Doctors Can Help Overcome Opioid Dependency but Patients Are Unaware, Studies Show

We are living in unprecedented times when it comes to addiction treatment. There are not only facilities and organizations that offer help for issues like opioid dependency, but now your primary care physician can prescribe medicine to treat the problem. So, why aren’t more people contacting their local doctors for help? Research suggests it’s often a simple lack of awareness.

One of the problems is that there is a disconnect between the people who need help with opioid addiction and the knowledge of how to get treatment. A 2023 survey showed that more than 80% of the people interviewed weren’t aware they could seek assistance from their doctors. Since more than 20 million people in the United States alone have an addiction issue, you might think this information would be more accessible.

Part of the miscommunication could be that until now, most of us have thought you must get help for any addiction in a facility, whether outpatient or inpatient treatment. While that can benefit many, it’s not always feasible for everyone. Fortunately, the changes in federal policy that removed some of the specialized training requirements for prescribing medications have helped pave a new path.

Now the number of physicians who can prescribe medications like buprenorphine has increased. This could present formidable financial savings to those who cannot afford either the treatment offered in centers or the time missed from work to get assistance.

What needs to happen to change the public’s perception of this potential game-changing benefit for opioid dependency? The predominant factor is more awareness. Once we know better, we can do better, and making the public more informed can dramatically alter the landscape of opioid addiction disorders. In this instance, knowledge truly is power.

The more people who know they can get help for their substance issues in the comfort of office-based care, the more likely it may be that the trajectory of this crisis will change. Although having the support and professional knowledge provided by addiction specialists may still be preferential to many facing opioid addiction, this will at least offer another avenue for assistance

Teens Prolonging Opioid Use Before and After Surgery, Study Shows

Why are so many youths getting prescription opioids too far in advance of surgeries and months afterward? According to a recent study, these frequent trips to the pharmacy aren’t associated with pain. The research shows that these teens are getting opioid prescriptions filled three to six months after their surgeries, which is rare for minor procedures. Why should this concern parents?

Close to 1.4 million young people have surgery every year in the United States. That’s a significant number when you consider that most of them will receive pain medications. Still using opioids months after surgery is often a sign of addiction. Some of the prescriptions were filled two weeks ahead of procedures that aren’t known to be associated with post-operative pain.

Interestingly, studies have shown that severe pain after surgery is not the cause of ongoing opioid use. Experts note that there are non-narcotic medications that can often control the pain after the specific procedures teens are having.

This new finding is significant because clinicians need effective means to manage surgical pain that doesn’t contribute to the persistent opioid crisis. Of course, there are times when opioids are necessary, but in most cases, physicians do not recommend taking pain medications months after a procedure.

With so many adults fighting opioid addiction, parents must be aware of what their children are taking and for how long. Prolonged use of these medicines after surgery can produce many complications. It can also quickly become an addiction for teens who are experimenting and don’t understand the severe consequences of opioid use, authorities caution.

For these youths, filling prescriptions several months after minimal procedures is a big problem. It shows we still have work to do regarding the opioid crisis and how to manage it, especially with youth. Many are calling for policymakers to update guidelines and legislation to help. Perhaps a new standard of care is needed to protect young people from becoming another opioid use statistic.

Cannabis Misuse on the Rise Among Older Adults, Study Shows

You may not think of your grandparents or their friends when it comes to marijuana use. Yet, the trends may be going in the wrong direction, a recent study shows. It isn’t such a small corner of the population, either. According to the data, there has been a noticeable increase in cannabis-related disorders among Medicare recipients 65 and older. The research used statistics from five years (2017-2022) and concentrated on medical claims mentioning cannabis-related problems.

So, why are so many seniors turning to marijuana consumption, and what are the ramifications of this shocking trend?

From the studies, it appears many people were using marijuana in states that had legalized cannabis. Individuals from physicians to politicians have voiced opinions regarding the medicinal use of marijuana, and there are now almost 15,000 cannabis dispensaries across the U.S., according to the Pew Research Center. With the floodgates now seemingly open, it’s important to remember that cannabis is a drug, whether legal or not, and there are still risks of addiction and other harmful effects that come with it.

Depending on the type of cannabis, it can affect your lungs, heart, and blood pressure and increase your risk of certain vascular diseases.

We may not often think of older adults becoming prone to addiction, but it happens more than you might think. With the mental health and substance use crises continuing to rise, our seniors are not immune to the devastating effects of drug abuse. Since marijuana is often a gateway drug, we can’t dismiss the possibility of cannabis leading to other problematic substances, like opioids.

It’s crucial that people have all the factual information regarding cannabis use and that we don’t fall prey to the commercialization and marketing attempts that make marijuana seem innocent. It is a drug with the potential to cause severe addiction, and our older adult population deserves to be well-informed of that fact.

Most Outpatient Mental Health Clinics Don’t Offer Opioid Addiction Meds

Only about one-third of outpatient mental health centers provide medication-assisted treatment for patients with opioid addiction, research shows. A nationwide survey published by JAMA revealed that although opioid use disorder rates are high among those experiencing mental health issues, the needed medications are not being utilized.

Treating those affected with opioid use issues with medicines like methadone, suboxone, and buprenorphine is considered the gold standard of care. These medications effectively reduce drug cravings and make the withdrawal process more comfortable. This is thought to contribute to higher recovery success rates.

Since hundreds of thousands of Americans die each year from opioid overdose, the lack of access to medication assisted treatment in mental health clinics puts lives at risk, experts contend. Proponents of the treatments suggest that these ecosystems would be a perfect point of entry for those needing opioid addiction treatment.

Some clinics not offering medication management reported that they referred patients to other facilities for this type of care. Many of these centers were within the same treatment system. This could make referrals easier for the facility but not necessarily for people needing treatment.

The researcher found that clinics providing integrated mental health and addiction recovery programs were much more likely to provide these FDA approved medications for opioid drug addiction.

These findings might indicate that outpatient clinics could improve recovery outcomes by offering a more comprehensive approach to care. Patients dealing with substance use issues and mental health problems could benefit from medication assisted treatment.

Experts speculate that more housing accommodations or easier referral processes could lead to these services being offered more. Whatever the breakdown may be, with the opioid crisis still looming, healthcare facilities may need to remove as many barriers to treatment as possible.

Mind Over Matter: Using Mindfulness to Curb Opioid Cravings

In a randomized trial, recent studies showed that individuals experiencing opioid use disorder benefited from mindfulness techniques. Mindfulness has gained attention and popularity in recent years due to the positive impact it has shown to have on stress, tension, and thought patterns.

Using mindfulness, individuals can reframe their thinking. Researchers have explained that this method helps people have an approach that is healthy and can help overcome opioid addiction by increasing the chances of continuing and finishing treatment.

The pilot study and the second phase showed encouraging results, suggesting that mindfulness training can be used to create a better protocol for opioid treatment. During recent research, Mindfulness Oriented Recovery Enhancement (MORE) intervention slashed treatment dropout rates by 59%. Further, it decreased relapse incidents by 42%, leading researchers to believe there is a definite place for mindfulness practices in addiction rehabilitation.

Why does this strategy work? It could be that individuals with opioid use disorder have changes in their brains, making them only receptive to the reward felt by experiencing opioid highs. MORE helps users retrain their brains with healthy activities, like noticing how a good meal tastes, the beauty of a serene landscape, or their favorite smells.

The practice of mindfulness teaches everyone to focus on the present. You meditate on your breathing and what you sense in the current moment. It has also been used to help manage pain and may be combined with medication-assisted treatment (MAT).

Studies are ongoing, but the initial results are positive. Mindfulness may be used to change the current standard of care, giving those with opioid use disorder a greater chance at sobriety. Larger research studies are planned to design more protocols that integrate MORE. In the meantime, researchers are looking for the best ways to train clinicians on using mindfulness techniques to help with substance abuse treatment.

Small Towns Can Spell Big Trouble for Persons with Substance Use Disorders

Studies show that persons in rural areas are significantly less likely to receive care for substance use disorders (SUD) than city dwellers. The evidence suggests that treatment disparities between rural and urban residents are not limited to opioid use disorders. They also span a range of addiction diseases such as alcohol use disorder. Studies also show that not only are those who live in rural areas less likely to initiate treatment but they’re also less likely to complete the recommended course of care.

However experts suggest that getting to the roots of the problem will require a sustained and multi-pronged approach. This is because persons who live in rural areas of the US face not just one barrier to care but many.

Among the most significant of these is the dearth of care providers in these areas. These shortages of behavioral and mental healthcare centers and addiction recovery specialists. This means that rural residents will often need to travel far from home to receive the care they need.

The frequency of treatment during early recovery may include up to five days of outpatient care per week. That makes the process untenable for adults who also have work and family responsibilities. A lack of access to reliable transportation and high fuel costs also make traveling great distances to receive care unfeasible for many rural residents.

In addition to these geographical barriers to treatment are the financial ones. Studies show that the care provided to most rural residents is out of network. This means that they will incur far more significant out of pocket costs than their urban counterparts for the same level of care.

Rural residents’ treatment expenses on everything from counseling to pharmacotherapy to transportation and beyond often those of city dwellers. Urban areas typically enjoy a host of therapeutic options and a selection of care providers who are in network with clients’ insurance plans.

Given the multitude of obstacles to care for the vast majority of Americans not living in the cities and suburbs, experts have advanced a new Collective Care Model to increase rural residents’ physical and financial access to treatment. One of the most important features of this new standard of care is the integrative approach that enlists patients’ primary care providers in the prevention, diagnosis, and treatment of SUD.

Incarcerated Persons with SUD Leave Prison Undiagnosed and Untreated

Incarcerated persons released from prison are unlikely to receive treatment needed for substance use.

National estimates suggest that 85% of inmates leave prison suffering from a drug addiction. Only 17% of former inmates have been diagnosed with substance use disorders, with even fewer being provided medications that combat addiction.

Researchers acquired data from Virginia’s health and corrections department to track former inmates who are diagnosed and treated for addiction following their release from prison. In 2022, more than 4,600 adults were released from jails and prisons, with 85% enrolling in Medicaid within one month of their release.

Despite the high percentage of Medicaid enrollment, only 17% of those released had seen a doctor and been diagnosed with a substance use disorder within three months of their release. This includes 13% of that group having an opioid use disorder.

However, only 25% of opioid-addicted ex-convicts are prescribed medications, like methadone and suboxone, to combat drug cravings and withdrawals. This is far less than the 78% of all Medicaid enrollees who received medication after their opioid addiction diagnosis.

Lead researcher Peter Cunningham, who is the interim chair of the Virginia Commonwealth University Department of Health Policy, stated, “Based on national statistics, we expected more people to receive a diagnosis and treatment for opioid addiction,” Cunningham went on to say “This is concerning because having an undiagnosed, untreated opioid use disorder greatly increases the risk of overdose.”

Most inmates do qualify for Medicaid during their time in prison. Although only emergency coverage is provided during their sentence, addiction treatment and most other benefits are not covered.

Researchers are surveying former inmates to discover what hurdles they face after being released. Cunningham stated, “If providers are able to diagnose substance use disorders and initiate treatment plans before a person is released from prison, this might reduce the risk of overdoses and improve health outcomes when they return to their community.”

Ozempic-Like Drugs Could Help People Stop Using Drugs and Alcohol

In recent studies, interest has been growing in the possible use of Semaglutide (sold as Ozempic, Wegovy, and Rybelsus) to treat addiction. Semaglutide is part of the new class of drugs, called GLP-1 receptor agonist drugs. While it is approved for use in diabetes and weight loss, there’s a possibility it can curb addiction.

The active ingredient, Semaglutide, was initially developed to treat diabetes. It works by stimulating the production of insulin to keep blood sugar levels in check. Additionally, there are anecdotal reports from patients taking Semaglutide for weight loss, suggesting it reduces appetite and food cravings. It’s because of this active ingredient that researchers are studying how this can be used for addiction treatment.

The rationale for studying GLP-1 agonists in addiction treatment stems from the overlap between the pathways that regulate hunger and those that mediate addiction. Both involve the brain’s reward systems which play a significant role in the pleasure and reinforcement of behaviors, including eating and drug use.

“”There’s really been a large number of clinical and anecdotal reports coming in suggesting that people’s drinking behaviors are changing and in some instances pretty substantially while taking [Ozempic or Wegovy],”” says Christian Hendershot, a psychologist and addiction researcher at the University of North Carolina.

Researchers have observed that by modifying the activity of these reward centers, GLP-1 agonists could potentially reduce the cravings that lead to the compulsive consumption of alcohol and other drugs. Preliminary animal studies have shown promising results, with drugs like Semaglutide reducing alcohol intake in rodents.

In addition, human trials are currently underway, with early anecdotal evidence supporting the theory that these medications could help manage addiction. Some individuals on GLP-1 agonists for diabetes or weight loss have reported a diminished urge to consume alcohol or engage in other addictive behaviors. These reports have fueled further clinical investigations into whether these drugs could serve as a tool in addiction therapy.

Gambling, Excessive Drinking–A Destructive Duo, Researchers Find

Problematic and potentially addictive behaviors strike on multiple fronts, according to a recent report from the American Psychological Association (APA). Current studies from the APA, persons who bet on sports are twice as likely as non-gamblers to also engage in binge drinking.

The study also found that the risk of alcohol misuse and/or alcohol use disorder (AUD) correlates with gambling behaviors. The higher the frequency of sports betting, the greater the likelihood of excessive alcohol consumption, researchers found.

More specifically, the data indicate that men who engaged in sports betting once or twice in the previous calendar year were 2.4 times more likely than the general population to binge drink. The risk of binge drinking among women who bet on sports was 1.9 times higher than the general population.

However, when gambling frequency increases, so, too, does the risk of alcohol misuse, according to the APA study. The data indicate that men who wager on sports at least once weekly are more than 4.7 times more likely than non-gamblers to binge drink. For women, in the same cohort, the binge drinking risk is nearly 6 times that of the general population.

And for those who gamble daily, the numbers are even more eye-popping. Daily sports betting is associated with a nearly nine-fold risk of binge drinking for men. Likewise, women who gamble on sports on a daily basis are more than 14 times more likely to binge drink than the general population.

The study reveals a significant correlation between addictive behaviors across multiple categories, providing researchers and clinicians alike with important insight into the etiology of addiction. The data also suggest that amendments in current standards of practice for healthcare providers may be required to include screenings for co-occurring addictions in persons engaging in problematic gambling or excessive drinking behaviors.

Doctors Urge FDA to Pull Genetic Opioid Marker Test Kit from Shelves

More than 30 prominent physicians across the country have signed a petition asking the FDA to reconsider its controversial decision to approve the opioid drug test AvertD. The drug, manufactured by SOLVD Health and approved by the FDA in 2022, claims to be able to check users for 15 genetic markers that make them susceptible to opioid use disorder. In theory, physicians who administer AvertD can be forewarned if patients have a greater susceptibility to becoming addicted to any pain medications that contain opioids.

However, as reported by NBC News, doctors have questioned AvertD’s promise. In their letter addressed to FDA Commissioner Robert M. Califf, AvertD’s ability to detect genetic markers predisposed to opioid addiction is not “any better than chance.” Studies have shown that the drug has a 20% chance of generating false positives–indicating that clients are likely to become addicted when they are actually not–or false negatives, in which a physician might assume that patients wouldn’t get addicted and over-prescribe medications.

In either case, one in five clients either had a false sense of security that they were immune from opioid addiction, or they were left stigmatized and deprived of needed medications.

In their letter, the doctors noted that, back in 2022, the FDA’s own review panel had highly recommended that the drug be rejected. Genetics, the panel had warned, was only one factor to consider. Opioid use disorder can be shaped by social and environmental factors, as well as the frequency of exposure.

The opioid crisis has called for innovation and, occasionally, taking chances on new medications that have yet to be fully proven to be effective. At times, the agency has had to reverse its decisions on drugs that can do more harm than good. In 2017, the FDA requested that Endo Pharmaceuticals recall its opioid medication Opana ER.

As for AvertD, the FDA has yet to respond to the petition.

Fentanyl to Play a Pivotal Role in Presidential Election, Pundits Predict

Voters unite on wanting to end the rampage that fentanyl has taken on US soil. Despite different ideas being tossed around, from tightening borders to increasing treatment options, partisans across the political spectrum charge that leaders have forgotten about the issue.

Between 2019 and 2023, an estimated 270,000 people died of drug-related causes. The synthetic opioid, fentanyl, is believed responsible for a majority of the overdoses, which have risen to 80,000 each year. Approximately 80% of voters in seven swing states consider the fentanyl crisis to be a key factor when deciding on who to vote for in the 2024 presidential election.

According to Bloomberg News, about one-third of voters trust neither Biden nor Trump to handle the crisis. Critics claim that the Trump administration failed to allocate the necessary resources to contain the crisis early on. Meanwhile, critics of the current Biden administration blame “lax” immigration laws under the current regime, pointing to the more than 100 million pounds of fentanyl and 150 million fentanyl-laced pills seized at the US southern border since Biden took office in January 2021.

While former President Trump has criticized Biden’s immigration policies for the increase in overdoses, Biden condemns Trump for encouraging conservative lawmakers to hold up a bipartisan border security bill that, proponents claim, would strengthen the US’s authority to sanction foreigners involved in fentanyl trafficking.

As political leaders continue to point fingers, progressive cities such as Portland, Oregon, and San Francisco, California, are implementing bills to tighten drug possession laws. In San Francisco, voters backed Mayor London Breed’s bill requiring suspected drug users on welfare to submit to drug screenings and attend a drug treatment program.

The swing states of Nevada and Arizona have reported a surge in lethal synthetic opioid exposures in the 12 months through October 2023. Such trends suggest that fentanyl will remain a pivotal issue for voters until election day.

Voters across parties believe that the US should work with Mexico and Canada to combat the cross-border trafficking of illicit drugs.

Youth 911 Calls Surge Following Magic Mushroom Decriminalization

Calls to US poison control centers and first responders among youth have surged in the wake of a recent push to decriminalize “magic mushrooms” by states and municipalities across the nation.

Statistics from the National Poison Data System show that emergency calls following exposure to psilocybin, the active ingredient in hallucinogenic mushrooms, more than tripled in the 13-19 age group between 2018 and 2022. Calls for emergency assistance more than doubled among young adults between the ages of 20 and 25 in the same time period.

The surge follows years-long efforts to decriminalize recreational psilocybin consumption among persons 21 and over. Decriminalization has already occurred across a number of states, including Colorado and Oregon, and cities, including Seattle, Detroit, and Washington D.C.

Despite efforts to restrict unlawful use by minors, however, the alarming increase in adverse medical and mental health events related to magic mushroom use among teenagers reflects the limitations of such regulations.

The implications are concerning, researchers note, because the long-term impacts of psilocybin on teens’ developing brains are unknown. However, the prevalence of severe adverse reactions, with more than 75% requiring medical intervention, does not bode well for youth who consume these hallucinogens.

Among the most prevalent effects of psilocybin exposure in teens and young adults include hallucinations and delusions, agitation, tachycardia, and confusion. Outbursts of violent behavior have also been reported.

The sometimes extreme neurophysiological impacts of magic mushrooms on young people are thought to be caused by disruptions to neurotransmitter activity. Given that any lingering effects on adolescent brain development and neurochemistry remain a mystery, the increasing accessibility and appeal of magic mushrooms to young people is especially worrisome, researchers suggest. They note that these hallucinogens are becoming widely available in edible forms that are likely to attract teens, including chocolates and gummies.