Expanding buprenorphine treatment could curb opioid overdoses

Expanding primary care buprenorphine treatment could curb opioid overdose crisis7

Brain basics in jargon-free language.

Expanding the availability of medication treatment for opioid use disorder in primary care settings would be a major step toward reducing overdose deaths, write two physicians specializing in addiction medicine and health care delivery in the July 5 issue of New England Journal of Medicine. In their Perspectives article entitled "Primary Care and the Opioid-Overdose Crisis - Buprenorphine Myths and Realities," Sarah Wakeman, MD, medical director of the Massachusetts General Hospital Substance Use Disorders Initiative and Michael Barnett, MD, of the Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, describe current barriers to expanded delivery of buprenorphine treatment and outline possible solutions.

"One of the tragic ironies is that with well-established medical treatment, opioid use disorder can have an excellent prognosis," they write, noting that almost 80 percent of Americans with opioid use disorder are unable to receive treatment and that the growth in distribution of buprenorphine - one of three FDA-approved medications for the treatment of opioid use disorder - has been slowing rather than increasing in recent years. "To have any hope of stemming the overdose tide, we have to make it easier to obtain buprenorphine than to get heroin and fentanyl."

The authors describe 5 persistent but inaccurate myths that they believe prevent buprenorphine from being more widely adopted:

O That is more dangerous that other common health care interventions,
O That buprenorphine treatment is just replacing one addition for another,
O That abstinence-based treatment - short-term detoxification and rehabilitation - is more effective than medication-based treatment,
O That providing buprenorphine treatment is particularly onerous and time consuming for primary care physicians (PCPs),
O That physicians should just reduce opioid prescriptions to address the overdose epidemic

Most outpatient buprenorphine treatment is already provided by PCPs, and expanding the availability of office-based buprenorphine treatment, as several other countries have done, presents a realistic solution to addressing the overdose crisis, the authors note. They write, "We are in the midst of a historic public health crisis that demands action from every physician. Without dramatic intervention, life expectancy in the United States will continue to decline. Mobilizing the PCP workforce to offer office-based buprenorphine treatment is a plausible, practical, and scalable intervention that could be implemented immediately."


###

Harvard T.H. Chan School of Public Health. EurekAlert

5 celebrities we've lost to drugs

Which Celebrities Have Battled with Addiction?

Addiction affects everyone, but the tragic stories of celebrity overdoses affect the millions of fans who were entertained or inspired by their work. Drugs have claimed the lives of countless stars, but some celebrities survived their brush with addiction, sought treatment and are in recovery today.

 
 

MORE IN THIS SECTION

No person is immune to addiction or its consequences. When celebrities abuse alcohol or other drugs, they’re at the same risk for developing substance use disorders as everyone else.

Their actions, and the consequences of their actions, are displayed in magazines, on TV and on the internet. When a celebrity checks into rehab or overdoses from a drug, the public knows. The constant reporting of celebrity drug use can make it seem like addiction is more common in Hollywood than in the rest of the world.

But celebrities have the same anatomies as everyone else. The percentage of celebrities who suffer from addiction is likely similar to that of the general public.

Source: Drugabuse.com

Prince, Fentanyl.

Amy Winewouse, Alcohol Intoxication.

Health Ledger, Prescription Drugs.

Jimi Hendrix, Barbiturate Overdose.

Whitney Houston, Cocaine and multiple other drugs.

Learn about drugs and the brain.

Take the distracted driving quiz.

Skip to


Want to be a safer driver? Here’s a start: Take the quiz below to see how much you know about drugged, drunken, and distracted driving. Correct answers are listed after the questions.

Learn about drugs and the brain.

Questions:

1. Of the top five causes of death for teens in the U.S., where do motor vehicle crashes belong on the list?
2. For high school seniors, what’s more common: driving after using drugs, or driving drunk?
3. Fill in the blank: ____ percent of all drivers aged 15 to 19 who were involved in fatal crashes were distracted (not focusing on the main task of driving) at the time of the crashes.
4. Are teens more likely to take risks when they’re driving alone or when they have passengers in the car?
5. True or false: Marijuana impairs a person’s ability to drive.
6. The average car’s weight is closest to that of a:
   1. Tyrannosaurus rex
   2. Black bear
   3. Beluga whale
   4. None of the above
7. If you text while you’re driving, how long on average do you take your eyes off the road while texting?

Answers:

1. Motor vehicle crashes are the leading cause of death for teens. Each year, enough teens die in car crashes to fill 50 school buses. 
2. More high school seniors are now driving after using drugs than are driving after drinking. 
3. Ten percent of all drivers aged 15 to 19 were distracted at the time they were involved in a fatal crash. 
4. One study found that teens are more likely to take risks when driving with their friends in the car, even if their friends aren’t talking. (National Highway Traffic Safety Administration.
5. True! Even a single marijuana cigarette can make it harder for a person to drive safely.
6. The answer is c., a beluga whale. The average car or truck weighs about 4,000 pounds—even more than a beluga whale. Driving one is a big responsibility! 
7. Almost five seconds is the average time your eyes are off the road while texting. When you’re driving at 55 miles per hour, that's enough time to cover the length of a football field blindfolded.

---

Provide fedback

74SHARES

More and better drug treatment needed in prisons

Drug abuse and crime continue to be linked; and although addiction is recognized as a chronic, relapsing disease, offenders are still not getting the treatment they need. 

Addiction is a brain disease. A preventable one, but nevertheless a brain disease. LEARN MORE HERE! 

• Chronic drug abuse causes long-lasting brain changes that contribute to an addicted person’s compulsion to seek and use drugs despite catastrophic consequences. These brain changes persist long after drug abuse ends, leading to high rates of relapse (as with other chronic diseases) and the need for continuing treatment to help an individual achieve recovery.
• More and better treatment is needed in the criminal justice system, and continuing through the period of re-entry into the community. It is estimated that about half of state and federal prisoners meet the criteria for drug abuse and dependence and yet fewer than 20 percent who need treatment receive it.
• As in the general population, co-occurring substance use and other mental disorders are common, with about 45% of inmates in local jails and State prisons having both. In addition, about 75% of inmates with a mental illness also meet criteria for substance abuse, and vice-versa. This high rate of co-occurrence underscores the need for offenders, both adults and juveniles, suffering from one disorder to be screened for the other and, where appropriate, treated for both, necessitating an integrated treatment approach.
• Involvement in the criminal justice system provides an opportunity to diagnose and treat these health problems, which also include infectious diseases like HIV. Fourteen percent of HIV-infected individuals pass through correctional facilities each year, and yet criminal justice–based services and community health and social services remain fragmented.

Treatment works, is cost-effective, and can help end the vicious cycle of drug abuse and criminal recidivism. 

• Research demonstrates that treatment can work for drug abusing offenders, even when it is entered involuntarily. Forced abstinence (when it occurs) during incarceration is not equivalent to treatment. Failure to receive needed treatment or access to services often leads to relapse and re-arrest, usually during the first 12 months after release.
  
  Juvenile Offenders: Virtually every juvenile offender should be screened for drug abuse and mental disorders, and receive an intervention:
  
  
  • Treatment for those who are dependent on alcohol or drugs, or mentally ill.
  • Drug abuse prevention for those who are not.
  • HIV prevention or treatment as needed.
• Longitudinal studies show that treatment begun in the criminal justice system and continued in the community garners lasting reductions in criminal activity and drug abuse. This includes medication-assisted treatment (i.e., methadone) for prisoners with heroin addiction (see figure below).
• Providing treatment is cost-effective, saving between $2 and $6 for every $1 spent on it, which in part reflects reductions in criminal behavior and re-incarceration.

TOMORROW

Getting proven treatments into the criminal justice system will promote abstinence, help identify and mitigate related diseases like HIV, and foster productive reintegration back into the community. 

Source: NIH

Limited offer: free e-books on the brain and health

These books, part of the Healing the Brain Series from A Thousand Moms cover topics important to teachers, students, parents, counselors...anybody concened with their family, their friends, theirselves. Please take a look, download these flipbooks, and share. 

About the author: David Balog is chief information officer for A Thousand Moms: Building Community Support for Lesbian, Gay, Bisexual and Transgender Youth in Foster/Adoptive Care. He was a science/medical writer at the Dana Foundation in New York City, where he created, wrote and edited the Dana Sourcebook of Brain Science through four editions. More than 50,000 copies of this widely acclaimed book was distributed to teachers, students, and professionals in all 50 states and numerous other countries.

Amazon.com reviews: Author David Balog has done an excellent job of creating a book for educators (or anyone working with youth) that explains the complicated workings of the brain in an easy to understand manner. Balog goes on to discuss various types of trauma and how the adolescent brain responds to trauma such as depression, stress, addiction, risk taking, PTSD, etc. 

[A] cohesive narrative about a subject that has been put in the dark by society. I was informed about things I thought I knew plenty about. I was inspired by the read and heavily recommend that anyone reading this reviews invests themselves into this book and the cause it strives for. 

Provides comfort and learning to the reader. Flows easily from one topic to the next and knits tidbits of information together in a unifying mosaic. Easy to read. Difficult to put down. 

CLICK HERE

CLICK HERE

CLICK HERE

CLICK HERE 

CLICK HERE

CLICK HERE

CLICK HERE

CLICK HERE

Ritalin and Cocaine: The Connection and the Controversy

Since the mid-1950s, doctors have been using Ritalin (also called methylphenidate) to treat a variety of conditions including depression, fatigue syndrome, and narcolepsy. Ritalin gained FDA approval for treatment of hyperactivity in children in 1961.

Ritalin is the most commonly prescribed medication for ADHD (attention deficit hyperactivity disorder). This treatment has helped thousands of people control their symptoms. But because Ritalin is a stimulant like cocaine, it may cause undesirable changes in the brain over time. It also has the potential for abuse, and because it’s a legal prescription drug, many wrongly assume that it is not dangerous.

So what are the benefits of Ritalin, and what are the risks?

Ritalin is currently prescribed to approximately six million people in the US. 75% of these are children, with boys receiving Ritalin about four times more often than girls.

Order your copy today and learn about the brain!

ADHD: The Benefits of Ritalin

People with ADHD have difficulty concentrating, and they can be hyperactive or impulsive. They also have lower levels of the brain chemical dopamine.

Dopamine helps people control their behavior, so having the right level of dopamine in the brain is important. Ritalin increases dopamine levels, helping those with ADHD to focus, filter out distractions, and make decisions based on reason rather than emotion.

Ritalin is Similar to Cocaine

Research shows that 10-30% of cocaine addicts have ADHD.
30-50% of adolescents in drug treatment centers report abusing Ritalin.

There can be unintended consequences when an adult uses cocaine to control their ADHD. --Dr. Glen Hansen

Like cocaine, Ritalin is a powerful stimulant that increases alertness and productivity. Ritalin and cocaine also look and act very much alike. They have a similar chemical structure, and both increase dopamine levels in the brain. They do this by blocking a dopamine transporter protein, which normally takes up dopamine from the synapse.

ADHD children are typically taken off of Ritalin when they reach adulthood. Interestingly, these individuals seem to be more prone to cocaine addiction. Why is that? Because Ritalin and cocaine are similar drugs, it's possible that ADHD adults are unknowingly using cocaine as a replacement for Ritalin. In other words, it may be an attempt to self-medicate. Cocaine may help individuals with ADHD focus and feel calm and in control.

 

Ritalin (left) and cocaine (right) share a similar chemical structure and mechanism of action.

Is Ritalin Addicting?

Ritalin is not addictive when prescribed by doctors and taken as directed. Why this difference between Ritalin and cocaine? Ritalin is a pill that you swallow, so the drug takes longer to reach the brain. Cocaine is taken in high doses by injection or snorting. It floods the brain quickly with dopamine, which makes it dangerous and addictive.

Unfortunately, Ritalin is quickly becoming a drug of choice for teens. It's relatively cheap and accessible. And because it's a prescription drug, it's perceived to be safe. But if Ritalin is abused (taken in high doses) or taken improperly (by injection or snorting), it can be just as addictive as cocaine. This is because drug delivery methods can influence the addictive potential of a drug.

Is Ritalin a “gateway drug”? Studies show that proper Ritalin use does not lead to drug abuse. --Dr. Kelly Lundberg

The Consequences of Misdiagnosis

Misdiagnosis of ADHD is a common problem that complicates the Ritalin controversy. Some say that Ritalin is now over-prescribed, and that it may cause undesirable changes in the brain over time.
Recent animal studies suggest that children who are mistakenly diagnosed with ADHD and treated with Ritalin may be more likely to develop depression as adults. This can be explained by Ritalin's effects on the reward pathway.

We know that Ritalin increases dopamine levels in the brain. But an unnecessary increase in dopamine during childhood may change how the brain develops. The brain may become desensitized to natural rewards like food, romance, and social interactions, leading to depression.
However, failing to diagnose has ADHD has its problems too: Kids with untreated ADHD are four times more likely than normal to abuse drugs.

Kids with untreated ADHD are four times more likely than normal to abuse drugs. --Dr. Glen Hanson

Copyright ©University of UtahGenetic Science Learning Center

Why do people take drugs?

Join us for our Network of Support!

Here's a preview:

 

Why do people take drugs?

In general, people begin taking drugs for a variety of reasons:

• To feel good. Most abused drugs produce intense feelings of pleasure. This initial sensation of euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the “high” is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opiates such as heroin is followed by feelings of relaxation and satisfaction.   
• To feel better. Some people who suffer from social anxiety, stress-related disorders, and depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a major role in beginning drug use, continuing drug abuse, or relapse in patients recovering from addiction.
• To do better. Some people feel pressure to chemically enhance or improve their cognitive or athletic performance, which can play a role in initial experimentation and continued abuse of drugs such as prescription stimulants or anabolic/androgenic steroids.
• Curiosity and “because others are doing it.” In this respect adolescents are particularly vulnerable because of the strong influence of peer pressure. Teens are more likely than adults to engage in risky or daring behaviors to impress their friends and express their independence from parental and social rules.

Over time, if drug use continues, other pleasurable activities become less pleasurable, and taking the drug becomes necessary for the user just to feel “normal.”

Join our conversation on the drug epidemic and families

The amount of drug that can kill. Fentanyl threatens to greatly worsen our addiction crisis.

A social worker in a small upstate New York town told me that in order to shoot up with meth, teens in his town used the only private space they could find: their family car. They shot up in the most secluded place they could find--empty downtown areas, WHILE DRIVING.

A mental health worker in Vermont told me that they're on the verge of giving up on today's youth and trying to prevent children from becoming the next generation of addicts.

Doctors in emergency rooms give families devastating news about their children, anywhere from the limited, compromised futures they face to the crushing news of their deaths.
 
Former President Bill Clinton gave a speech recently saying that the opioid epidemic will destroy this country.

WHAT WE'RE DOING

A Thousand Moms, which has produced a series of books entitled "Healing the Brain," will hold a four-week conference-call series entitled "Network of Support: Addiction and Our Families." 

Made possible by a donation from a concerned supporter, A Thousand Moms’ four-part information series for educators, parents, social workers, other concerned individuals is now free of charge. Dates for Network of Support: The Addiction Crisis are Tuesdays, July 18/19, July 25/26, August 1/2 and August 8/9. (Original presentations are repeated on the following day for the convenience of participants. Times: Tuesdays at 11:00 am EDT., Wednesdays at 7:00 pm EDT. 

Calls last one hour. CONF CALL #: 605 475-6333  ACCESS CODE: 2456474

Presented in clear, non-complicated language

To empower participants, coverage in this series will include a basic understanding of how addiction works in the brain and body. Each session will combine addiction facts with practical strategies for coping with current or potential substance abuse by a loved one. Substance abuse topics include: How the brain works; Why is addiction a brain disease? Opioids/heroin;  Methamphetamines, cocaine; and Alcohol and marijuana. Support topics include: Positive parenting as a prevention tool for drug abuse; Communication, encouragement,and negotiations; Setting limits; supervision, and knowing your child's friends. 

The conference call programs are presented by Fred Elia, MS, president of A Thousand Moms, and David Balog, author, Dana Foundation’s Sourcebook of Brain Science and Healing the Brain: Stress, Trauma and Development.

First call: Tuesday, July 18, 11:00 AM EDT

CONF CALL #: 605 475-6333  ACCESS CODE: 2456474 

Foods that May Prevent Alzheimer's

Source: Web MD: 

The MIND Diet

 

Want another great reason to eat healthy? The food choices you make daily might lower your odds of getting Alzheimer’s disease, some scientists say.

Researchers have found that people who stuck to a diet that included foods like berries, leafy greens, and fish had a major drop in their risk for the memory-sapping disorder, which affects more than 5 million Americans over age 65.

The eating plan is called the MIND diet. Here’s how it works.

Brain-Friendly Foods

MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It’s similar to two other healthy meal plans: the DASH diet and the Mediterranean diet. 

But the MIND approach “specifically includes foods and nutrients that medical literature and data show to be good for the brain, such as berries,” says Martha Clare Morris, ScD, director of nutrition and nutritional epidemiology at Rush University Medical Center.

You eat things from these 10 food groups:

• Green leafy vegetables (like spinach and salad greens): At least six servings a week
• Other vegetables: At least one a day
• Nuts: Five servings a week
• Berries: Two or more servings a week
• Beans: At least three servings a week
• Whole grains: Three or more servings a day
• Fish: Once a week
• Poultry (like chicken or turkey): Two times a week
• Olive oil: Use it as your main cooking oil.
• Wine: One glass a day

You avoid:

• Red meat: Less than four servings a week
• Butter and margarine: Less than a tablespoon daily
• Cheese: Less than one serving a week
• Pastries and sweets: Less than five servings a week
• Fried or fast food: Less than one serving a week

The Benefits

One study showed that people who stuck to the MIND diet lowered their risk of Alzheimer’s disease by 54%. That’s big. But maybe even more importantly, researchers found that adults who followed the diet only part of the time still cut their risk of the disease by about 35%.

 Join us for Network of Support: The Addiction Crisis