Alcoholism & Drug Abuse Weekly最新文献

Last week, Congress released its funding bill keeping the federal government going until March 2025. It's level-funding for the substance use disorder field. Notably, the Modernizing Opioid Treatment Access Act (MOTAA) bill is not included. If you want to read the 1,500-plus pages, here it is: https://docs.house.gov/billsthisweek/20241216/CR.pdf. However, as of December 19, Congress had gone back to the drawing board, with Republicans ordered by President-Elect Trump and by his close associate Elon Musk to remove funding or to just allow the government to shut down.

A recent study comparing the effectiveness of buprenorphine and methadone found that the risk of discontinuation was greater with buprenorphine than methadone. For the study, the researchers looked at a retrospective cohort of patients via databases in British Columbia, Canada. The study covered a total of 30,891 patients, who received treatment from 2010 to 2020.

When a public figure avows that he will stop drinking, as Pete Hegseth, nominated by President-Elect Trump to head the Department of Defense, reportedly said he will do if confirmed (https://abcnews.go.com/Politics/pete-hegseth-back-scrutiny-grows-misconduct-allegations/story?id=116444894), the recovery movement squirms. Another public figure, Aaron Peskin, supervisor of San Francisco, also has a history of drinking, says he will enter treatment and has been public about the entire problem, most recently suggesting that even Trump and Putin drink when they are together. It is well known that Trump does not drink and derides alcoholism; for this reason many thought he would withdraw Hegseth's nomination. But he hasn't, and both men indicate that they will move forward.

Adolescent substance use remains low, according to the most recent Monitoring the Future (MTF) study. Results released last week by the National Institute on Drug Abuse (NIDA) show the fourth year of continued lowered levels for this age group.

Most probably influenced by media images of smash-and-grab robberies, almost 10 million California voters (68.6%), by voting “Yes” for Proposition 36, decided that these crimes should be addressed. Unfortunately, once again drug use and users were joined to these crimes, and the result is a rollback of some of the progressive drug policies of recent years.

Exempting pharmacy orders of buprenorphine from investigative reports and eliminating prior authorization requirements for the medication are among the significant recommendations offered in an opinion piece calling for expanded access to the treatment.

Now the National Advisory Council on Drug Abuse (NACDA) has a working group made up of people with “lived or living experience with substance use.” The new group will help the council, which is operated by the National Institute on Drug Abuse, by providing input to help the agency “co-create standards for engagement in research for individuals with lived or living experience with substance use.” NIDA is is seeking individuals with current or former experience with either substance use or substance use disorder (SUD), or as a caregiver of someone who does. Applications are due January 10, 2025. Additional details on expectations for the workgroup and how to apply can be found here.

Last week the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a 181-page description of the rationale behind the new guidelines for opioid treatment programs (OTPs). The new guidelines, which greatly liberalize federal rules regarding take-homes, eligibility for treatment, and more, were issued in February 2024 (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34023). The manual issued last week, Federal Guidelines for Opioid Treatment Programs (https://store.samhsa.gov/sites/default/files/federal-guidelines-opioid-treatment-pep24-02-011.pdf), noted that Title 42 of the Code of Federal Regulations (42 CFR) part 8 “sets the standards for services” in OTPs, and regulates their certification and accreditation.

Researchers have found that contingency management (CM)– rewarding desired behavior – using a smartphone application is effective in the treatment of opioid use disorder (OUD). In “Smartphone App–Based Contingency Management and Opioid Use Disorder Treatment Outcomes published in the December 2 issue of JAMA Network Open, researchers reported that augmenting medication for opioid use disorder (MOUD) with a smartphone app that financial rewards to patients for not using opioids was effective. Patients participating using the app plus receiving MOUD had fewer days of illicit opioid use and were retained in treatment longer than patients receiving MOUD only. Led by Elise N. Marino, Ph.D. of the Be Well Institute on Substance Use and Related Disorders, University of Texas Health Science Center at San Antonio, the researchers suggested that such programs should be expanded. Senior author Jennifer S. Potter, Ph.D. reported as a conflict of interest that she has received funding from KIOS, which makes a smartphone app to treat addiction, but did not participate in this study. The study was funded by Texas Targeted Opioid Response, a public health initiative operated by the Texas Health and Human Services Commission (HHSC) through federal funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and from the National Institute on Drug Abuse (NIDA). The study used the WEconnect smartphone app, a competitor to KIOS. The sample included 600 individuals, with 300 in each treatment group.

On December 7, The New York Times published a story purporting to investigate Acadia Healthcare's opioid treatment programs (OTPs). The article was not written by reporters familiar with the field, but by reporters whose beat is exposing medical harms. The December 7 article was based mainly on accusations of ex-employees – not lawsuits, not insurance problems, not anything documented. The OTP chain, which is based in Nashville, was described as, to take the story paragraph by paragraph.