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How can Kentuckiana fight heroin, opioid crisis?
New guidelines highlight hospitals’ role in curbing opioid abuse
60% of Patients Have Unused Opioids; 20% Share Them
http://www.healthleadersmedia.com/physician-leaders/60-patients-have-unused-opioids-20-share-them#
US health fraud stings net 301 people this year, most ever
‘Astounding’ number of opioids prescribed to elderly, report finds
https://www.statnews.com/2016/06/22/many-opioid-prescriptions-seniors/
A Small Town Bands Together To Provide Opioid Addiction Treatment
British Columbia Declares Public Health Emergency Over Fentanyl Overdoses
IUPUI Prof: Follow-up needed after overdose interventions
http://indianapublicmedia.org/news/iupui-prof-followup-needed-overdose-interventions-100858/
Am J Addict. 2010 Sep-Oct;19(5):422-32. doi: 10.1111/j.1521-0391.2010.00070.x.
A randomized trial of oral naltrexone for treating opioid-dependent offenders.
Coviello DM1, Cornish JW, Lynch KG, Alterman AI, O'Brien CP.
Abstract
Offenders with a history of opioid dependence are a particularly difficult group to treat. A large proportion of offenders typically relapse shortly after release from prison, commit drug-related crimes, and then are arrested and eventually re-incarcerated. Previous research demonstrated that oralnaltrexone was effective in reducing opioid use and preventing recidivism among offenders under federal supervision. The 111 opioid-dependent offenders in this study were under various levels of supervision that included county and federal probation/parole, a treatment court, an alternative disposition program, and an intermediate punishment program. Subjects were randomly assigned to receive 6 months of either 300 mg per week of oral naltrexone plus standard psychosocial treatment as usual (n = 56) or standard psychosocial treatment as usual (TAU) without naltrexone (n = 55). While the TAU subjects who remained in treatment used more opioids than the naltrexone subjects who remained, the high dropout rate for both groups made it difficult to assess the effectiveness of naltrexone. The study provides limited support for the use of oral naltrexone for offenders who are not closely monitored by the criminal justice system.
Anti-Cocaine Vaccine To Be Tested in Humans Soon
Aug 8, 2016
The vaccine can potentially blunt the effects of cocaine
Weill Cornell Medicine and NewYork-Presbyterian have developed a vaccine to blunt the effects of cocaine and potentially prevent it from reaching the brain. The vaccine, called dAd5GNE, has successfully completed pre-clinical studies and has now advanced to Phase 1 testing in humans.
Investigators are now enrolling active cocaine users in a randomized, double-blind, Phase 1 control study to evaluate the mechanism, effects, and safety of the dAd5GNE vaccine in humans. The trial is looking to enroll 30 subjects, to be divided into 3 consecutive 10-person cohorts: 7 receiving the vaccine and 3 receiving placebo. Investigators will assess efficacy and safety measures, including urine drug screens, EKGs, complete blood counts, anti-cocaine antibodies, self-reports on cocaine cravings, and desire for other drugs and alcohol, through frequent meetings (2–3 times/week) with each subject.
Each participant needs to be cocaine-free for at least 30 days before receiving the vaccine, as tested by frequent urine drug screenings. The first vaccine dose will be administered as an injection in the shoulder, with subsequent boosters given every 4 weeks until 6 total injections have been received. After the last vaccine, subjects will be monitored for 3 months until the study's conclusion at Week 32. The Phase 1 study is expected to be completed in about 3 years.
The dAd5GNE vaccine is designed to absorb cocaine in the bloodstream before its ability to pass through the blood-brain barrier. It works by linking a cocaine-like molecule (GNE) to a disrupted protein of an inactive adenovirus virus, likely producing an immune response that will produce anti-cocaine antibodies.
MARIJUANA: June 2016 Published in the Journal of Clinical Psychological Science.
Researchers from the University of California and Duke University published a 20 year longitudinal study following 947 marijuana users from the age of 18 to 38. The findings were: regular marijuana users (4 or more days a week) experienced downward social mobility and more financial problems such as troubles with debt and cash flow than those who did not use marijuana persistently. They also had more antisocial behaviors at work (such as stealing money or lying to get a job) and experienced more relationship problems such as intimate partner violence and controlling abuse. Additionally, persistent marijuana users had a lower IQ, lower motivation to achieve, higher levels of impulsivity, more criminal convictions, and abuse or alcohol and hard drugs. Even for cannibis users that were never convicted of a crime, there was lower economic status and increased social problems. Regular use of cannabis and heavy alcohol use were equally associated with these issues with the exception cannabis users experienced more financial difficulties than did heavy alcohol users.