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HHS leaders call for expanded use of medications to combat opioid overdose epidemic

posted Apr 24, 2014, 9:22 AM by Victor   [ updated Apr 24, 2014, 9:26 AM ]
April 24, 2014

A commentary published in the New England Journal of Medicine describes that the current medications used to treat opioid addiction (methadone, buprenorphine, or naltrexone) are currently underutilized in addiction treatment services and discusses ongoing efforts by major public health agencies to encourage their use. The authors of the commentary include leaders from the National Institute on Drug Abuse (NIDA), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA).
HHS leaders call for expanded use of medications to combat opioid overdose epidemic
National Institute on Drug Abuse - April 24, 2014


A national response to the epidemic of prescription opioid overdose deaths was outlined yesterday in the New England Journal of Medicine by leaders of agencies in the U.S. Department of Health and Human Services.  The commentary calls upon health care providers to expand their use of medications to treat opioid addiction and reduce overdose deaths, and describes a number of misperceptions that have limited access to these potentially life-saving medications. The commentary also discusses how medications can be used in combination with behavior therapies to help drug users recover and remain drug-free, and use of data-driven tracking to monitor program progress.

The commentary was authored by leaders of the National Institute on Drug Abuse (NIDA) within the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Centers for Medicare and Medicaid Services (CMS).

“When prescribed and monitored properly, medications such as methadone, buprenorphine, or naltrexone are safe and cost-effective components of opioid addiction treatment,” said lead author and NIDA director Nora D. Volkow, M.D. “These medications can improve lives and reduce the risk of overdose, yet medication-assisted therapies are markedly underutilized.”

Research has led to several medications that can be used to help treat opioid addiction, including methadone, usually administered in clinics; buprenorphine, which can be given by qualifying doctors; and naltrexone, now available in a once-a-month injectable, long-acting form. The authors stress the value of these medications and describe reasons why treatment services have been slow to utilize them. The reasons include inadequate provider education and misunderstandings about addiction medications by the public, health care providers, insurers, and patients. For example, one common, long-held misperception is that medication-assisted therapies merely replace one addiction for another – an attitude that is not backed by the science. The authors also discuss the importance of naloxone, a potentially life-saving medication that blocks the effects of opioids as a person first shows symptoms of an overdose.

The article describes how HHS agencies are collaborating with public and private stakeholders to expand access to and improve utilization of medication-assisted therapies, in tandem with other targeted approaches to reducing opioid overdoses.  For example, NIDA is funding research to improve access to medication-assisted therapies, develop new medications for opioid addiction, and expand access to naloxone by exploring more user-friendly delivery systems (for example, nasal sprays). CDC is working with states to implement comprehensive strategies for overdose prevention that include medication-assisted therapies, as well as enhanced surveillance of prescriptions and clinical practices. CDC is also establishing statewide norms to provide better tools for the medical community in making prescription decisions.

“Prescription drug overdoses in the United States are skyrocketing.  The good news is we can prevent this problem by stopping the source and treating the troubled,” said co-author and CDC director Tom Frieden, M.D., M.P.H. “It is critical that states use effective prescription drug tracking programs so we can improve prescribing practices and help get those who are abusing drugs into treatment.”

Continue reading at National Institute on Drug Abuse...