Over the next few months, I will provide a pale silhouette of the exceptional editing done by Dr. Richard Soper, during his years as Editor-in-Chief of ASAM Weekly. It will provide encouragement to those of you with editing ambitions to apply for the position of permanent Editor-in-Chief. All applications will be happily received and promptly referred to the Publications Committee, Dr. Lori Karan, Chair. In the meantime, the ASAM publications staff, with Brendan McEntee, Emily McMartin, and I will further welcome any conference or calendar items from the respective state societies, Regions, and ASAM collaborators, for publication.
Aloha, Bill Haning
(Wm. Haning, MD, FASAM, DFAPA - Director Region 8)
Vital Signs: Alcohol Poisoning Deaths — United States, 2010-2012 CDC Morbidity and Mortality Weekly Report This article reinforces awareness of the comparative lethality of alcohol use disorders and indirectly reminds one of the very narrow therapeutic index for this drug, such that the difference between the dosage required for intoxication and that able to cause death is quite small. In the introductory paragraph, there is the comment, “... Most binge drinkers (90%) are not alcohol dependent.” The 2014 study which is cited employs DSM IV TR criteria rather than the newer DSM-V criteria, which would likely permit a diagnosis of “alcohol use disorder” in more of the study sample. The inference remains valid, that binge drinking patterns may escape the usual thresholds for referral and treatment.
Recent Trends in Treatment Admissions for Marijuana Use During Pregnancy Journal of Addiction Medicine (free ASAM member resource) Caitlin Martin and associates’ examination of the trend in treatment of cannabis use disorder by pregnant women emphasizes the need for screening, in order to be able to encourage treatment. It is important to know the specific law in each state when submitting patients to screening, to anticipate the consequences, such as compulsory treatment and interrupted child custody by state authorities.
AMA House of Delegates Meeting Update ASAM In the AMA Policy and Regulatory News, the resolutions include one that directly impacts care standards for those at risk for addictions, pain patients; and two on e-cigarette and nicotine regulation. They are directed at federal agencies with great influence or control over the standards for prescription analgesia and nicotine regulation. The document is brief and very readable.
Dissecting Impulsivity and Its Relationships to Drug Addictions Annals of the New York Academy of Sciences In their review article on impulsivity and addictions, J. David Dentsch and colleagues make a case for impulsivity as both a causal factor for and a consequence of substance use disorders.
Buprenorphine–Naloxone Treatment in Opioid Dependence and Risk of Liver Enzyme Elevation: Results from a 12-Month Observational Study The American Journal on Addictions Michael Soyka and co-authors provide the latest indication that “...buprenorphine–naloxone is relatively safe with respect to liver injury.” This 12-month prospective observational follow-up study in opioid-dependent patients under buprenorphine–naloxone treatment assessed outcome and safety issues. At baseline, 337 eligible datasets were available; 181 patients completed the 12-month study. Liver enzymes were tested at baseline and after 12, 24, and 52 weeks' treatment.
Substance Use and Response to Psychiatric Treatment in Methadone-Treated Outpatients with Comorbid Psychiatric Disorder Journal of Substance Abuse Treatment The article by Michael Kidorf, et al., regarding comorbidity in MMTP patients, provides additional input on the question of the impact of continued illicit drug use in that setting. Those without concurrent illicit drug use appeared to benefit more from treatment of psychiatric co-morbidity; however, all appeared to benefit.
Psychophysiology of Pain and Opioid Use: Implications for Managing Pain in Patients with an Opioid Use Disorder Drug and Alcohol Dependence Opioid use disorders and the complexity of their management in the face of pain is the topic of Amy Wachholtz and colleagues’ piece. The authors remark the hyperalgesic effect of chronic opioid use, and its paradoxical effect for those seeking amelioration.
Oxytocin Facilitates the Extinction of Conditioned Fear in Humans Biological Psychiatry The effect of oxytocin on fear, and thus modulation of anxiety, is addressed in the piece by Monika Eckstein and colleagues. This is an encouraging step in early translational research involving neural pathway modulation, potentially without the abuse risks associated with current anxiolytic treatment.
Substance Abuse Treatment Often Impossible to Find USA Today In a series of stories this year, USA Today is exploring the human and financial costs the country pays for not caring more about the 10 million Americans with serious mental illness. This article on barriers to obtaining addiction treatment provides useful, if disturbing material for friends and families of those with addictions. It calls for advocacy.
ASAM Joins NIDAMED Coalition of Healthcare Organizations ASAM ASAM announces its participation in the newly formed NIDAMED Coalition of Healthcare Organizations which together with National Institute on Drug Abuse (NIDA) will work to help increase clinician education on how best to address and prevent adolescent substance use (SU).
ASAM Memberships Expired December 31, 2014 Don’t let your ASAM membership benefits lapse! Join or renew online today. Membership offers the opportunity to keep up to date with the latest science, attend world-renowned courses, network with peers, and so much more.
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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.