Buprenorphine

WEDNESDAY, June 19, 2024 -- Only a third of outpatient mental health facilities offer medications essential for treating opioid addiction, a new study finds. Standard care for treating people with opioid use disorder involves drugs like buprenorphine, methadone and naltrexone, which help suppress cravings and blunt the effects of narcotics. But most front-line mental health facilities don’t offer these medications , researchers reported June 18 in the journal JAMA Network Open . “Outpatient community mental health treatment facilities can be an important part of the treatment ecosystem for individuals with opioid use disorders,” said lead study author Jonathan Cantor , a policy researcher at RAND Corp. For the study, researchers surveyed 450 clinics located in 20 states with the highest opioid overdose death rates in the nation -- Arizona, California, Connecticut, Delaware, Florida, Indiana, Kentucky, Maine, Maryland, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, West Virginia and Wyoming. More than 80,000 Americans died from opioid overdoses in 2021, researchers noted in background notes. Unfortunately, medication treatment for opioid addiction remains vastly underused. A recent study found that nearly 90% of those with opioid use disorder weren’t prescribed these meds, researchers noted. Because an estimated 25% of adults with opioid addiction also suffer from mental illness, outpatient mental health facilities are a potentially important access point for such medication treatment, researchers said. “Further attention is needed to address challenges to offering medication treatment, and to assess whether referral models cited by many of the clinics are effective at meeting patients’ needs,” Cantor said in a RAND news release. Most clinics that did not offer medication treatment said they referred patients to other facilities for such care, often sending them to sites that were within the same treatment system. Clinics that offer integrated treatment services -- in which substance abuse and mental health problems are addressed at the same time -- were more than five times as likely to offer medication for opioid addiction, researchers found. Likewise, facilities that reported having a specialized treatment program for people with both mental health and substance use problems were more than twice as likely to provide medication treatment. “Our findings suggest that offering integrated substance use disorder services for people with co-occurring mental illnesses is a potential avenue toward improving uptake of medication-assisted treatment among those with opioid use disorder,” Cantor said. Places also were more likely to offer medication treatment for opioid addiction if they had housing services for patients or had on-site laboratory services. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

MONDAY, June 17, 2024 -- Opioid overdoses in pregnant women are at an all-time high in the United States, and researchers think they’ve figured out one way to counter this phenomenon. Attention deficit-hyperactivity disorder (ADHD) is strongly tied to substance use disorders, which means some women who become pregnant are taking ADHD medications while receiving treatment for opioid addiction . Researchers found that women who keep taking their ADHD medications during pregnancy are more likely to adhere to addiction treatment and less likely to overdose. “Treatment of ADHD is a huge knowledge gap in obstetrics and even more so in patients with substance use disorder,” said researcher Dr. Jeannie Kelly , an associate professor of obstetrics & gynecology at Washington University School of Medicine in St. Louis. “In obstetrics, a knowledge gap frequently leads to reluctance to treat because of unknown risks to the fetus,” Kelly said. “However, it’s also really important to discuss the risks of not treating, because untreated disease also can have huge implications for mom’s and baby’s health.” Overdose death rates doubled among pregnant and postpartum women in recent years, rising to about 6 deaths per 100,000 in 2021 from 3 deaths per 100,000 in 2018, researchers said in background notes. In fact, opioid OD now accounts for about 1 in 10 of all pregnancy-related deaths, researchers said. Nearly 1 in 4 people diagnosed with ADHD also has a substance use disorder, but there’s little research indicating how both conditions should be safely managed during pregnancy, researchers said. “It’s very common for pregnant patients to ask their doctors, ‘Is this medication safe?’” said researcher Dr. Tiffani Berkel , a psychiatry resident at Washington University. “The physicians have to say, ‘We don’t know.’ That’s not very reassuring to a pregnant person. They have to do this risk-benefit analysis themselves.” For the study, researchers evaluated data for 168 pregnant patients who were prescribed methadone or buprenorphine to treat their opioid addiction. Women who continued with their ADHD medication despite pregnancy stayed roughly two months longer on buprenorphine therapy than patients who stopped taking ADHD meds, researchers found. There also were fewer ER visits related to opioid addiction. About 41% of patients who remained on ADHD meds went to the ER, compared with 54% of those who stopped. One possible explanation is that ADHD drugs help control impulsive behavior, which might help patients better manage their addiction treatment. The new study was published June 11 in the journal Nature Mental Health . Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.