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Friday, October 28, 2016

Opioid Addiction Medication Preauthorizations

The American opioid epidemic highlights the need for greater access to addiction treatment services throughout the country. While over 70 people die from an opioid related overdose every day, there are effective addiction treatments that are being underutilized. In recent years, there has been a huge push from both Federal and local government agencies to ensure that everyone who wants or needs treatment—gets it. Whether it be through residential treatment or intensive outpatient, millions of Americans desperately need care.

At reputable residential treatment centers around the country, the drug buprenorphine is widely used for detoxification purposes. The drug can ease the painful and uncomfortable symptoms of opioid withdrawal. Most people with an opioid use disorder would struggle making it through detox without buprenorphine, sold under the brand name Suboxone. However, buprenorphine is a semisynthetic opioid derivative, that can cause euphoria and lead to dependence if taken for extended periods of time.

Most treatment centers will wean patients off of Suboxone after their withdrawal symptoms subside and before they are discharged from the facility. On the other hand, primary care physicians around the country have begun prescribing Suboxone in an effort to stem the tide of opioid addiction epidemic, it is a program referred to commonly as medication-assisted treatment (MAT). There are conflicting opinions about MAT. On the one hand it is considered to be the lesser of two evils when compared to heroin abuse, yet the drug is addictive and withdrawing from Suboxone can be more painful than that of heroin.

As was mentioned earlier, people are dying so there is a real need to combat this epidemic where and when we can. If the recommendation from the Substance Abuse and Mental Health Administration (SAMHSA) is MAT, then it is likely that more and more doctors will be prescribing Suboxone in the coming years. Last week, the insurer Cigna announced that it will no longer require pre-authorization for prescriptions to treat opioid addiction, USA Today reports. The news comes in the wake a national settlement announced by New York Attorney General Eric Schneiderman.

"Getting people into treatment faster, and when the window of opportunity is open, is vital to stemming the opioid addiction crisis,” Schneiderman said in a statement. “Other health insurers should take notice of Cigna’s actions to remove access barriers to treat opioid dependency and I encourage those insurers to follow suit.”

Friday, October 21, 2016

National Prescription Drug Take-Back Day

prescription opioids
Even if you are not in recovery, or work in the field of addiction medicine, you can play a role in helping to end the American opioid epidemic. Every year, millions of prescription opioids are handed out by doctors to American patients. The United States accounts for about 5 percent of the planet’s population, yet we prescribe and consume the vast majority of all opioid narcotics.

Naturally, not everyone who is prescribed a painkiller is going to abuse them, or become dependent on the drugs. In many cases, people prescribed opioids for pain will only use the drug until the pain eases up. They often have leftover drugs that will just sit in the medicine cabinet collecting dust. While it may not seem like a big deal to just forget about one’s unwanted or unneeded medications, in actuality, many peoples' initiation into the world of prescription opioids is made possible by a friend or family member's prescription.

In fact, many Americans have no problem diverting some of their Vicodin or OxyContin to someone in need, even though the act is illegal. They will often do this despite having the knowledge that we are in the grips of an epidemic, believed to be caused by prescription opioids. It is crucial that unwanted medications are disposed of safely, so they do not end up in the wrong hands or lead to another person developing an opioid use disorder.

On October 22nd, Americans across the country can take part in National Prescription Drug Take-Back Day. The event, which is organized by the Drug Enforcement Administration (DEA), could help keep millions of unwanted opioids out of the wrong hands. With more than 5,000 collection sites nationwide, there will be ample opportunity to dispose of your drugs. You can find a location close to you by clicking here.

Additionally, the White House points out that major pharmacies are doing their part to help with the cause:
  • Walgreens Pharmacy has installed more than 500 drug disposal kiosks at pharmacies in 35 states and Washington, D.C.
  • CVS Pharmacy has donated more than 600 disposal units to law enforcement and is holding more than 125 events across the country for Take-Back Day.
If you have unwanted medication, please keep in mind that safely disposing of those drugs could save lives.

Friday, October 14, 2016

Slowing Mental Illness Progression

mental illness
Mental health organizations and addiction medicine professionals observed Mental Illness Awareness Week (#MIAW) during the first week of October. Sponsored by the National Alliance on Mental Illness (NAMI), the aim of MIAW was to shine a light on disorders that will affect 1 in 5 Americans in any given year. By doing so, hopefully we can chip away at the stigma and discrimination that people with mental illness face every day, which could result in more people seeking help.

There are currently a number of scientifically accepted treatments and therapies for mental health disorders, such as addiction, anxiety, bipolar disorder, depression and post-traumatic stress disorder. The use of medication in conjunction with cognitive behavioral therapy, can result in people, with a form of mental illness, leading a relatively normal life.

There is a still much that is not understood about the causes of mental illness. This is why researchers continue to probe to find answers, which could result in the development of preventative measures and new, more effective treatments. Interestingly, the causes of mental illness may be answered by studying the brain of fruit flies.

A team of researchers from Plymouth University Peninsula Schools of Medicine and Dentistry and the School of Biological Sciences at Bangor University, may have shed some light on the causes of mental health disorders, ScienceDaily reports. The findings were published in Scientific Reports.

The fruit fly, known scientifically as Drosophila, shares a number of genetic similarities with humans, with 70 percent of the genes expressed in our brains matching the fruit fly’s brain, according to the article. The human brain has a RNA processing protein known as SRSF5, which is important to the synthesis of acetylcholine, a molecule which acts as a messenger between neurons. Previous research has shown imbalances in SRSF5 and acetylcholine production in the brains of patients with bipolar disease. The fruit fly’s brain has an equivalent protein known as B52, which could lead to drugs being developed to mitigate or slow the progression of mental health disorders.

"Our findings are exciting and have the potential to form the basis of drug therapies to address mental diseases in humans,” said study leader, Dr Torsten Bossing, Senior Research Fellow in Neurobiology at the School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry.

Friday, October 7, 2016

Young Adults Abusing Prescription Opioids

Everyone in America has been touched by the prescription opioid and heroin epidemic. Even if you do not have a problem with opioids yourself, there is a good chance you know somebody who does, or has struggled with opioids in the past. In no other time in our history, have we seen a substance abuse problem affect people from so many different walks of life, which reinforces the idea that addiction does not discriminate.

Prescription opioid abuse often starts with a patient complaining about pain to their primary care physician. Patients with no history of drug or alcohol abuse start by taking their painkillers as prescribed, but as time goes on what started as intended use, can quickly turn into unintended use and abuse. One of the reasons the problem in America has gotten so bad, is that doctors often fail to explain the dangers of prescription opioid use. What’s more, doctors typically prescribe more pills than a patient requires. When the pain subsides, the leftover pills often sit collecting dust or end up in the wrong hands.

Unfortunately, sometimes those wrong hands belong to young adults. In fact, new research suggests that young adults are at a greater risk of forming an addiction to prescription opioids than they were in years past, HealthDay reports. They were also more likely to use heroin, which is often stronger, cheaper and easier to come by than prescription opioids. The findings were published in the journal Addictive Behaviors.

Researchers from Columbia University's Mailman School of Public Health in New York City found that opioid use disorder more than doubled among 26- to 34-year-olds, rising from 11 percent to 24 percent, between 2002 and 2014, according to the article. Opioid use disorder increased 37 percent among 18- to 25-year-olds.

"Our analyses present the evidence to raise awareness and urgency to address these rising and problematic trends among young adults," said study first author Dr. Silvia Martins, an associate professor of epidemiology. "The potential development of prescription opioid use disorder among youth and young adults represents an important and growing public health concern."

Saturday, October 1, 2016

National Bullying Prevention Month

While it would be nice if teenagers could treat each other with equal respect, unfortunately a number of adolescents are subjected to ridicule and abuse from their peers. Some would argue that pain and discomfort is a part of growing up, that in the end it may make the victim of such treatment a stronger person. The reality is more times than not quite the opposite.

High school can be real challenge, making friends with the “right” clique or striving for popularity in a sea of awkward teenage growing pains. Some students manage to sail through their high school years without any problems, whereas others are the punchline of people's jokes. There are times when such criticisms become a constant problem, and can even elevate to physical abuse at times. Yet, as bad as that is, bullying continues to go unchecked among teenagers and young adults. As you might imagine this can cause serious mental health problems for victims down the road, but you may not have thought that bullies are susceptible to problems of their own.

The Centers for Disease Control and Prevention (CDC) reports that:

“Bullying can result in physical injury, social and emotional distress, and even death. Victimized youth are at increased risk for depression, anxiety, sleep difficulties, and poor school adjustment. Youth who bully others are at increased risk for substance use, academic problems, and violence later in adolescence and adulthood. Compared to youth who only bully, or who are only victims, bully-victims suffer the most serious consequences and are at greater risk for both mental health and behavior problems.” 

The aforementioned point highlights just how important it is to curb bullying, as neither the victim nor the bully wins in the end. October is National Bullying Prevention Month. The anti-bullying campaign known as STOMP Out Bullying™ is calling upon schools and organizations to help them “encourage communities to work together to stop bullying and cyberbullying by increasing awareness of the prevalence and impact of bullying on all children of all ages.”

The CDC points out that in a 2015 nationwide survey, 20% of high school students reported being bullied on school property in the 12 months preceding the survey. This is a nationwide problem worthy of concern.

Throughout the month there will be events held with the aim of opening up the conversation about bullying. The hope is that when people see others being bullied they will intervene, and that victims will find the strength to come forward for help. This coming Monday, STOMP Out Bullying™ is asking that as many people as possible where a blue t-shirt to show support for National Bullying Prevention Month and to help end bullying and cyberbullying.
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