Tag Archives: Addiction

Scientists Explore Deep Brain Stimulation (DBS) to Fight Addiction

doctors doing brain surgery

Addiction is costly in many ways. It can cost relationships, families, jobs, and lives. The stigma of addiction can cause people not to seek help, and it seems that the stigma is international, just like the disease of addiction itself.

China has been experimenting with different solutions for addiction for years. People often go to the research doctors out of desperation. A recent article by the Associated Press detailed the desperation a man named Yan, in China, felt when over the years he became addicted to crystal meth and, eventually, heroin. His father wanted to help but was tired of watching him bounce in and out of drug rehabilitation. He gave him a choice between another trip to drug rehabilitation, or to try Deep Brain Stimulation surgery. “Of course, I chose surgery,” Yan said. “With surgery, I definitely have the chance to get my life back.”

China’s Research into DBS for Addiction

China doesn’t have the same medical laws as America, and for many years they tried an archaic and painful surgery to “cure” addiction doctors call “brain lesioning”.  Desperate families paid doctors thousands of doctors to “lesion” the brain. Similar to a lobotomy, the method destroyed small clumps of brain tissue, causing a variety of neurological ailments for patients, including mental health disorders, memory problems and sexual dysfunction. Even worse, it rarely worked.

Deep brain surgery involves an implant in the brain, which electrically stimulates specific areas. In the United States, DBS has only been approved for Parkinson’s disease. Few patients, however, can afford the $100,000 DBS surgery costs.  

In China, where medical regulations are lax, clinical trials are already underway. Dr. Sun Bomin, director of Ruijin Hospital’s functional neurosurgery department, says the need outweighs concerns about side effects or efficacy. “They are human beings. You cannot say, ‘Oh, we do not have any help, any treatment for you guys.’”

Sun said he has served as a consultant for two Chinese companies that make deep brain stimulators — SceneRay Corp. and Beijing PINS Medical Co. He has tried to turn Ruijin into a center of DBS research, not just for addiction, but also Tourette syndrome, depression and anorexia.

China’s studies don’t come to any definitive conclusions. One trial had a patient that died from a heroin overdose just a few months after surgery. Another study in January by doctors at a military hospital in Xi’an found five out of eight heroin users stayed off drugs for two years after DBS surgery.

Yan, it turns out, is more of a Guinea pig than a patient. There are risks of a brain hemorrhage, changes to his personality, seizures, or an infection. There is also scant evidence that DBS will cure or treat his addiction.

DBS in the USA

The scientific community has concerns about any clinical trials done in China, outside of labs with ethical guidelines and rigor in place.

“It would be fantastic if there were something where we could flip a switch, but it’s probably fanciful at this stage,” Adrian Carter, who heads the neuroscience and society group at Monash University in Melbourne, told the Associated Press “There’s a lot of risks that go with promoting that idea.”

Few clinical trials have explored DBS outside of Parkinson’s research. U.S. clinical trials on DBS for depression were nixed due to a lack of evidence for benefits. (It is incredibly hard for scientists to ethically justify cutting into somebody’s skull without any scientific evidence it will help.) SceneRay, another Chinese company exploring DBS for addiction, was turned down for clinical research trials by the U.S. Food and Drug Administration.

However, the FDA has allowed a small, separate trial of DBS for opioid use disorder. Led by Dr. Ali Rezai, at the West Virginia University Rockefeller Neuroscience Institute, it will launch in June.

Cocaine-Opioid Cocktails Have Been Killing Since 2010

flaming candles

People have been dying from opioid and cocaine cocktails regularly since 2010, but there hasn’t been much reporting on it. That’s partially because the focus is on the fact that these deaths were from opioids. But calling these deaths “opioid overdoses” is problematic because, in some cases, the drug users were never aware that they were using an opioid.

According to the Washington Examiner, more than 10,100 people died from mixing the drugs in 2017. 7,241 of those deaths showed both cocaine and fentanyl in their systems. Fentanyl is a potent opioid about 50 to 200 times stronger than morphine. It’s also the deadliest opioid in the US, with the majority of deaths in 2017.

Deaths caused by opioids and cocaine have risen nearly 76 percent since 2012.

Recently, opioid test strips have emerged across the United States as a part of harm-reduction efforts. The strips, which cost $1 each and have been given out with needle exchange programs and at other places drug users frequent, can detect even a minute amount of fentanyl. Cocaine and heroin users must mix some the drug with water to create a liquid form.

The test strips are not perfect and sometimes may give a false positive. Officials worry that the strips will give drug users a sense of false security, but harm reduction proponents say that combined with other methods of harm reduction, such as t6he overdose-reversal drug Naloxone, it will save lives. People will use their drug of choice, either way, harm reduction advocates say.

Harm reduction advocates hope that these tools, combined, will give a person enough tools to stay alive so that when they want to quit getting high, they can. After all, you can’t get a dead person into addiction treatment.

It’s not clear why drug dealers are adding fentanyl to the supply of other illicit street drugs. Many of the drugs sold in the US come from chemists in China or other international supply. Sometimes the drugs are pressed in the US, but sometimes the drugs are bought already formulated.

Getting the drugs off the streets seems a monumental task. Testing for the drugs, however, will be a bit more straightforward now that the test strips have begun to circulate.

Grant Awarded to Create, Upgrade Much-Needed Sober Housing in Mass.

Image of a man's hand pointing at miniature models of ranch-style homes.

In Massachusetts, in some ways, they are catching up to the opioid epidemic and facing it head-on. This sometimes means sending addicted patients home with medication-assisted treatment, offering sober coaching programs, and even providing drop-in clinics in some cities where drug addiction therapy is scarce. Now, The Center for Community Recovery Innovations (CCRI) has awarded a total of $696,995 in grant funding to help house recovery populations that include men, women, families, veterans, the homeless and ex-offenders.

The money will go to creating and modernizing 118 affordable sober housing units in communities across Massachusetts.

The grants come from the Center for Community Recovery Innovations, Inc. (CCRI), a nonprofit subsidiary of MassHousing. The goal of the award is to help nonprofits create or preserve affordable sober housing in Massachusetts.

This is not the first grant that has been awarded to support substance-free housing. Total, CCRI has awarded more than $10 million in grants. Without these grants, there would be few options for recovery housing, which is often considered the best option for people who have completed a long-term residential program. Sober homes help formerly addicted people to transition back into the community slowly.

Total, CCRI has helped create and maintain nearly 2,200 units of substance-free housing. In Worcester, the Latin American Health Alliance was able to put a down payment on financing to acquire Casa Colon, which will create 11 units of affordable sober housing for men, an essential addition for the overlooked demographic of LatinX community members in recovery.

“A safe, healthy and supportive housing environment is a critical component to substance misuse recovery,” said MassHousing Executive Director Chrystal Kornegay. “These grants help to meet the tremendous need for sober housing that is affordable and accessible to individuals who are working to overcome addiction. The projects funded through these awards will strengthen communities across the Commonwealth, by creating and modernizing affordable homes that promote successful recovery, helping individuals in need access the critical support services they need to successfully prevail over substance misuse.”

 

Horizon BCBC Offers NJ Members Free Peer Recovery Counselors

A blond woman is having a videochat. A computer sits on her lap and a man is on the computer, talking to her.

In New Jersey, Horizon Blue Cross Blue Shield is offering their clients a new secret weapon as they begin their recovery journey. Peer recovery counselors, trained to help others who are trying to get clean, will be offered to anyone who is currently receiving treatment for a substance use disorder.

The counselors will be available 24/7 via telehealth sessions. The sessions will take place over live video chat, which is how they can be offered any time, day or night. Horizon told the media that about 1.35 million of the 3 million members they currently have would be eligible for the program. Nearly seven out of a hundred thousand people in their network end up seeking help for a substance use disorder.

Why Peer Recovery Counselors?

Allen Karp, Horizon’s executive vice president, says that peer-support programs “dramatically improves a person’s chances of achieving long-term success.” People in treatment or counseling, who have begun treatment and are considered “stable” will be eligible for extra help.  The first few months are a critical point in many peoples’ recovery journey; when they begin to feel better and wonder if they need to stay in treatment at all. A recovery support specialist, who has been through similar things, can often reassure people that staying clean and sober is worth it.

About 1.35 million of the 3 million people insured by Horizon will be eligible for the program, a spokesman said. Horizon’s commercially insured members are diagnosed with substance disorder at a rate of slightly more than seven in 1,000.

This tactic of using healthcare to try to help people in recovery isn’t new, but it’s rare. Healthcare companies, including insurers, have been limited in their support of treatment centers. After all, there are high relapse and drop out rates. Horizon BCBS is trying to change that.

New Jersey seems to be leading the charge for healthcare-facilitated drug addiction treatment. Currently, the state of New Jersey also funds “opioid recovery specialists” – people who visit patients who just experienced an overdose. In recovery themselves, they’re there to let overdose victims know that there’s a better way of life. Their purpose is to engage the patient and encourage them to get treatment.

How Will the Opioids Crisis Response Act Fight Addiction?

Opioids Crisis Response Act into law

Much to the excitement of addiction recovery advocates and after a time stalled in Congress, lawmakers are finally close to passing a hefty bill to combat opioid abuse. The measure would combine law enforcement and public health measures, and includes initiatives and funding to help make addiction recovery services more accessible to people with opioid use disorder. If passed, the law will be the most comprehensive action to date to deal with the opioid epidemic.

The bill is a rare bipartisan effort in a time where many initiatives have stalled entirely due to the deep political divides in both the House and the Senate. The bill itself stalled in the House of Representatives earlier because Democrats objected to a part of the law that would benefit a group tied to the pharmaceutical industry that helped create the epidemic of addiction that our country faces today.

Finally, a compromise was reached in the Senate this week removing the provision, and the bill was modified to focus on a variety of other efforts, including:

  • Attacking illegally imported drugs by creating a new type of cooperation between the federal Food and Drug Administration and Customs and Border Protection.
  • Providing the Postal Service with tools and equipment to detect and stop illegal shipments of synthetic compounds like fentanyl from coming into the country.
  • Providing money to increase boost research on non-opioid pain treatments
  • Make substance-abuse therapy more accessible to Medicare via telemedicine services.
  • Create a pilot program of Medicare coverage for opioid addiction treatment.
  • Give more access to medication-assisted treatment by lifting a cap on the number of patients (from 100 to 275) that a qualified doctor can prescribe drugs like Suboxone, a drug that helps limit opioid cravings and ease the physical pain of withdrawal.
  • Authorize $500 million per year through 2021 for new grants to help states fight opioid addiction.
  • Create new grants to be used by the Department of Health and Human Services to develop to help support addicts in recovery in their transition to independent living. It would also help create job programs for them.
  • Launch a pilot program that would provide temporary sober housing for people in recovery.

Although addiction recovery advocates say that the bill still doesn’t provide the states with enough money, it’s a good step towards combating the opioid addiction epidemic. Some of the funds may be matched in the states to help round out the costs.

The Senate expects to vote on the legislation next week.

 

 

 

 

Fentanyl-Cocaine Combo Causing Deaths in MD

Image shows an empty hospital bed.

In Maryland, the government has been doing its best to fight the addiction crisis, but they’re not yet winning: in 2017, the number of fatal overdoses increased 9%. Most of these overdoses (90%) were considered to be opioid-induced, with Fentanyl overdoses increased by 42 percent last year, rising from 1,119 in 2016 to 1,594. Fentanyl is a drug that is 50 times stronger than heroin and is typically used in a medical setting. When added to other street drugs, it can be deadly, especially if novice opioid users are taking the drug. In Maryland, they have discovered that a fentanyl-cocaine combination of drugs is causing deaths. Between 2015 and 2016, cocaine deaths doubled because of this lethal combination.

The Maryland Department of Health Secretary Rober R. Neall called the increase in fentanyl-related deaths “staggering.” Officials think that the overdose deaths of cocaine containing fentanyl were accidental; the user may have had no clue that the two drugs were combined. Over 71% of cocaine deaths in 2017 was due to the fatal combination.

These deaths did not seem to have anything in common other than they were accidental. State officials say that the increase in cocaine deaths took place across demographics, affecting all age groups and both genders almost equally.

Heroin overdose deaths have also been decreased in the last year. In 2016, they had amounted to 58% of overdose deaths in the state.

In 2017, the amount of drug fatalities hit an all-time high in Maryland, although the actual increase in drug deaths was just 9%. This number compares to a 66% increase from 2016 to 2017. So it’s possible that efforts to combat fatal overdoses are working. One way the state is helping prevent these overdoses is via Narcan, an opioid antagonist that can help reverse overdoses. They are available both to first responders as well as over-the-counter for residents that have taken the training online.

 

 

Medicaid Recipients Have Better Access to Treatment Than Others

Medicaid Recipients

Poor adults seeking help for their opioid use disorder can get more help using Medicaid than other people, including those who may have no insurance or private insurance, according to a report by the Kaiser Foundation.

Medicaid has been instrumental to combatting the opioid epidemic, and in areas where the Affordable Care Act expanded Medicaid, the most vulnerable populations are given a lifeline. Not only do they get help with any long-lasting medical effects of drug addiction, but they also are often able to attend an inpatient or outpatient treatment program.

Republicans have often spoken about retracting the expansions of Medicaid or forcing participants to participate in work programs to “earn” their health insurance. Although many people with substance abuse disorders experience extreme poverty as a barrier to treatment, no new funds have been made available on a federal level to increase access to drug treatment.

According to the Kaiser Foundation, 43% percent of nonelderly adults with opioid addiction who were covered by Medicaid received inpatient and outpatient opioid addiction treatment services in 2016. In comparison, only 21% of those with private insurance and 23% of the uninsured were able to get the addiction treatment services they needed.

About 1.9 million adults experienced opioid addiction in 2016. Of those who were able to attend a treatment program, Medicaid covered 38%. Health experts credit the Medicaid expansion in 33 states, which has extended access to a range of treatment services. People who are covered by Medicaid can get access to life-changing addiction treatment services. Medicaid typically covers medication-assisted treatment such as Suboxone alongside counseling and other support services.

People with an opioid abuse disorder and the right kind of medical coverage usually have access to treatment in either inpatient or outpatient settings. There are some ways that addiction treatment can be administered, from a private doctor’s office or clinic setting to a fully-scheduled and monitored inpatient treatment program. Having access to a variety of options allow individuals the flexibility they need according to their lifestyles and needs.

If you are looking for information on which states have expanded Medicaid, click here.

Kratom Recall Due to Salmonella Expands Nationwide

kratom recall

Recently, the Centers for Disease Control notified the public that a salmonella outbreak caused by Kratom had prompted a recall of the product. Kratom products sold under brand names including Botany Bay, Enhance Your Life and Divinity by Divinity Products Distribution are all part of the voluntary recall. Kratom is often touted as an opioid substitute that can help people with a variety of issues, from addiction and chronic pain to anxiety and inflammation. The supplement, which is currently legal, is a plant native to southeast Asia that has become more popular in recent years due to its easy availability on the internet.

The Oregon Health Authority asked people to stop using kratom last week when testing found salmonella bacteria in several product samples. Four people in Oregon have already gotten sick from the bad batches they consumed.

The Food and Drug Administration issued a “voluntary destruction and recall” for the kratom supplements distributed nationwide under the brands mentioned earlier. If you own products included in the kratom recall, it is most appropriate to throw them away or even use them as compost, according to the FDA.

“There are currently no FDA-approved therapeutic uses of kratom, and importantly, the FDA has evidence to show that there are significant safety issues associated with its use,” federal regulators told the media in a news release. The DEA recently announced that kratom works similarly to prescription opioids, and has caused deaths in the US due to heart issues, anaphylaxis, and other complications. Kratom is often referred to as a type of “snake oil” supplement, with vendors and users claiming it can cure everything from the pain of arthritis to mental health issues and even addiction itself.

While used to help opioid users detox from heroin and other deadly opioids, Kratom has few studies to show its effectiveness, and there have been no studies to determine whether it is addictive or not. Users who take the drug often say there are no ill effects, although there are dozens of anecdotes online of people who have trouble ceasing Kratom after using it for a few months or more. Headaches are one of the most common complaints of people who are attempting Kratom cessation.

If you or somebody you love is taking Kratom as a supplement, and you don’t think you can stop on your own, there is help available. Addiction treatment can help you cease to use in a therapeutic, calm environment where you can work on reclaiming your own life. Medication-assisted treatment may be helpful, but this is something that you and your treatment center will need to weigh based on your health conditions and patterns of use.

Office of National Drug Control Policy Needs New Drug Czar

The Trump Administration recently employed 24-year-old Taylor Weyeneth to be the deputy chief of staff (also known as the drug czar) of the Office of National Drug Control Policy or ONDCP. While many addiction advocates were hoping the Administration would be filled by an experienced professional, the appointment of Mr. Weyeneth proved to be profoundly flawed.

Before Mr. Weyeneth’s work for the Trump administration, there were only two jobs from which he gleaned experience the only position he’d held since graduating from college in 2016. One of these tasks was working on President Donald Trump’s presidential campaign, the Washington Post reported earlier this month. Aside from his young age, and lack of experience in the field of mental health or addiction, this young man’s lack of knowledge also spilled into the jobs he listed on his resume. Included in the resume was a post he held at a law firm, where the attorneys terminated him for being a “no show” just seven months into the position.

Like many young people first entering the world of employment, he had three versions of his resume. However, each resume had discrepancies that at best, were inaccurate. At worst, they were meant to deceive and claim that he had more experience than he did, even as the experience listed was meager. For example, on all three resumes, Weyeneth asserted he had a master’s degree from Fordham University. The Washington Post spoke with a university spokesman who told them that Weyeneth had not completed his coursework and did not earn the degree.

How did such an inexperienced person get appointed to the commission? The question remains unanswered. Weyeneth graduated from college in May 2016 and was quickly named a White House liaison to the drug office the following March. By July, he was promoted to deputy chief of staff in July. His resume noted no experience in the field of health and human services, mental health or addiction.

Although Mr. Weyeneth has announced his plans to step down by the end of the month, his appointment is a cause for alarm in a department meant to set policy and recommend funding and programs for states, cities, and counties struggling with an epidemic with no end in sight.

ONDCP Needs an Experienced Drug Czar to Tackle Addiction

In the addiction field, honesty is paramount, and policy needs to be set by experienced mental health professionals, medical professionals, and people experienced in the area of addiction and recovery. It is unclear who is in charge in the interim once Mr. Weyenth’s post is vacant; however, the ONDCP website lists Richard Baum as Acting Director. Mr. Baum has a wealth of experience in the drug policy field as an academic and serves as an Adjunct Professor at Georgetown University’s McCourt Graduate School of Public Policy where he teaches students about American drug policy.

Every year, ONDCP works on and plans a National Drug Control Strategy, which outlines the presidential Administration’s efforts to reduce drug use, manufacturing and trafficking. The policy also focuses on lowering drug-related crimes, overdoses, and other health consequences. In 2017, the agency was still acting on former President Obama’s plan.

Using Marijuana for Morning Sickness is Dangerous

A new study shows that more women than ever are turning to marijuana for morning sickness, although there is no medical evidence to show that this is safe. In fact, experts are warning that using marijuana while with child is dangerous for the unborn.

The study, which followed trends in pregnant women in California, is a cause for alarm for many reasons. For one thing, the marijuana use referenced in the study was self-reported, which means that study participants likely under-reported their use of cannabis. An earlier study by the same organization also found marijuana use among pregnant women rose from 2.37% in 2002 to 3.85% in 2014.

The numbers may sound small, but the worries of medical providers are not. Nora D. Volkow, director of the National Institute on Drug Abuse, published an editorial explaining the many dangers. Few things are known about the effects of marijuana use on fetal development. However, with reports that women should avoid sugar, caffeine, and even specific candies such as licorice to help with normal fetal growth, it seems that marijuana use would be an automatic “no” for pregnant women. Most of the women in these studies were younger, typically ages 18-24, and may not be aware of the dangers.

Many people are suspicious of prescriptions and worry the dangers of “big pharma” drugs are more pronounced than the dangers of marijuana. Marijuana is touted as a natural, safe alternative to other medications, and more women seem to think it’s less dangerous than medical treatments for morning sickness and other ailments. It is also possible that many of these pregnant young women are addicted to marijuana, and have trouble quitting usage on their own.

Marijuana is a drug. It has mostly been viewed as a recreational drug in the past 10 years, and few medical studies can back up the medicinal usage for pregnant women.

marijuana for morning sickness

What the Research on Using Marijuana During Pregnancy Says

No research or recommendations, even from medicinal marijuana providers, suggest that marijuana usage during pregnancy is a good idea.

In fact, research from the Centers for Disease and Control shows pregnant women who use marijuana put their child at risk of low birth weight and developmental problems. According to the National Institute of Drug Abuses, animal studies have linked marijuana use to miscarriages, but no human evidence currently shows how large this risk is. However, research shows that women who use marijuana while pregnant are 2.3 times as likely to have a stillborn child.

Using drugs while pregnant is more dangerous than drinking coffee or soda while pregnant, and it is not a solution to your medical needs. Whatever you put in your body, you are putting in a vulnerable, not-fully-developed body that hasn’t even taken its first breath. If you are having severe morning sickness, talk to your obstetrician or primary care doctor. The American College of Obstetricians and Gynecologists recommends that women avoid marijuana while trying to get pregnant, during pregnancy, and while they are still breastfeeding. Using marijuana for morning sickness can be dangerous to your baby’s health.

If you are pregnant and having trouble ceasing drug or alcohol use, there is help available. You’re not alone, and you’re not a bad person. Addiction is a disease and it can be treated with the right support network in place. Please call a treatment center on this page or your local Narcotics Anonymous or Alcoholics Anonymous hotline. You don’t have to use if you don’t want to, and you don’t have to make the journey alone.