Patients with long-term opioid prescriptions and depression who take antidepressants are more likely to stop using opioids, a new study concludes. “Depression can worsen pain and is common in patients who remain long-term prescription opioid users,” lead researcher Jeffrey Scherrer, PhD, of Saint Louis University said in a news release. “Our study should encourage clinicians to determine if their non-cancer pain patients are suffering from depression and aggressively treat patients’ depression to reduce opioid use.” He added, “Effective depression treatment may break the mutually reinforcing opioid-depression relationship and increase the likelihood of successful opioid cessation.” The findings will be published in British Journal of Psychiatry.

A NIDA-funded randomized clinical trial found that primary care patients with opioid and alcohol use disorders (OAUD) who were offered a collaborative care intervention were more likely to receive evidence-based treatment and refrain from using opioids and alcohol six months later, compared to patients receiving usual care. The collaborative care intervention increased both the proportion of patients receiving evidence-based treatment for OAUD (39.0% vs. 16.8%) and the number refraining from opioids or alcohol use at six months. (32.8% vs. 22.3%). Collaborative care was designed to increase the delivery of either a six-session brief psychotherapy treatment, and/or medication-assisted treatment, with either buprenorphine/naloxone for opioid use disorders or long-acting injectable naltrexone for alcohol use disorders. Usual care participants were given a number for appointment scheduling and a list of community referrals for OAUD treatment. The authors suggest the findings indicate that treatment for OAUDs can be integrated into primary care settings effectively. For...

Some patients prescribed opioids for pain relief after surgery may face a high risk for developing a long-term addiction to the medicine, a new study concludes. The study included more than 36,000 surgery patients, who were followed for six months. None had taken opioids before their surgery. The researchers found 5 to 6 percent of patients continued to fill prescriptions for opioids long after what would be considered normal surgical recovery, HealthDay reports. Rates of new chronic use did not differ between patients who had major or minor surgery, the researchers wrote in JAMA Surgery. This suggests patients continue to use these medications for something other than treating pain from surgery, they said. Risk of long-term opioid use was highest among smokers, patients who had struggled with alcohol and/or drug use in the past, those previously diagnosed with depression or anxiety, and those who had a history of chronic pain.

A new study suggests that the longer patients are enrolled in treatment, the better chance they have of successful recovery after treatment. The study, published in the current issue of Open Journal of Psychiatry, followed 72 patients with a variety of addiction types over the course of a year. Patients were nearly divided evenly by gender with the mean average age about 30 years old. The patients were treated for a number of chemical dependencies, including alcohol, amphetamine, benzodiazepines and opioids. Those patients undergoing an industry standard 30-day treatment program exhibited a 54.7 percent treatment success rate after one year. In contrast, patients that participated in a treatment program lasting more than 30 days experienced a success rate of 84.2 percent. The study is significant, as most private and government insurance programs only reimburse the patient for 30 days of addiction treatment. “Aftercare is crucial once an individual has completed drug...

The Department of Health and Human Services (HHS) issued a final rule to update and modernize the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. This change will facilitate information exchange within new health care models while addressing the legitimate privacy concerns of patients seeking treatment for a substance use disorder. These modifications also help clarify the regulations and reduce unnecessary burden. The laws and regulations governing the confidentiality of substance use disorder records were written out of great concern about the potential use of substance use disorder information against individuals, causing individuals with substance use disorders not to seek needed treatment. The disclosure of records of individuals with substance use disorders has the potential to lead to a host of negative consequences, including: loss of employment, loss of housing, loss of child custody, discrimination by medical professionals and insurers, arrest, prosecution, and incarceration. The purpose of the regulations at...

Many doctors feel ill-equipped to counsel their patients about the potential medical uses of marijuana, USA Today reports. Some states are establishing physician training programs to address marijuana’s health effects. Currently, 25 states and the District of Columbia allow medical marijuana. Some states are starting to require doctors to take continuing medical education classes that discuss how marijuana interacts with other medications and affects the nervous system. In most states that allow medical marijuana, patients with qualifying medical conditions must receive certification from a doctor. Many doctors say that without knowing the health effects of marijuana, they are uncomfortable writing a certification. Many also say they are uneasy about dealing with medical marijuana because the drug remains illegal under federal law.

A new study finds medical services for people dependent on opioids rose more than 3,000 percent between 2007 and 2014, according to Kaiser Health News. The study is one of the first to analyze data from privately insured patients who are dependent on opioids. It was conducted by Fair Health, a nonprofit databank corporation focused on health care costs and insurance. Researchers used data from 150 million patients. A diagnosis of opioid dependence often leads to office visits, lab tests and related treatments, the study found. Patients with an opioid dependency diagnosis used these services 217,000 times in 2007, and 7 million times in 2014

As the Obama Administration and public health officials push for a reduction in prescription opioids, they are facing some resistance from both patients and doctors, experts tell The New York Times. Insurance coverage for alternative treatments is inconsistent, the article notes. The plans may not cover all treatments, or they may impose strict limits on coverage. Alternative pain treatments include acupuncture, yoga, chiropractic and osteopathic manipulation, massage, meditation and cognitive behavioral therapy. Medicaid does cover physical therapy for patients who gained coverage under the Affordable Care Act, but the level of coverage varies by state. Matt Salo, Executive Director of the National Association of Medicaid Directors, says benefits for alternative treatments are often the first to be eliminated when budgets are cut, because they are considered optional. A complicating factor is the widely varying amounts of evidence about the effectiveness of these treatments. Many patients resist nondrug treatments for pain, because...

Routinely prescribing naloxone to certain patients who take opioid medications might reduce the number of overdose deaths, a new study suggests. The study followed almost 2,000 people who were prescribed opioid painkillers for long-term pain at San Francisco clinics, HealthDay reports. About 38 percent were also prescribed the opioid overdose antidote naloxone. Patients were more likely to receive a prescription for naloxone if they were on a higher dose of opioids, or had experienced an opioid-related emergency room visit. Patients who received a naloxone prescription had 47 percent fewer opioid-related emergency department visits per month in the six months after receiving the prescription, and 63 percent fewer visits after one year, compared with patients who did not receive naloxone. Patients who received naloxone were told when and how to use the drug, which was provided in a nasal spray device. They were also told to ensure someone else knew where the...

Patients suffering from chronic pain say they are finding it more difficult to get prescriptions for opioid painkillers, The Boston Globe reports. Federal and state regulations to reduce access to opioids have made doctors and pharmacists more reluctant to prescribe and dispense the drugs. Chronic pain patients say they are frequently required to prove they are not addicted to opioids, the article notes. An estimated 100 million adults in the United States are thought to suffer from chronic pain. In many cases, the pain is caused by injury, disease or nervous system problems. There are a number of non-opioid treatments available, including anti-seizure drugs, antidepressants, devices such as spinal stimulators, physical therapy and meditation. While these treatments rarely stop the pain, patients often use a variety of these options to help them cope with it. Some patients see opioids as critical in helping them deal with their pain. Claire Sampson, Co-Chairwoman...