Casey, McConnell Introduce Bipartisan Bill to Address Maternal Addiction and Infant Opioid Withdrawal Robert P. Casey, Jr: US Senator for Pennsylvania US Senator Bob Casey (D-PA) and Majority Leader Mitch McConnell (R-KY) introduced legislation to address the rise of prenatal opioid abuse and infants suffering from opioid withdrawal. The bipartisan Protecting Our Infants Act would direct the Secretary of Health and Human Services (HHS) to develop recommendations for preventing and treating prenatal opioid abuse and for treating infants born dependent on opioids. The measure would also direct the HHS Secretary to lead a review of departmental planning and coordination and develop a strategy to address research and program gaps, which is a recommendation that was made in a Government Accountability Office report last month.
Editor’s Comments William Haning, MD, FASAM, DFAPA One of the most melancholy emotions is the sense of not being able to meet everybody's needs. It is that way with friends, with family, with patients, and is a sensation that can shred self-assurance and morale. Finding oneself overwhelmed by equally urgent demands, the physician is exasperated, then angered, then, if unwary and not adequately supported, demoralized. Hard enough that there may be insufficient money support for treating addicts; it is harder still to know where best to place that money.
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ASAM Performance Measures for the Addiction Specialist Physician Released ASAM On March 25th, ASAM released performance measures for the addiction specialist physician. This document, developed by the Performance Measures Expert Panel led by Dr. Corey Waller as part of the Practice Improvement Performance Measurement Action Group (PIPMAG), provides nine measures to evaluate and improve the quality of addiction related care. They may be accessed directly here. These quality-improvement measures intended for active practice also invite inclusion in the Systems-Based Practice (SBP) core competency training of the Addiction Medicine Fellowship curricula.
FDA Expands Uses of Vyvanse to Treat Binge-Eating Disorder US Food and Drug Administration The US Food and Drug Administration has expanded the approved uses of Vyvanse (lisdexamfetamine dimesylate) to treat binge-eating disorder in adults. The drug is the first FDA-approved medication to treat this condition. Two clinical studies were used to support the decision, including 724 adults with moderate-to-severe binge-eating disorder. In the studies, participants taking Vyvanse experienced a decrease in the number of binge eating days per week and had fewer obsessive-compulsive binge eating behaviors compared to those receiving placebo. In this press release, there is no discussion of treatment details: the anticipated duration of medication treatment, including therapeutic end-point, risk-benefit in light of this Schedule II agent’s risk for dependence and misuse, and screening such as for cardiac
anomalies.
Opioid Abuse in the US and HHS Actions to Address Opioid-Drug Related Overdoses and Deaths US Department of Health and Human Services On Thursday, March 27, US Health and Human Services Secretary Sylvia M. Burwell announced a targeted initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence. The Secretary’s efforts focus on three priority areas that tackle the opioid crisis, significantly impacting those struggling with substance use disorders and helping save lives: providing training and educational resources, including updated prescriber guidelines, to assist health professionals in making informed prescribing decisions; increasing use of naloxone; and expanding medication-assisted treatment.
#SubOversight Continues Its Review of Growing Threat of Prescription Drug and Heroin Abuse Energy and Commerce Committee The House Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), held a hearing to discuss the growing problem of prescription drug and heroin abuse from state and local perspectives. Members heard from a number of experts who confront this growing crisis in communities all across the country. The subcommittee last year held a hearing to discuss this issue with witnesses from federal agencies.
NIH Holds Competition to Create Better Wearable Alcohol Biosensor National Institute on Alcohol Abuse and Alcoholism Reminiscent of the geographic exploration prizes of the early 20th century, an initiative was announced that is bound to cause controversy, at the same time that it is a sensible way of leveraging limited governmental resources: in the search for a wearable or otherwise discreet device capable of measuring blood alcohol levels in real time, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has issued the Wearable Alcohol Biosensor Challenge, seeking a more efficient and practical implement than those currently available.
Clonidine Maintenance Prolongs Opioid Abstinence and Decouples Stress from Craving in Daily Life: A Randomized Controlled Trial with Ecological Momentary Assessment American Journal of Psychiatry Clonidine, a readily available medication, may be useful in opioid dependence not just for reduction of withdrawal signs, but also as an adjunctive maintenance treatment that increases duration of abstinence. In the absence of physical withdrawal, the authors argue that it decouples stress from craving in everyday life. It is noteworthy that all participants were also receiving buprenorphine during the trial.
Naltrexone vs Placebo for the Treatment of Alcohol Dependence JAMA Psychiatry This is a genomic matching study, aiming to predict efficacy. The results of this study do not support the hypothesis that the Asp40 allele moderates the response to naltrexone treatment. It is premature to use the Asn40Asp polymorphism as a biomarker to predict the response to naltrexone treatment of alcohol dependence. It is a valuable addition to the developing literature on pre-therapeutic genomic testing.
Socioeconomic Status Moderates Genetic and Environmental Influences on Alcohol Use Alcoholism: Clinical and Experimental Research Research on genetic and environmental influences underlying alcohol use has thus far failed to uncover specific causes, likely because genetic and environmental influences vary by context. A study of the moderating effects of socioeconomic status (SES) on genetic and environmental influences on alcohol use has found that genetic effects on amount of alcohol use are greater in socioeconomically disadvantaged environments.
Marijuana Legalization in Italy: Motion to Legalize Cannabis Receives Bi-Partisan Support International Business Times Lawmakers in Italy have taken a bold stance on marijuana legalization, signing a motion to legalize cannabis across the country, according to the ANSA news agency. The proposal, introduced by Sen. Benedetto Della Vedova, was backed by 60 politicians, mostly from the ruling center-left Democratic Party but with some support from the right.
The ASAM Essentials of Addiction Medicine Available for Pre-Order ASAM Pre-order The ASAM Essentials of Addiction Medicine today. The ASAM Essentials, edited by Abigail J. Herron, DO, and Timothy Koehler Brennan, MD, MPH, summarizes the contents of The ASAM Principles of Addiction Medicine
into a quick reference on virtually all addiction topics. Among its extensive offerings, the guide features new methods to provide care to patients, as well as definitive answers on how to assist those suffering from addiction with early intervention tactics. An e-book version is included with the print edition and includes over 300 content review questions. ASAM members receive a 10% discount.
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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.