NIH Pathways to Prevention: The Role of Opioids in the Treatment of Chronic Pain National Institutes of Health An unbiased, independent panel developed a final report of the 2014 NIH Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain, which summarizes the workshop and identifies future research priorities. The 43-page conference outcome responded to issues such as the effectiveness of opioids, safety and harm of opioids in patients with chronic pain, effectiveness of opioid management strategies and risk mitigation strategies for opioid treatment.
Editor’s Remarks William Haning, MD, FASAM, DFAPA This week's offerings are keyed to a variety of interests, as always. There is an elliptical orbit around two particular foci, alcohol and development; and opioid use disorders. Those whose practice encompasses recovering adults with children will be familiar with an anxious topic: will our child develop alcoholism, and what can we do to prevent that?
BMC Medicine is the flagship medical journal of the BMC series, publishing original research, commentaries and reviews that are of significant interest to all areas of medicine and clinical practice, including the impact of addiction.
People with Opioid Dependence in Recovery Show 'Re-Regulation' of Reward Systems Journal of Addiction Medicine (free ASAM member resource) Scott Bunce and colleagues report the outcome of the effect of time on multiple measures; the measures chosen are those which suggest susceptibility to relapse. While a small sample size (N=7), the study benefited by depth of investigation, length of study (2-3 months), and significant effect size. The results of this study suggest possible re-regulation of dysregulated hypothalamic-pituitary-adrenal axis and brain reward systems in prescription opioid-dependent patients over the drug-free period in residential treatment.
Clinical Use of Extended-Release Injectable Naltrexone in the Treatment of Opioid Use Disorders: A Brief Guide Substance Abuse and Mental Health Services Administration This 38-page free manual offers guidance on the use of medication-assisted treatment (MAT) with extended-release injectable naltrexone for the treatment of an opioid use disorder. It covers patient assessment, initiating MAT, monitoring progress, and deciding when to end treatment. The appendices include valuable, practical informational links.
DEA Moves Three Synthetic Cannabinoids into Schedule I Federal Register This document from the Drug Enforcement Administration is a notification of intent for the DEA to temporarily schedule three synthetic cannabinoids into schedule I. It explains which substances will be rescheduled and the reasons for doing so. It is noteworthy that the intended schedule placement is not controversial; the rule is only “temporary” in that further investigation is pending. The placement is for two years.
“Parity Poster” Helps Patients Report Unfair Insurance Practices American Psychiatric Association Federal law is clear that insurers can no longer discriminate against patients with mental illness, including substance use. But how many people know what constitutes a violation under the Mental Health Parity and Addiction Equity Act (MHPAEA)? Patients who know their rights are better equipped to protect their rights. That’s why the American Psychiatric Association has created a new tool to help enforce the parity law and end discrimination...
An Extended Swedish National Adoption Study of Alcohol Use Disorder JAMA Psychiatry Kenneth S. Kendler and associates linked registers and health databases to examine the effects of parenthood and environment on Swedish adoptees, in the development of alcohol use disorders (AUD). Genetic risk for AUD reflects both a specific liability to AUD and to other externalizing disorders. Environmental risk reflects features of both parental psychopathology and other aspects. Three classes or subtypes of AUD were identified in the course of the study, with considerable and intriguing similarity to older systems...
A Latent Growth Curve Analysis of Alcohol-Use Specific Parenting and Adolescent Alcohol Use Addictive Behaviors This study by Jennifer M. Zehe and Craig R. Colder investigates how changes in alcohol use-specific parenting were associated with adolescent drinking trajectories, using a sample of 378 aged 10-13 years. Three waves of data from a longitudinal study investigating adolescent substance use were used. The community sample (N = 378) was aged 10–13 at the first wave of assessment. The findings show that over time, parents are less likely to discipline their adolescents' drinking, more likely to grant their adolescent permission to drink. There was an association with increased alcohol use, not to be confused with causation. It is a non-comparative longitudinal study.
Opioid Abuse and Dependence during Pregnancy: Temporal Trends and Obstetrical Outcomes Anesthesiology Ayumi Maeda and colleagues at MGH, Brigham and Women’s Hospital, and the CDC provide this examination of nationwide trends in opioid abuse or dependence during pregnancy and assess the impact on maternal and obstetrical outcomes in the United States. They found considerable associated obstetrical morbidity and mortality, with increasing U.S. prevalence. The article focuses on perinatal events, principally involving the mother, and not upon downstream effects such as neonatal withdrawal syndrome.
Opiate Abuse, a Cyclical Challenge The New York Times Opioids now cause more deaths than any other drug, more than 16,000 in 2010. That year, the combination of hydrocodone and acetaminophen became the most prescribed medication in the United States. This article discusses the history, sociology, and science of opioid use disorders (OUD) in the U.S. Recognizing that the popular literature escapes strict peer review criteria, pieces such as this still carry great impact. They deserve reading and consideration for those involved in legislative testimony and policy development.
Beginning Search for New Editor-in-Chief of ASAM Weekly! The American Society of Addiction Medicine invites nominations and applications for the position of Editor-in-Chief (EIC) for ASAM Weekly for a 1-year, renewable term. Candidates must hold an MD or equivalent and should hold an ongoing research, clinical practice and/or academic position. Candidates should have demonstrated experience as an active member of ASAM, with a proven record of accomplishment for excellence and timeliness; ASAM Fellows preferred. Candidates must possess excellent communication and organizational skills.
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The views and positions of any content published in ASAM Weekly are not necessarily endorsed by ASAM nor a reflection of ASAM's beliefs and policies. The features are presented as a summary of the contemporary issues being represented and expressed in scientific, governmental, commercial, and media sources across the specialty field of addiction medicine. Contact ASAM Weekly with any comments or feedback.