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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and most effective medications to treat this disorder — methadone — is out of reach for many people, largely due to outdated federal laws.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. 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/

Portugal. How Portugal Is Kicking its Heroin Habit (Video)

Back in the 1990s, Portugal faced a heroin crisis. Most people knew someone affected by the lethal drug. Just two decades later, the country has one of the lowest drug-related death rates in the world. This dramatic turnaround isn't credited to a hard-line approach, but instead by decriminalizing all drugs. (Bloomberg, 24.05.2018, Video, 03:42)

https://www.youtube.com/watch?v=lba9nkK-DDY

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

Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice

Johan Kakko,Charlotte Gedeon,Mikael Sandell,Henrik Grelz,Inge Birkemose,Thomas Clausen,Valgerður Rúnarsdóttir,Kaarlo Simojoki,Richard Littlewood,Hannu Alhoand Fred Nyberg

Substance Abuse Treatment, Prevention, and Policy2018, 13:22, doi.org/10.1186/s13011-018-0160-7

https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-018-0160-7

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

Policy Pathways to Address Provider Workforce Barriers to Buprenorphine Treatment.

Haffajee RL, Bohnert ASB, Lagisetty PA.

Am J Prev Med. 2018 Jun;54(6S3):S230-S242. doi: 10.1016/j.amepre.2017.12.022.

https://linkinghub.elsevier.com/retrieve/pii/S0749-3797%2818%2930074-6

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/

Prescribing Practices of Rural Physicians Waivered to Prescribe Buprenorphine.

Andrilla CHA, Coulthard C, Patterson DG.

Am J Prev Med. 2018 Jun;54(6S3):S208-S214. doi: 10.1016/j.amepre.2018.02.006.

https://www.ajpmonline.org/article/S0749-3797%2818%2931548-4/fulltext

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

Cost of provision of opioid substitution therapy provision in Tijuana, Mexico.

Burgos JL, Cepeda JA, Kahn JG, Mittal ML, Meza E, Lazos RRP, Vargas PC, Vickerman P, Strathdee SA, Martin NK.

Harm Reduct J. 2018 May 23;15(1):28. doi: 10.1186/s12954-018-0234-x.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/29792191

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

USA. Advancing Therapeutic Development for Pain and Opioid Use Disorders Through Public-Private Partnerships: Proceedings of a Workshop.

National Academies of Sciences, Engineering, and Medicine. 2018. Washington, DC: The National Academies Press. doi.org/10.17226/25060.

https://www.nap.edu/catalog/25060/advancing-therapeutic-development-for-pain-and-opioid-use-disorders-through-public-private-partnerships

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

USA. APF Launches Hospital Toolkit to support emergency medicine providers as part of a comprehensive response to addiction

This toolkit is open source, and we encourage you to utilize it to begin dialogues with Emergency Department physicians, nurses, support staff and administrators in your area. (addictionpolicy.org, USA, 16.05.2018)

http://www.addictionpolicy.org/hospitaltoolkit

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

USA. We really do have a solution to the opioid epidemic — and one state is showing it works

Virginia shows how Medicaid can help end the opioid crisis. (VOX, USA, 10.05.2018)

https://www.vox.com/policy-and-politics/2018/5/10/17256572/opioid-epidemic-virginia-medicaid-expansion-arts

USA. When an Iowa Family Doctor Takes On the Opioid Epidemic

Few primary care doctors are willing to do what Nicole Gastala has: endure the challenges of prescribing buprenorphine, a medication for opioid addiction. (The New York Times, 23.06.2018)

https://www.nytimes.com/2018/06/23/health/opioid-addiction-suboxone-treatment.html

Schweiz. Was von den Pionieren der Drogenpolitik blieb

Methadon oder Therapie: Das sollte keine Frage der Ideologie mehr sein. Doch die alten Gräben sind noch da. (Tagesanzeiger, Schweiz, 21.04.2018)

https://www.tagesanzeiger.ch/schweiz/standard/Was-von-den-Pionieren-der-Drogenpolitik-blieb/story/17057654

Perceived barriers to methadone maintenance treatment among Iranian opioid users.

Khazaee-Pool M, Moeeni M, Ponnet K, Fallahi A, Jahangiri L, Pashaei T.

Int J Equity Health. 2018 Jun 11;17(1):75. doi: 10.1186/s12939-018-0787-z.

https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0787-z

Challenges in implementing opioid agonist therapy in Lebanon: a qualitative study from a user's perspective.

Ghaddar A, Khandaqji S, Abbass Z.

Subst Abuse Treat Prev Policy. 2018 Apr 19;13(1):14. doi: 10.1186/s13011-018-0151-8.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909215/

Indien. Putting people at the centre of harm reduction: lessons from India 

Blink, and you would miss the National Drug Dependency Treatment Centre (NDDTC) in Sunder Nagri, New Delhi. Housed in a nondescript community centre in an area known for high levels of poverty, unemployment, and conservative values, it’s not necessarily where you would expect to find a drug treatment centre.

As we walk into the clinic, a row of people wait patiently to be seen. A man in his twenties approaches the nurses’ station, ready to take his daily dose of methadone. After five minutes, the procedure is complete. His paperwork is checked and he’s free to go about his day. (aidsalliance.org, 22.06.2018)

http://www.aidsalliance.org/blog/1109-putting-people-at-the-centre-of-harm-reduction-lessons-from-india

Barriers and facilitators affecting the implementation of substance use screening in primary care clinics: a qualitative study of patients, providers, and staff.

McNeely J, Kumar PC, Rieckmann T, Sedlander E, Farkas S, Chollak C, Kannry JL, Vega A, Waite EA, Peccoralo LA, Rosenthal RN, McCarty D, Rotrosen J.

Addict Sci Clin Pract. 2018 Apr 9;13(1):8. doi: 10.1186/s13722-018-0110-8.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890352/

USA. After Opioid Overdose, Only 30 Percent Get Medicine To Treat Addiction

More than 115 Americans die every day of opioid overdose. Many more who overdose survive due to the antidote medication naloxone. But a study out Monday finds that just 3 in 10 patients revived by an EMT or in an emergency room received the follow-up medication known to avoid another life-threatening event. (KHN – Kaiser Health News, USA, 19.06.2018)

https://khn.org/news/after-opioid-overdose-only-30-percent-get-medicine-to-treat-addiction

Status Investigation of Outpatients Receiving Methadone Maintenance Treatment (MMT) in Shanghai from 2005 to 2016.

Bao J, Zhang L, Ning Z, Fu J, Zhao M, DU J.

Shanghai Arch Psychiatry. 2017 Dec 25;29(6):343-351. doi: 10.11919/j.issn.1002-0829.217030.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925585/

USA. AMA: Remove barriers to opioid-use disorder treatment

On Monday, U.S. Surgeon General Jerome Adams, MD, called on his fellow AMA member physicians to work toward eliminating stigma associated with substance-use disorder and removing barriers to treatment. Then, over the course of the next two days, the AMA House of Delegates did just that in voicing support for policies to raise public awareness of, and improve patient access to, substance-use disorder treatments. (AMA – American Medical Association, 14.06.2018)

https://wire.ama-assn.org/ama-news/ama-remove-barriers-opioid-use-disorder-treatment