Prescription Practices Involving Opioid Analgesics Among Americans with Medicaid, 2010 Journal of Health Care for the Poor and Underserved Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. The authors examined claims from enrollees aged 18-64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states.
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FROM JOURNAL OF ADDICTION MEDICINE
Relationship Between Drug Dreams, Affect, and Craving During Treatment for Substance Dependence Journal of Addiction Medicine (free ASAM member resource) The results of this study are consistent with the hypothesis that drug dreams (DD) can act as drug-conditioned stimuli to elevate negative affect and craving in abstaining individuals. Although correlational, such findings support the implementation of psychological and pharmacological interventions aimed at minimizing the impact of DD on individuals in recovery from drug addiction. However, while the temptation arises to make use of treatment options that have demonstrated value in other settings (e.g., prazosin for PTSD nightmares), it should be noted that the study addresses the occurrence of DD but not the occurrence of relapse in conjunction with DD. The way remains open to explore whether DD require an intervention, particularly if it is to be pharmacological one.
Opinion: The Implications of Marijuana Legalization in Colorado Journal of the American Medical Association The legalization of marijuana in Colorado has had complex effects on the health of its citizens. Physicians have the responsibility to present a balanced perspective, identifying both the potential health benefits and risks associated with marijuana use. In this Viewpoint, the authors discuss the history of marijuana policy in Colorado and the expected and unexpected effects of increased marijuana availability. Other states considering marijuana policy liberalization will want to learn from the experiences in Colorado. The ASAM Board of Directors continues to weigh breaking research and policy updates regarding use of cannabis.
Drug-Impaired Driving: Additional Support Needed for Public Awareness Initiatives US Government Accountability Office This well-written summation of data also provides reasoned discussions of the many confounds in identifying substance-impaired drivers. Various state and national-level data sources—including surveys, arrest data, drug-testing results, and crash data—provide limited information on the extent of drugged and drug-impaired driving in the United States. For example, based on preliminary results from a representative sample of weekend-nighttime and Friday daytime drivers, the National Highway Traffic Safety Administration's (NHTSA) 2013-2014 National Roadside Survey of Alcohol and Drug Use by Drivers (NRS) estimated that 20 percent of drivers would have tested positive for at least one drug, with marijuana being the most common drug.
Improved Medication-Assisted Treatment Policy Could Aid Epidemic of 20 Million Americans with Untreated Addiction Legal Action Center Following the reintroduction of the Comprehensive Addiction and Recovery Act, Legal Action Center (LAC) released a report urging policymakers to take steps to address the growing opioid and heroin epidemic through more effective use of medication-assisted treatment (MAT). The report, “The Case for Expanding Access to Medication-Assisted Treatment to Address the Heroin and Opioid Epidemic,” outlines the health, justice, and economic advantages of medication-assisted treatment along with several policy recommendations for improving addiction treatment.
AMERSA Accepting Abstracts for Annual Conference Association for Medical Education and Research in Substance Abuse AMERSA’s (Association for Medical Education and Research in Substance Abuse) annual conference will take place November 5-7 in Washington, DC. The association is currently accepting abstracts for presentation at the conference, as well as workshops, the deadline for both being May 29. ASAM members who have not attended this conference previously will find it to be a heterogeneous band of disciplines, in a congenial setting, with excellent presentations.
Prescription Opioid Analgesic Use Among Adults: United States, 1999–2012 Centers for Disease Control and Prevention The percentage of adults aged 20 and over who used a prescription opioid analgesic in the past 30 days significantly increased from 5.0% in 1999–2002 to 6.9% in 2003–2006, and then remained stable through 2011–2012 (6.9%). Together with findings from the third National Health and Nutrition Examination Survey (1988–1994), these findings indicate that the use of opioid analgesics among US adults has more than doubled since 1988–1994, when 3.4% used opioid analgesics. Among adults who used opioids during 1999–2012, the percentage of adults who used only a weaker–than–morphine opioid analgesic declined from 42.4% to 20.0%, while the percentage of adults who used a stronger–than–morphine opioid increased from 17.0% to 37.0%.
National Record Linkage Study of Mortality for a Large Cohort of Opioid Users in England, 2005–2009 Drug and Alcohol Dependence Opioid users’ excess mortality persists into old age and for some causes is exacerbated. 198,247 opioid users in England were identified from drug treatment and criminal justice sources (April, 2005 to March, 2009) and linked to mortality records. Mortality rates and standardized mortality ratios (SMRs) were calculated by age-group and gender. This study highlights the importance of managing the complex health needs of older opioid users.
Prescription Drug Abuse Awareness Month National Coalition Against Prescription Drug Abuse March is Prescription Drug Abuse Awareness Month throughout California and numerous activities have been scheduled to increase community awareness about America’s prescription drug abuse epidemic. This event gives an example of an increasingly popular component, a drug-return amnesty booth for safe disposal of old medications; although the concept necessitates attention to site security.
Drugs for Alcoholism Don’t Have to Lead to Sobriety Bloomberg Drugs to treat alcoholism can gain approval by proving patients using them no longer drink heavily, the Food and Drug Administration clarified Wednesday. The agency released draft guidelines for pharmaceutical companies wanting to develop alcoholism treatments that make clear that sobriety doesn’t have to be the main goal. A better choice of words would have been that “sobriety doesn’t have to be the sole goal”, as statements supporting one therapy need not be at the expense of pursuing a therapeutic ideal.
Refining Deep Brain Stimulation to Emulate Optogenetic Treatment of Synaptic Pathology Science Circuit remodeling driven by pathological forms of synaptic plasticity underlies several psychiatric diseases, including addiction. Deep brain stimulation (DBS) has been applied to treat a number of neurological and psychiatric conditions, although its effects are transient and mediated by largely unknown mechanisms. This animal study bears on future human therapeutic possibilities, emphasizing stimulant (cocaine) dependence.
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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.