Despite More Prescriptions, Naloxone is Still Dramatically Underprescribed. When given promptly, naloxone can reverse an opioid overdose and save a life. But despite an increase in prescriptions since 2012, and despite being recommended as a risk mitigation strategy in the CDC Guideline for Prescribing Opioids for Chronic Pain, naloxone is still highly underprescribed, according to a new study from the Centers for Disease Control and Prevention.

Medication-based treatment with methadone, buprenorphine, or extended-release naltrexone is effective for opioid use disorder (OUD), saving lives and improving long-term outcomes even in the absence of other forms of treatment, according to a major new review from the National Academies of Sciences, Engineering, and Medicine. The study was led by Alan Leshner, Emeritus CEO of the American Association for the Advancement of Science, the publisher of the journal Science.

New HHS guide on reducing or discontinuing Opioids: individualize, and go slow. The Department of Health and Human Services has released a decision-making guide for physicians who are considering reducing or discontinuing opioid treatment for their patients.

Medication-assisted treatment (MAT) for opioid use disorder (OUD) has emerged as a key strategy for combatting the opioid epidemic. Controlled research has shown it to be more effective than abstinence programs in treating patients with the disorder (Connery, 2015).

New Case Study now available: When considering Opioid therapy—the importance of baseline drug testing for amphetamines and methamphetamines. When following CDC guidelines and ordering baseline drug testing prior to initiating opioid therapy, it can be challenging to identify potential amphetamine and methamphetamine misuse. This case study illustrates some steps that could be appropriate to take to better understand your patient’s potential use or misuse of these two drugs.

Attitudes, and the Language that Reflects Them, Take Their Toll on Patients

In-depth interviews with patients with substance use disorder reveal the toll taken by stigma on patients’ experience in the healthcare system, according to a new study. The study included 48 individuals across Ontario, Canada, who were taking opioids for chronic pain (n=28) or other reasons (n=31)."

For Pregnant Women, Early Screening and Medication-Assisted Therapy Provide the Best Outcomes for Opioid Use Disorder, for Both Mothers and Infants. Pregnant women should be screened for opioid use disorder (OUD) and receive medication- assisted therapy (MAT) instead of withdrawal, according to recommendations from the American College of Obstetrics and Gynecology (ACOG). The Committee Opinion was published in August, 2017 in collaboration with the American Society of Addiction Medicine.

Do you know the signs of opioid use disorder? The Centers for Disease Control and Prevention offers a Continuing Medical Education Module on this topic, as part of its effort to reduce the harms from use of opioids and other drugs. 

Payers Have an Important Role to Play in Reducing Opioid Harm. Health insurance companies can play a central role in limiting the harm of opioids, according to a 2017 white paper by the Healthcare Fraud Prevention Partnership (HFPP). In “Healthcare Payer Strategies to Reduce the Harms of Opioids,” the HFPP encourages appropriate care and prescribing practices for patients; identifying and eliminating fraud, waste, and abuse within the healthcare system; and supporting dissemination of information about effective opioid misuse strategies.

Pill shaving refers to the practice of scraping or crushing part of a pill to dissolve it in a urine sample. What can you do to rule out pill shaving?

How the Words We Use Can Create, or Avoid, Stigma for the Person with Substance Use Disorder. “Language matters,” says Shawn Ryan, MD, chief medical officer at BrightView Health in Cincinnati, Ohio. “We know that patients can suffer under the stigma of inappropriate language” when referring to their use of opioids and other drugs.

Reducing stigma is a key part of fighting the opioid crisis, according to Patrice Harris, MD, President of the American Medical Association and Chair of the AMA’s Opioid Task Force. “We must all confront the intangible and often devastating effects of stigma,” she said.

Heightened awareness of the dangers of prescription opioids has prompted a movement to limit use of opioid therapies for patients with acute or chronic pain. Primary care practitioners stand on the front lines of this care shift, and many are curtailing prescribing opioids in response.

The US Food and Drug Administration has updated its recommendationson co-prescribing benzodiazepines with medication-assisted therapy treatment, stating that buprenorphine and methadone “should not be withheld from patients taking benzodiazepines or other drugs that depress the central nervous system.”

How Well are Physicians Complying with CDC Opioid Prescribing Recommendations? A report by the insurance industry group AHIP (America’s Health Insurance Plans) suggests that physicians still have a way to go to be in compliance with the 2016 opioid prescribing and monitoring recommendations from the Centers for Disease Control and Prevention. 

Labor force participation among men of prime working age is lowest in areas where prescription opioid use is highest, according to a 2017 analysis by Alan Krueger, PhD, of Princeton University and the National Bureau of Economic Research.

Access to medication-assisted treatment will increase under the new opioid bill. In October 2018, the president signed the SUPPORT for Patients and Communities Act,which addresses multiple aspects of the opioid crisis. Several provisions in the bill are slated to increase access to medication-assisted treatment (MAT), in which buprenorphine or another medication is part of the treatment plan for substance use disorder.

Led by Synthetic Opioids, Drug Overdose Deaths Climbed Through 2017. Have They Reached a Plateau? Data released by the Centers for Disease Control and Prevention indicate that deaths due to drug overdoses climbed from 2015 through the end of 2017, but preliminary data suggest the annual death rate may have reached a plateau.

As a Prescriber, What is Your Role in Preventing Prescription Drug Diversion?Diversion of prescription medications is a major part of the epidemic of substance abuse in the United States. Clinicians who prescribe opioids and other controlled substances have an important role to play in preventing drug diversion, through maintaining good records and secure prescription pads, communicating with patients and other prescribers, and monitoring compliance with urine drug testing.