Alcoholism & Drug Abuse Weekly最新文献

After a spate of reports showing that physicians don't want to or can't prescribe treatment for opioid use disorder (OUD) (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34212), the American Society of Addiction Medicine (ASAM) has reiterated its July recommendations that pharmacists play a greater role in providing medications. In “The Role of Pharmacists in Medications for Addiction Treatment,” ASAM noted that pharmacists already help by dispensing buprenorphine. However, some pharmacies are reluctant to provide it, “possibly conflating harms associated with diversion of medications like oxycodone and alprazolam with buprenorphine's diversion risks,” ASAM wrote in the introduction to the policy statement. “Pharmacies are crucial to accessing and improving the utilization of medications for addiction treatment, however.”

The annual AMERSA Conference (Association for Multidisciplinary Education and Research in Substance use and Addiction) will be held November 14-16 in Chicago. For more information, go to https://amersa.org/

Last week's election saw the defeat of four legalization measures on state ballots: recreational marijuana in Florida, psychedelics in Massachusetts, and the third cycle of defeats in North Dakota and South Dakota.

If you are in recovery from a substance use disorder (SUD), a peer would be another person in recovery from a SUD. At least, that's the purist way of thinking, before the word “peer” came into common usage. For years, the Substance Abuse and Mental Health Services Administration (SAMHSA) has endeavored in various ways to promote the blending of SUDs and mental illnesses, mainly in terms of the recovery workforce. Most recently, SAMHSA's publication, Peer Support Specialists: A Growing Mental Health and Addictions Workforce, adds further confusion to the issue. We asked experts in the field to comment.

A new report published in JAMA Network Open found striking increases in the amounts of illicit fentanyl, methamphetamine and cocaine detected in urine drug test (UDT) specimens. The study, led by Andrew Huhn, Ph.D., associate professor of psychiatry and behavioral sciences and Kelly Dunn, Ph.D., professor of psychiatry and behavioral sciences, both at Johns Hopkins University School of Medicine, and co-authored by Millennium Health researchers, showed that concentrations of fentanyl and methamphetamine were 8.3 and 5.2 times higher in these specimens, respectively, in 2023 when compared with 2013 levels. Cocaine concentrations also doubled during this time, while levels for heroin fell by more than half. “Fentanyl, methamphetamine and cocaine concentrations are higher now relative to any time in the past decade, suggesting that the people who are using these drugs are doing so in larger quantities and/or with greater frequency now,” said Huhn. “The findings also demonstrate that aggregated, quantitative UDT data offer a scalable surveillance method that can provide swift and nimble feedback on real-time changes in drug exposure levels as well as emerging threats, like xylazine, that are not routinely captured by other methods,” he added. The analysis, which included 921,931 unique patient UDT specimens collected in SUD treatment settings across the U.S., also evaluated how these concentrations have changed in different parts of the country. With a few exceptions (eg, greater methamphetamine concentrations in the West and part of the South, largely stable heroin concentrations in the West), changes in drug exposure concentrations have been relatively similar across the U.S. over time. “These findings reveal that the drug use epidemic is evolving not only in terms of what drugs are being used but how much drug is being used,” said Angela Huskey, Pharm.D., chief clinical officer at Millennium Health. “This is the most granular assessment of drug use patterns in the U.S. to date and highlights an important, underappreciated nuance about drug use that may effect overdose risk and other clinically relevant phenomena.”

Academically focused recovery high schools for youths with substance use disorders aren't considered treatment programs and usually aren't affiliated with treatment centers, but several recent trends have forced some of these programs to include more treatment-like components. Chief among these developments, according to the executive director of one of the nation's oldest recovery high schools, is the relative absence of adolescent treatment services in most communities, meaning that youths often arrive to these academic settings with limited skills for recovery.

Recently, the Centers for Disease Control and Prevention announced that preliminary overdose death numbers in the U.S. have decreased over the last 12-month period. That is great news!

Schools may consider suspending or expelling a child for drug use but the American Academy of Pediatrics says removing a child from school should only occur when criminal or violent behavior is present. Drug use is a sign of a problem that can be helped and it is not likely to be helped by removing the child from school, unless to attend inpatient treatment. The policy statement, “School Suspension and Expulsion,” is published in the October issue of Pediatrics.

The annual AMERSA Conference (Association for Multidisciplinary Education and Research in Substance use and Addiction) will be held November 14-16 in Chicago. For more information, go to https://amersa.org/

“Accidental exposure to medication is a leading cause of poisoning in children,” the Food and Drug Administration (FDA) warned in a September 2024 announcement about fentanyl skin patches. “Young children, in particular, have died or become seriously ill after being exposed to a skin patch containing fentanyl, a powerful opioid pain reliever.”