Answer Addiction

Tag: addiction medicine

  • Device To Automatically Stop Opioid Overdoses In Development

    Device To Automatically Stop Opioid Overdoses In Development

    The groundbreaking device would deliver naloxone throughout the body in the event of an overdose.

    Researchers at Purdue University are working on developing a device that can be injected under a person’s skin that will automatically deploy in the event of an overdose, delivering the opioid-blocking drug, naloxone, into their system.

    With this in place, a person’s life could be saved even if they overdose while alone, without anyone to call 911 or administer Narcan—the common naloxone-based nasal spray.

    According to Fast Company, the device holding the drug is being designed to be as simple as possible. The tiny capsule is plugged at one end with material that will melt when the metal touching it becomes hot, releasing the drug. This will require an additional device, about the size of a golf ball, that is worn on the arm just outside of the capsule and monitors the wearer’s vitals. 

    How It Will Work

    During an opioid overdose, the victim’s heart rate and breathing slow to dangerous levels. If this happens, the device would activate a strong magnetic field, heating up the metal touching the plug. The naloxone released into the body will block the opioid receptors in the brain, stopping the drug’s ability to affect the body, and saving the victim’s life.

    “The antidote is always going to be with you,” said Assistant Professor of Biomedical Engineering at Purdue, Hyowon “Hugh” Lee.

    This device is still in the development stage, and it will be at least a few years before it is made available to the public. It needs to be thoroughly tested and gain FDA approval. “If you assume the device is working and it doesn’t, it would be truly problematic,” Lee pointed out.

    However, Lee also believes that the device could be further improved and developed into something like a smartwatch, with the capsule injected in the wrist. It could also be used to administer other medications to people with life-threatening conditions such as severe allergies. Someone suffering a dangerous allergic reaction could have the device automatically administer a dose of epinephrine, eliminating the need for these individuals to carry EpiPens or rely on others to inject them.

    “People with allergies need epinephrine right away. This setup might remove the need for an epi pen,” Lee said.

    More High-Tech Solutions

    Purdue isn’t the only institution responding to the opioid crisis with high-tech solutions. A contractor from Boston recently began deploying a system he developed to create overdose-resistant bathrooms. John King’s invention can alert employees of convenience stores, coffee shops, and other establishments with single-use bathrooms if a person has fallen to the floor and hasn’t stood up for several seconds.

    This system has already allowed employees to respond quickly to overdose cases, ensuring that naloxone can be administered soon enough to save lives.

    View the original article at thefix.com

  • Can Medication-Assisted Treatment Repair Damage Caused By Drug Use?

    Can Medication-Assisted Treatment Repair Damage Caused By Drug Use?

    Dr. Nora Volkow is testing this theory by studying the brain scans of people with opioid use disorder. 

    Over the past few years medication-assisted treatment (MAT) has become the standard of care for people with opioid use disorder, helping to cut users’ risk of fatal overdose by as much as half.

    Now, researchers from the National Institute on Drug Abuse (NIDA) are hoping to understand why. 

    NIDA director, Dr. Nora Volkow, has a theory. She believes that medications including methadone, buprenorphine and naltrexone don’t just help people deal with cravings for drugs. She thinks these medications also help repair the damage done to the brain by drug use, the AP reported.

    “Can we completely recover? I do not know that,” she said. However, people on medication-assisted treatment are “creating stability” in their brains, which allows the brains to react more normally to stimuli. 

    The Theory

    Volkow is testing her theory by completing brain scans on people with opioid use disorder. This includes people who are actively using, those in early recovery, and people on established MAT plans. Volkow and her research team are examining how people react to various stimuli—e.g. what reaction does a picture of a cupcake garner, for example, compared to a picture of heroin?

    The researchers are also doing other work to measure people’s impulse control with exercises like offering them $50 now or $100 in a week’s time. 

    “You need to be able to inhibit the urge to get something [to overcome addiction],” Volkow said. “We take for granted that people think about the future. Not when you’re addicted.”

    Volkow also wants to study how each medication affects people differently. For example, she suspects that buprenorphine will have more of an effect on mental and emotional health than methadone. 

    She expects to see big difference in the brain scans of people who use opioids, compared with those who are on medication-assisted treatment. 

    “You should be able to see it with your eyes, without having to be an expert,” she said.

    The Search For Participants

    Unfortunately the research team has struggled to find participants who are healthy enough to be considered. Research subjects cannot be on any medications that affect the brain other than their MAT regimen. 

    Overall, Volkow hopes that by better understanding medication-assisted treatment and how it can help people with opioid use disorder, scientists will dispel some of the myths and misunderstandings about MAT. 

    “People say you’re just changing one drug for another,” she said. “The brain responds differently to these medications than to heroin. It’s not the same.”

    View the original article at thefix.com

  • More ERs Are Providing Withdrawal Meds As First Step To Recovery

    More ERs Are Providing Withdrawal Meds As First Step To Recovery

    Patients in need are receiving buprenorphine to address their withdrawal symptoms. 

    Kicking an opioid habit comes with a host of physical withdrawal symptoms so severe that people often end up in the emergency room.

    There, they are usually treated for diarrhea or vomiting, but not the underlying issue. Now, however, more emergency rooms around the county are providing buprenorphine to help ease withdrawal and get more people into treatment. 

    “With a single ER visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings,” Dr. Andrew Herring, an emergency medicine specialist at Highland Hospital in Oakland, California, told The New York Times. 

    At Highland, people who come in presenting with withdrawal symptoms are given a dose of buprenorphine, also known as Suboxone, and are told to follow up with Herring, who runs the hospital’s buprenorphine program. 

    “It can be this revelatory moment for people—even in the depth of crisis, in the middle of the night,” Herring said. “It shows them there’s a pathway back to feeling normal.”

    Although the Drug Enforcement Administration (DEA) requires doctors to receive special training and a license to prescribe buprenorphine, doctors in the ER can provide the medication without this training. Still, Herring said, many healthcare providers hesitate to provide the first step toward medication-assisted treatment (MAT). 

    “At first it seemed so alien and far-fetched,” he said. 

    Yet, research into the practice is promising. A 2015 study showed that people who were given buprenorphine in the ER were twice as likely to be in treatment 30 days later than those who were not given medication to help with withdrawal.  

    “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” said Dr. Gail D’Onofrio, lead study author. “They’re beyond thinking they can just be a revolving door.”

    California has plans to expand treatment for withdrawal in emergency rooms, using $78 million in federal funding to establish a hub-and-spoke system where people would get their first dose of medication in the emergency room before being connected with ongoing services.

    Dr. Kelly Pfeifer, director of high-value care at the California Health Care Foundation, said this is the next step in providing quality care for people fighting addiction. 

    “We don’t think twice about someone having a heart attack, getting stabilized in the emergency department, and then getting ongoing care from the cardiologist,” she said. “And the risk of death within a year after an overdose is greater than it is for a heart attack.”

    View the original article at thefix.com

  • Addiction Medicine Coming To San Francisco's Homeless Community

    Addiction Medicine Coming To San Francisco's Homeless Community

    The outreach program is a response to the “striking increase” in the number of people who inject drugs in public spaces.

    The city of San Francisco is rolling out a program that will bring buprenorphine, a medication used to treat opioid use disorder, to its homeless community. City officials say it’s time to start meeting this community where they’re at.

    Back in May when the outreach program was introduced, Mayor Mark Farrell told the San Francisco Chronicle, “The consequences of standing still on this issue are unacceptable. Drug abuse is rampant on our streets, and the recipe of waiting for addicts to come into a clinic voluntarily is not working. Plain and simple. So we’re going to take a different approach.”

    Dr. Barry Zevin, medical director for Street Medicine and Shelter Health, who has provided medical care to the city’s homeless community since 1991, echoed the mayor’s sentiment.

    In a new interview with the New York Times, Zevin explained that meeting the homeless where they’re at may expedite the healing process, rather than waiting for them to seek help. He noted that this population, in particular, has a dire need for mental health and substance abuse services, as well as medical care.

    “On the street there are no appointments, and no penalties or judgments for missing appointments,” said Zevin.

    Following a yearlong pilot program, 20 out of the 95 participants were still using buprenorphine under the care of the city’s Street Medicine Team, the NYT noted.

    With a two-year budget of $6 million, the program is setting out with a goal of providing buprenorphine to 250 more people—just a fraction of the estimated 22,500 injection drug users in San Francisco, but a start.

    Zevin noted that there is a concern that the same-day buprenorphine prescriptions may end up being abused, but said that the city is prepared to deal with it on a case by case basis.

    “I do have to worry about diversion, but I want to individualize care for each person and not say that the worry is more important than my patient in front of me, whose life is at stake,” he told the NYT.

    The outreach program is a response to the “striking increase” in the number of people who inject drugs in public spaces.

    “Ultimately, this is about helping these individuals, but it’s also about improving the conditions of our streets,” said Mayor Farrell.

    View the original article at thefix.com

  • Medical Schools Focus On Addiction Medicine Training In Light Of Opioid Crisis

    Medical Schools Focus On Addiction Medicine Training In Light Of Opioid Crisis

    Medical students are seeking out addiction medicine training and schools are making adjustments to fulfill their needs. 

    The opioid crisis is changing the way some medical schools are approaching training, according to the San Francisco Chronicle. 

    At the University of California, San Francisco (UCSF) School of Medicine, this is being done by implementing a yearlong fellowship in addiction medicine, the Chronicle reports. 

    The fellowship program is funded by the city and county of San Francisco and works to incorporate addiction medicine into overall medical training, rather than just psychiatric medicine. 

    Dr. Hannah Snyder is one of the fellowship participants and is expected to complete the program this month. 

    “I started learning about treating addiction and realizing we had highly effective medications to treat addiction,” Snyder told the Chronicle. “I got really excited about that because there’s a way to prevent people from having those complications in the first place.”

    According to the Chronicle, Snyder works at Ward 93 as part of the fellowship. Ward 93 is a methadone clinic at San Francisco General Hospital. There, she meets with patients to discuss treatment. 

    Snyder is also assisting other U.S. hospitals with new protocols for treating those with opioid use disorders. The Chronicle states that this “primarily means getting patients started on buprenorphine or methadone—two long-term prescription medications for opioid-use disorder—when they come to the hospital after overdosing or having severe withdrawal symptoms.” 

    The fellowship at UCSF School of Medicine isn’t the only one of its kind. In fact, since 2011, 52 U.S. addiction medicine fellowships have been accredited by the Addiction Medicine Foundation. 

    Fellowships are typically completed by doctors who have already finished their three- to six-year residency in a specific area and wish to take part in more training in a subspecialty, the Chronicle notes. It wasn’t until 2016 that addiction medicine was recognized as a subspecialty. 

    Dr. Anna Lembke, a psychiatrist at Stanford School of Medicine, is working to add addiction medicine courses to Stanford’s curriculum. 

    “It’s the dawning awareness within the medical community that addiction in general is a growing problem in our patient population,” she told the Chronicle. “The opioid epidemic has put it front and center in a way that gives people permission to focus on it. Suddenly there are research dollars available to study it, and federal grants. It has momentum it never had before.”

    At Stanford specifically, students are the ones pushing for additional education in the area. The Chronicle states that Alexander Ball, a fifth-year medical student, partnered with Lembke to create lectures centered around pain and addiction for first and second-year students. Some were incorporated into courses this year, and more will be next year, the Chronicle notes. 

    The lectures concentrate on opioid prescribing, administering buprenorphine and other medications and motivational interviewing, which is a counseling technique. 

    At UCSF, buprenorphine training has been offered as optional for residents and faculty since 2011, the Chronicle reports. Buprenorphine is used to treat opioid dependence and is a Schedule III narcotic, meaning doctors have to complete eight hours of training and get a waiver in order to prescribe it. 

    According to Dr. Scott Steiger, associate professor of medicine and psychiatry at UCSF, the buprenorphine training is drawing more and more medical professionals. 

    “Last year, we had to turn people away because we had reached our capacity for the room, which was 77,” Steiger told the Chronicle. “The next one (this spring), we had it in an auditorium to fit all the people. It’s telling that people are trying to get as much training as they can.”

    View the original article at thefix.com