Tag Archives: treatment

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.

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.

Single-Step Naloxone Most Effective in Reversing Overdoses

Naloxone Narcan

Addiction professionals and first responders cope with a lot of variables when responding to an overdose, but nothing has changed the outcomes of emergency calls like Naloxone (also known as Narcan), an opioid antagonist drug that has the power to reverse overdoses. There are several versions of Naloxone delivery available. However, research has revealed that the single-step nasal inhaler seems to be most effective at reversing overdoses, according to new research led by faculty at Binghamton University, State University at New York.

In the past few years, expanded access to naloxone has saved thousands of lives by reversing fatal overdoses in people with opioid use disorder. While many people who overdose are not ready for help yet, others identify the moment their overdose occurred as a pivotal point in their life that helped them choose to get into recovery. Law enforcement and other first responders carry the drug on them all the time, especially in places like Ohio where overdoses take place in parking lots and other public spaces.

There is more than one way to administer Naloxone. Injections can be difficult for the untrained person to deliver, but there is often help available for people who choose to carry the drug. Sometimes injections are required multiple times for serious overdoses, and the skill of the person injecting the drug may come into play when it comes to reversing the drug.

William Eggleston, the clinical assistant professor at the School of Pharmacy and Pharmaceutical Sciences at Binghamton University, wanted to know if everyday people can successfully administer naloxone after basic video training. His research found that for ordinary people who aren’t first responders, the single-step nasal spray was used most successfully with minimal problems.

Eggleston conducted a study to estimate and compare the rate of successful administration and the time to successful administration by community members for single-step nasal spray, multi-step atomized nasal spray, and intramuscular simulated naloxone.

For the study, and over the course of several days, 138 adults with no prior naloxone training were asked to watch a two-minute video teaching them how to administer the drug. For each type of administration, they were asked to the adminster the reversal drug on a dummy.

After the video training, participants were able to administer the single-step nasal spray naloxone with a higher rate of success than the other types. This information is important for community naloxone programs across the United States.

“With training, nasal sprays, in general, had a higher degree of success than the shot,” Eggleston said. “Even if it seemed to us it was a no-brainer that we should be using nasal sprays, we had no data before, so now we have some to support that.”

Many people don’t realize it, but Naloxone has also been used to help people who have overdosed on other drugs such as synthetic marijuana and benzodiazepines.

The cost of the single-step Narcan spray is about $140, making it more cost prohibitive than the injection, which is about $40.

Image courtesy and copyright Adapt Pharma.

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.

Using Science to Fight Addiction

According to the 2010 National Survey on Drug Use and Health, about 21 million Americans currently need treatment for a substance abuse disorder. Ninety percent of them will not receive treatment; many will end up incarcerated because of crimes related to their addiction.

nora volkow NIDA

Since that report was released, an increasing number of doctors and scientists are calling for more recognition of addiction as a brain disorder. The Los Angeles Times recently reported that Gil Kerlikowske, director of the Office of Drug Control Policy and the leading drug authority in the government, spoke out against current perceptions of addiction in a speech delivered at the Betty Ford Center. Kerlikowske characterized addiction as a “chronic disease of the brain” rather than a moral failing on the part of the individual.

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Study Suggests LSD as Treatment for Alcoholism

Before LSD became widely used by the Woodstock generation, scientists explored the potential of using the hallucinogenic drug to treat anxiety, pain and alcoholism.

Researchers in Norway have recently revisited the question of whether LSD (lysergic acid diethylamide) is an effective treatment option for alcoholism.

A research team from Norway’s University of Science and Technology reviewed six U.S. studies on LSD and alcoholism conducted between 1966 and 1970. The studies included 536 people under treatment for alcoholism. One group of test subjects was given a single dose of LSD while a control group was given a stimulant, no drug or a smaller dose of LSD.

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