AT Forum NEWS NOTES & UPDATES #120
June 2008
Compiled & Edited by Sue Emerson - Publisher
Prior Edition: May 2008
Contents
Medication-Assisted Treatment (MAT)
SAMHSA Issues Guidance on Labeling of Take-home Medication Bottles
AATOD Issues Methadone Induction Advisory
Critics Say Health Plans Put Lives at Risk by Requiring Prior Approval for Buprenorphine
Drugs in the News
FDA Panel Skeptical of New OxyContin Formula
Suicide Link Doesn't Prevent Chantix Endorsement
HIV/AIDS
Updated Fact Sheets on HIV/AIDS and Black Americans, Latinos, and Women Available
Innovations in Addiction Treatment
Computer Programs Help Drug Abusers Stay Abstinent, Yale Researchers Find
Presidential Nominees Views on Healthcare and Addictio
Obama and McCain: Where they Stand on Addiction Issues
Miscellaneous
Drug Addicts Can Learn How to Save Lives, Yale Researchers Find
Baby Boomers Continue Recreational Drug Use in Senior Years
People in the News
MEDICATION-ASSISTED TREATMENT
SAMHSA Issues Guidance on Labeling of Take-home Medication Bottles
On May 14, 2008, Dr. Clark sent a “Dear Colleague” letter to OTPs, emphasizing that according to 42 C.F.R., take-home medication bottles should be properly labeled with the OTP’s name, address, and telephone number. He noted that SAMHSA recommends also including on the label the name of the patient, physician, and medication, and the dispensing date. He added, “We believe that the inclusion of the above information on take-home bottle labels will help reduce diversion of methadone and buprenorphine and improve patient safety.”
The Dear Colleague letter can be accessed at: http://www.dpt.samhsa.gov/pdf/dearColleague/DearColleague_BottleLabels_051408.pdf
Source: SAMHSA – May 14, 2008
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AATOD Issues Methadone Induction Advisory
On April 25, 2008, the American Association for the Treatment of Opioid Dependence (AATOD) issued an advisory on Dosage Induction with Methadone in the OTP.
The advisory excerpts references from SAMHSA/CSAT’s TIP 43 “Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs (2005),” in addition to SAMHSA/CSAT’s Guidelines for the Accreditation of Opioid Treatment Programs (July 20, 2007), and Dr. Westley Clark’s correspondence to the field (September 4, 2007) concerning this topic.
The advisory can be accessed at: http://www.aatod.org/dosage_induction.html
Source: AATOD – April 25, 2008
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Critics Say Health Plans Put Lives at Risk by Requiring Prior Approval for Buprenorphine
A major healthcare provider recently announced that it would begin requiring preauthorization for prescriptions of the buprenorphine-based addiction medications Suboxone and Subutex, a move that has raised concern among physicians and patient-advocacy groups about erecting new barriers to treatment.
United Healthcare and its Oxford Health Plans subsidiary announced the new preauthorization policy in April, stating, "Effective May 1, 2008, coverage for Suboxone and Subutex will be limited to the uses indicated in U.S. Food and Drug Administration approved labeling and other published clinical evidence. As part of our notification program, your doctor must provide information regarding your condition for which Suboxone and Subutex is being prescribed."
The new policy applies both to new prescriptions and renewals. Doctors writing prescriptions for Suboxone and Subutex now are required to call the company for a 'notification review' ... "We will then send a letter to you and your doctor indicating whether or not your medication is covered under your pharmacy benefit plan," according to the April 2008 letter from Oxford.
Michael W. Shore, M.D., a Cherry Hill, N.J., physician who has 100 current buprenorphine patients and has been prescribing the drug since it first became available for treatment of opiate addiction in 2002, said
requiring preauthorization for Suboxone and Subutex was unworkable for both patients and physicians.
Shore, a solo practitioner, said he does not have the time to spend 20 minutes on the phone answering questions about preauthorization. "If this policy is allowed to continue I simply won't take on any new patients who have United Healthcare," he said.
"I think their point [of the policy] is to save money and discourage utilization," continued Shore. "The whole point of the DATA 2000 law [which authorized office-based buprenorphine prescriptions] was to expand access and this is putting impediments up ... Patients can't wait two or three days for a decision to be made. They are in opiate withdrawal and they are going to go out and use. I've had two patients die while waiting for treatment and I won't let it happen again."
Source: JoinTogether.org - May 16, 2008 - Bob Curley
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DRUGS IN THE NEWS
FDA Panel Skeptical of New OxyContin Formula
Drugmaker Purdue Pharma says that it has made the painkiller OxyContin harder to abuse by adding a plastic-like coating to the pills, but a Food and Drug Administration (FDA) advisory panel said that more testing is needed before the drug can be brought to market, the Associated Press reported May 5.
The FDA typically follows the advice of its advisory panels, although the agency isn't legally bound to do so. "What we heard from the committee was that they have a lot of concern that the formulation had not been adequately evaluated," said Curtis Rosebraugh of the FDA's drug-evaluation office.
The opiate OxyContin has become a popular drug of abuse during the past decade, earning the moniker "hillbilly heroin." Users typically crush the pills to defeat the time-release formula, then snort or inject the powder. The FDA asked its advisory panel to review the latest version of the drug to help determine whether it should be marketed as tamper-resistant, among other concerns.
Source: JoinTogether.org - May 6, 2008
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Suicide Link Doesn't Prevent Chantix Endorsement
The drug Chantix has been linked to increased risk of suicide, but new U.S. government stop-smoking guidelines for doctors nonetheless endorse the drug, the Associated Press reported May 8.
The guidelines from the U.S. Public Health Service said that while Chantix has been linked to depression and suicidal behavior, the Pfizer product remains the most effective drug for helping people quit smoking. The guidelines recommend stop-smoking counseling, but advise doctors to discuss medication with all patients who smoke. Doctors also are advised to inquire about patients' past psychiatric history before prescribing Chantix, and to monitor the mood and behavior of those on the drug.
The lead author of the guidelines, Michael Fiore, was a consultant to Pfizer as recently as 2005. The advisory panel that issued the guidelines reviewed 83 studies and found that Chantix was effective in helping about one in three smokers quit, whereas the six-month quit rate for patients receiving placebos was 14 percent.
Source: JoinTogether.org- May 9, 2008
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HIV/AIDS
Urgent Action Needed To Address HIV/AIDS Among Minority Communities As Cases 'Skyrocket,' Expert Says
HIV/AIDS rates among black and Hispanics in the U.S. have reached alarming levels, and the U.S. urgently needs to establish new initiatives to address the spread of the disease among the groups, Beny Primm, executive director of Brooklyn, N.Y.-based Addiction Research and Treatment, said at an event in Connecticut on Sunday, the Hartford Courant reports. Primm, who was a federal health official under President George H.W. Bush, spoke at the Greater Hartford chapter of The Links, a professional black women's group, where he was recognized for his work related to substance abuse, domestic violence and HIV/AIDS.
Primm said, "It's not on the radar screen. There are not enough voices being raised." Primm said the spread of HIV among black women in particular has not received the same media attention as other groups. He said HIV/AIDS cases among blacks and Hispanics "are skyrocketing," while cases "are at emergency numbers" in black women.
The full article can be accessed at: http://www.medicalnewstoday.com/articles/106516.php
Source: Medical News Today – May 7, 2008
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Updated Fact Sheets on HIV/AIDS and Black Americans, Latinos, and Women Available
The Kaiser Foundation has updated three fact sheets that provide snapshots of the impact of HIV/AIDS on minorities and women in the U.S, Each fact sheet includes the latest data on key trends and current cases, as well as population-specific information on HIV transmission patterns and access to care.
"Black Americans and HIV/AIDS" provides information on the disproportionate impact of HIV/AIDS on Blacks. "Latinos and HIV/AIDS" focuses on the largest and fastest growing ethnic minority group in the country. "Women and HIV/AIDS in the United States" highlights the challenges for women living with and at risk for HIV.
Source: Kaiser Foundation - May 9, 2008
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National HIV Testing Day
June 27, 2008
http://www.hhs.gov/aidsawarenessdays/days/testing/index.html
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INNOVATIONS IN ADDICTION TREATMENT
NIDA Reports Good Results from Computer Counseling
A randomized controlled trial has found that addiction patients who received a computer learning program in addition to traditional counseling remained abstinent longer than those who received counseling alone, according to the National Institute on Drug Abuse (NIDA).
Researchers from the Yale University School of Medicine studied the impact of providing patients receiving face-to-face counseling with an additional multimedia computer program to aid in cognitive-behavioral therapy, focusing on such core concepts as coping with craving, problem-solving, and refusing offers of alcohol and other drugs.
Urine tests were used to confirm patients' self-reports of illicit drug use; the computer-learning group submitted significantly fewer positive urine samples and tended to remain abstinent longer, researchers found.
The study was published in the May 1, 2008 issue of the American Journal of Psychiatry.
The complete press release can be accessed at: http://www.eurekalert.org/pub_releases/2008-05/yu-cph042808.php
Source: JoinTogether.org - April 29, 2008
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PRESIDENTIAL NOMINEES VIEWS ON HEALTHCARE AND ADDICTION
Obama and McCain: Where they Stand on Addiction Issues
JoinTogether.org has prepared a special news feature which addresses the Presidential nominees views on addiction-related issues. A link is provided to Obama’s Blueprint for America, which spells out the Democratic nominee’s approach to a broad range of issues, including a pledge to sign a universal healthcare plan by the end of his first term as president. A link to McCain’s campaign website is also included which contains his healthcare position statement.
Source: JoinTogether.org – June 6, 2008 – Bob Curle
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MISCELLANEOUS
Drug Addicts Can Learn How to Save Lives, Yale Researchers Find
Drug users can be taught to identify and quickly respond to overdoses of heroin or other opioids as effectively as medical experts, a Yale University study suggests.
The study supports efforts of some drug counselors, physicians and public health experts who have started community-based programs to train addicts and supply them with the opioid antagonist drug naloxone in order to respond to potentially fatal drug overdoses
Ten individuals who were regular users of heroin or other opioid drugs such as oxycodone or hydromorphone were enrolled in the study at each of six sites across the U.S. They were divided into two groups, one with members who had previously received training in overdose response and one with members who had not. Individuals were interviewed to determine if they could recognize signs of opioid overdose and when it was appropriate to administer naloxone. Their responses were then compared to those given by a group of medical experts.
The training, conducted well before the interviews were done, included recognizing differences between overdoses caused by opioids and those caused by other substances such as cocaine, for which use of the drug naloxone is not indicated.
“The study shows opioid users with training can spot an opioid overdose, are less likely to miss true opioid overdoses, and can determine whether naloxone should be administered and when it should not be administered,” Green said.
The study was funded by the National Institute of Mental Health.
Source: Yale University - May 1, 2008
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Baby Boomers Continue Recreational Drug Use in Senior Years
One-third of the U.S. population was born during the Baby Boom -- the years 1946 to 1964 -- and many Boomers grew up using drugs and may be continuing to do so, Scientific American reported May 16.
Researchers from the National Institute on Drug Abuse (NIDA) cast doubt on the theory that these lifelong recreational drug users will "age out" of use of marijuana or other substances as they get older. For example, hospitals reported that cocaine mentions at emergency rooms rose 240 percent among people ages 55 and older between 1995 and 2002, while heroin mentions rose 160 percent, marijuana mentions rose 467 percent, and amphetamine mentions rose 700 percent.
Moreover, the National Survey on Drug Use and Health found that illicit drug use among people ages 50-59 rose from 2.7 percent in 2002 to 4.4 percent in 2005.
Experts say that the trends may be related to the fact that people are living longer but also holding on to the drug-use habits of their youth. They worry, however, that drug use could have serious effects on brain function among older Americans and that drug users could face other health consequences as their metabolism slows with age. Interaction with prescription drugs also is a hazard.
The NIDA research appears in the journal Neuropsychopharmacology.
Source: JoinTogether.org - June 3, 2008
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PEOPLE IN THE NEWS
New CSAP Director Named
Frances M. Harding, a former New York state addiction official, has been named the new director of the federal Center for Substance Abuse Prevention (CSAP).
Harding, previously the associate commissioner of the Division of Prevention and Recovery in the New York State Office of Alcoholism and Substance Abuse Services, will take over as head of CSAP in July.
In the past, Harding also has served as president of the National Prevention Network and on the board of directors of the National Association of State Drug and Alcohol Directors. She also has served on advisory panels for the U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, and the Network Addressing Collegiate Alcohol and Other Drug Issues.
Source: JoinTogether.org - May 5, 2008
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Notice:
All facts and opinions are those of the sources cited. News reports may have been edited for length and/or modified for clarity without altering essential data as originally published.
Addiction Treatment Forum and its associates do not endorse any medications, products, or treatments described, mentioned, or discussed in any of the sources referenced. Nor are any representations made concerning efficacy, appropriateness, or suitability of any such products or treatments. This News Update is made possible by an educational grant from Mallinckrodt Inc., distributors of methadone and naltrexone.
In view of the possibility of human error or advances in medical knowledge, Addiction Treatment Forum and its associates do not warrant the information contained in the above news updates is in every respect accurate or complete, and they are not responsible nor liable for any errors or omissions that may be found in such information or for results obtained from use of such information.