Low-Barrier Buprenorphine Treatment for People Experiencing Homelessness. 

Gibson CL, Lo E. 

Psychiatr Serv. 2022 Oct 18:appips20220426. doi: 10.1176/appi.ps.20220426. Epub ahead of print. PMID: 36254451.

https://ps.psychiatryonline.org/doi/10.1176/appi.ps.20220426

Analyzing opioid-use disorder websites in the United States: An optimized website usability study. 

He S, Shyamsundar S, Chong P, Kannikal J, Calvano J, Balapal N, Kallenberg N, Balaji A, Ankem A, Martin A. 

Digit Health. 2022 Oct 6;8:20552076221121529. doi: 10.1177/20552076221121529. PMID: 36225987; PMCID: PMC9549183.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549183/

Traitement de substitution des usagers dépendants des opiacés - L’expérience du Centre de prise en charge intégré des addictions de Dakar [Substitution treatments for opiate-dependent users. An experience of the Integrated Addiction Treatment Center in Dakar]. 

Gaye S, Malissin I, Gadji M, Thiam MH, Mégarbane B. 

Med Sci (Paris). 2022 Oct;38(10):832-837. French. doi: 10.1051/medsci/2022125. Epub 2022 Oct 11. PMID: 36219086.

https://www.medecinesciences.org/en/articles/medsci/full_html/2022/08/msc220101/msc220101.html

Flexible Buprenorphine/Naloxone Treatment Models: Safe and Effective in Reducing Opioid Use Among Persons With Prescription Opioid Use Disorder. 

Saunders EC. 

Am J Psychiatry. 2022 Oct;179(10):699-701. doi: 10.1176/appi.ajp.20220687. PMID: 36181331.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20220687

Racial inequity in medication treatment for opioid use disorder: Exploring potential facilitators and barriers to use. 

Hollander MAG, Chang CH, Douaihy AB, Hulsey E, Donohue JM. 

Drug Alcohol Depend. 2021 Oct 1;227:108927. doi: 10.1016/j.drugalcdep.2021.108927. Epub 2021 Jul 28. PMID: 34358766; PMCID: PMC8464525.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464525/

A qualitative exploration of patients' experience of mobile telephone-delivered contingency management to promote adherence to supervised methadone. 

Getty CA, Weaver T, Metrebian N. 

Drug Alcohol Rev. 2022 Oct 21. doi: 10.1111/dar.13555. Epub ahead of print. PMID: 36269110.

https://onlinelibrary.wiley.com/doi/10.1111/dar.13555

Implementation opportunities for scaling up methadone maintenance treatment in Kyrgyzstan: Methadone dosage and retention on treatment over two years. 

Ivasiy R, Madden LM, Farnum SO, Shumskaya N, Galvez de Leon SJ, Bromberg DJ, Kurmanalieva A, Duishenaliev A, Tokubaev R, Altice FL. 

Drug Alcohol Depend Rep. 2022 Sep;4:100075. doi: 10.1016/j.dadr.2022.100075. Epub 2022 Jul 19. PMID: 36267100; PMCID: PMC9581459.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9581459/

Schweiz. Erleichterte Heroinabgabe für Süchtige auch nach der Pandemie 

Menschen mit einer Sucht hatten während der Coronazeit besondere Regelungen bei der Abgabe des Heroins. Damit seien gute Erfahrungen gemacht worden, heisst es bei den Abgabestellen. (SRF – Schweizerischer Rundfunk, Schweiz, 05.11.2022, Text und Audio, 01:12)

https://www.srf.ch/news/schweiz/drogen-abhaengigkeit-erleichterte-heroinabgabe-fuer-suechtige-auch-nach-der-pandemie

USA. Providers of methadone treatment say a big increase in access could backfire

BALTIMORE — Providers of methadone for addiction treatment have a message for advocates seeking a giant expansion in access: Be careful what you wish for. 

Methadone, they acknowledge, is a highly effective medication for opioid addiction. But allowing doctors to prescribe it directly to patients could backfire, they argue, by leading to an increase in low-quality care or even overdoses on methadone itself. (Stat News, USA, 03.11.2022)

https://www.statnews.com/2022/11/03/providers-of-methadone-treatment-say-a-big-increase-in-access-could-backfire/

National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009-2020. 

Na PJ, Bommersbach TJ, Petrakis IL, Rhee TG. 

EClinicalMedicine. 2022 Oct 12;54:101696. doi: 10.1016/j.eclinm.2022.101696. PMID: 36267498; PMCID: PMC9576812.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576812/

USA. Buprenorphine Access: Telehealth Revolution Faces Uncertain Future

This summer, a young woman was revived by paramedics after an overdose at her home in Upstate New York. She refused transport to the hospital, a common occurrence among people who use drugs who have been historically mistreated by the health care system. Two years prior, emergency responders would have noted her as “refusing treatment” and swiftly left her. Instead, she was given a completely different option—one she actually wanted.

A mere 20 minutes after the paramedics left, from the comfort of her own living room, she was able to meet virtually with an addiction medicine prescriber, who offered her a prescription for buprenorphine.

“An example like that happens every day,” Dr. Joshua Lynch, founder and medical director of NY MATTERS, told Filter. (Filter, USA, 25.10.2022)

https://filtermag.org/buprenorphine-telehealth-pandemic

Navigating Opioid Agonist Therapy among Young People who use Illicit Opioids in Vancouver, Canada. 

Pilarinos A, Kwa Y, Joe R, Thulien M, Buxton JA, DeBeck K, Fast D. 

Int J Drug Policy. 2022 Sep;107:103773. doi: 10.1016/j.drugpo.2022.103773. Epub 2022 Jun 30. PMID: 35780565.

https://www.sciencedirect.com/science/article/pii/S095539592200192X

Problematic opioid use in Ireland, 2015–2019. 

Hanrahan, Michael T and Millar, Sean and Phillips, Karl P and Reed, Thomas E and Mongan, Deirdre and Perry, Ivan J (2022) 

Dublin: Health Research Board. 

https://www.drugsandalcohol.ie/35856/1/HRB_CRC_Report-Problematic_opioid_use_in_Ireland_2015-2019.pdf

Simulating the experience of searching for LGBTQ-specific opioid use disorder treatment in the United States. 

Paschen-Wolff MM, Velasquez R, Aydinoglo N, Campbell ANC. 

J Subst Abuse Treat. 2022 Sep;140:108828. doi: 10.1016/j.jsat.2022.108828. Epub 2022 Jun 16. PMID: 35749919.

https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(22)00110-6/fulltext

Implementing a Novel Statewide Network to Support Emergency Department-initiated Buprenorphine Treatment. 

Clemency BM, Hoopsick RA, Burnett SJ, Kahn LS, Lynch JJ. 

West J Emerg Med. 2022 Jun 5;23(4):451-460. doi: 10.5811/westjem.2022.3.54680. PMID: 35980408; PMCID: PMC9391018.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391018/

Improving Uptake of Emergency Department-initiated Buprenorphine: Barriers and Solutions. 

Kelly TD, Hawk KF, Samuels EA, Strayer RJ, Hoppe JA. 

West J Emerg Med. 2022 Jul 11;23(4):461-467. doi: 10.5811/westjem.2022.2.52978. PMID: 35980414; PMCID: PMC9391022.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391022/

Association between treatment setting and outcomes among oregon medicaid patients with opioid use disorder: a retrospective cohort study. 

Hartung DM, Markwardt S, Johnston K, Geddes J, Baker R, Leichtling G, Hildebran C, Chan B, Cook RR, McCarty D, Ghitza U, Korthuis PT. 

Addict Sci Clin Pract. 2022 Aug 19;17(1):45. doi: 10.1186/s13722-022-00318-1. PMID: 35986384; PMCID: PMC9389731.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389731/

The Role of Context in Integrating Buprenorphine into a Drop-In Center in Kampala, Uganda, Using the Consolidated Framework for Implementation Research. 

Dickson-Gomez J, Krechel S, Katende D, Johnston B, Twaibu W, Glasman L, Ogwal M, Musinguzi G. 

Int J Environ Res Public Health. 2022 Aug 20;19(16):10382. doi: 10.3390/ijerph191610382. PMID: 36012015; PMCID: PMC9407835.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407835/

Prioritizing measures to assess performance of drug treatment services: a Delphi process with funders, treatment providers and service-users.

Stirling, R, Nathan, S, Ritter, A.

Addiction. 2022. doi.org/10.1111/add.16038

https://onlinelibrary.wiley.com/doi/full/10.1111/add.16038

Transforming Management of Opioid Use Disorder with Universal Treatment

Gupta R, Levine RL, Cepeda JA, Holtgrave DR. 

N Engl J Med. 2022 Sep 21. doi: 10.1056/NEJMp2210121. Epub ahead of print. PMID: 36129991.

Barriers at multiple levels impede the use of evidence-based medication for opioid use disorder. Actions by clinicians, health care systems, and policymakers could substantially expand treatment access.

https://www.nejm.org/doi/full/10.1056/NEJMp2210121

USA. Methadone Treatment for Opioid Use Disorder - Improving Access Through Regulatory and Legal Change: Proceedings of a Workshop 

Methadone is a Food and Drug Administration- (FDA-) approved medication for treating opioid use disorder (OUD), a chronic brain disease that affects more than 2.7 million people in the United States aged 12 and older. Despite its effectiveness in saving lives, many barriers impede access to, initiation of, and retention in methadone treatment for OUD. To address these barriers, on March 3 and 4, 2022, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on "Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations and Laws," at the request of the Office of National Drug Control Policy in the Executive Office of the President. This publication summarizes the presentation and discussion of the workshop. (National Academies, USA, 2022)

https://nap.nationalacademies.org/catalog/26635/methadone-treatment-for-opioid-use-disorder-improving-access-through-regulatory

USA. Overview of Opioid Treatment Program Regulations by State - Restrictive rules put evidence-based medication treatment out of reach for many

Opioid treatment programs (OTPs) are the only health care facilities that can offer patients all three forms of FDA-approved medication for opioid use disorder (OUD): methadone, buprenorphine, and injectable extended-release naltrexone.1 But Pew found that nearly all states have rules governing OTPs that are not based in evidence and in turn limit access to care or worsen patient experience.2 (PEW - The Pew Charitable Trusts, USA, Issue Brief 19.09.2022)

Https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2022/09/overview-of-opioid-treatment-program-regulations-by-state

Residential treatment and medication treatment for opioid use disorder: The role of state Medicaid innovations in advancing the field. 

O'Brien PL, Stewart MT, Shields MC, White M, Dubenitz J, Dey J, Mulvaney-Day N. 

Drug Alcohol Depend Rep. 2022 Sep;4:100087. doi: 10.1016/j.dadr.2022.100087. Epub 2022 Aug 20. PMID: 36157615; PMCID: PMC9495301.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495301/