Author: Shernide Delva
In the past, we’ve talked about the potential of opioid vaccines. These vaccines could have a major impact on lowering a number of opioid overdose deaths. They could completely shift the direction of how we treat opioid addiction. However, is the future of opioids imminent or far, far away?
Sadly, it will be a long time before we see opioid vaccines available for widespread use. Experts all agree that although the future of opioid vaccines looks bright, the process of getting a drug into the market is a lengthy one and we should not hold our breath just yet.
Recently, Health and Human Services Secretary Tom Price mentioned opioid vaccines as an exciting new development in the war against opioid abuse.
“One of the exciting things that they’re actually working on is a vaccine for addiction, which is incredibly exciting,” Price said during a briefing about the drug epidemic.
However, experts say it won’t be made public for years… if ever.
The process of a drug going from the research phase to the production phase is a long, tedious process. Opioid addiction vaccines have not even begun human trials yet. Researchers would have to put drugs through phase one, two and three trials before submitting them for approval by the Food and Drug Administration (FDA), given that the trials are successful.
“He may be a physician, but he’s not terribly well-informed about addictions,” said Dr. Thomas R. Kosten, a psychiatry professor at the Baylor College of Medicine with a concentration in addiction vaccines. “I can’t imagine the vaccine would be on the market before the Trump administration is over.”
Dr. Kosten knows all about vaccines. He worked on cocaine vaccines for 16 years before deciding that it “just didn’t work well enough” to continue. Today, he is working on a vaccine for fentanyl, an opioid painkiller up to 100 times stronger than morphine. Fentanyl has been a major culprit for overdose deaths in the current opioid epidemic.
Those who previously used painkillers turn to heroin due to the lower price and easier access. Unfortunately, often heroin is not just heroin and instead is laced with powerful painkillers like fentanyl which make a user much more susceptible to an overdose.
Dr. Kosten hopes his work on the vaccine will pan out, but he wants to ensure people are not holding their breath. These things take time.
“There are no opiate vaccines that have been in people at this point,” said Dr. Kosten.
Even if the vaccine passes trials and goes into full-scale production, it would only be used therapeutically, not as a preventative measure.
“The purpose is not to “mass-immunize a whole bunch of kids,” Dr. Kosten said. “That’s not at all what they’re designed for.”
For now, the vaccine is proving to be effective in animal testing. However, this is not necessarily good news.
“Sometimes, the translation from animals is not necessarily the same in humans. So we have to do the human studies,” said Dr. Ivan Montoya of NIDA’s Division of Therapeutics and Medical Consequences.
The goal of the vaccine is to allow the body’s own immune system to combat opioids before they can reach the brain and take effect.
“We don’t have to modify the brain to produce the effect,” said Dr. Montoya. “You take advantage of your own immune system and prevent access of the drug to the brain.”
In the future, Dr. Montoya hopes to come up with a vaccine that can block the effects of a wide range of opioids including fentanyl, heroin, and OxyContin.
While the prospect of opioid vaccines sounds promising, we are still far away from this becoming a reality. Therefore, stating vaccines as an exciting solution to the opioid epidemic is a bit of a stretch for now. Instead, the focus should be placed on increasing access to treatment. With the right program, recovery is possible. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Shernide Delva
These are just a few of the incentives doctors have received from prescription opioid companies. Did these goodies get you your last opioid prescription?
Could incentives be responsible for our current opioid epidemic?
That’s exactly what researchers set out to understand.
A recent report confirmed what many have suspected: doctors are receiving incentives from major opioid makers. In fact, one out of every 12 U.S doctors gets money, lunch or something else of value from companies that make opioid drugs, the study concluded.
Furthermore, companies are spending more time and effort marketing opioids to doctors than they are other less addictive painkillers. These finding will help understand why doctors have played such a major role in the opioid addiction crisis.
“A large proportion of physicians received payments — one in 12 physicians overall,” said Dr. Scott Hadland of the Boston Medical Center. “Tens of millions of dollars were transferred for marketing purposes for opioids.”
Dr. Hadland and colleagues went through databases from the Centers for Medicare and Medicaid Services, the federal government office that oversees public health insurance.
The 2010 Affordable Care Act includes the Physicians Payments Sunshine Act. This act required medical product makers to report any offerings or goodies made to doctors or to teaching hospitals. However, incentives are often disguised as something else.
“In some cases, they are money provided directly to physicians — for example, the speaking fees, the consultant fees and the honoraria. In other cases it is reimbursement for things like travel,” Hadland said.
On average, doctors get a single “payment,” usually a mean worth of $15 about once a year. Still, there are a select few doctors that are reaping the most benefits.
“The top 1 percent of physicians (681 of them) received 82.5 percent of total payments in dollars,” the team wrote in their report, published in the American Journal of Public Health.
These incentives could influence doctors to prescribe opioids to their patients:
“One of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” the study notes.
Between 2013 and 2015, the team found 375,266 payments totaling 26 million distributed to more than 68,000 doctors.
While larger fees mostly accounted for speaker fees, more leisurely incentives like food and drink accounted for 94 percent of the payments.
“I do think the practice is exceedingly common. Increasingly, medical schools are restricting the ability of pharma companies to come to speak to medical students and even faculty,” Hadland said.
With all this said, do small incentives really make a difference? After all, can a doctor really be bought for the price of a boxed lunch?
The research indicates that, yes, these little goodies do influence prescribing. Last year, a study revealed that physicians who accepted even one meal by a drug company were more likely to prescribe a name-brand drug to patients later.
This is not the first time investigations were conducted on possible incentives. After earlier controversies and studies, the Pharmaceutical Research and Manufacturers of America issued a voluntary code of conduct to curb the once widespread practice of handing out free mugs, prescription pads, and other swag covered in drug brand names.
Some cities and states especially hit by the opioid abuse epidemic have even sued drug makers saying their practices have helped fuel the problem. The CDC states doctors have contributed to the addiction crisis by prescribing opioids to too many patients. These prescriptions are often prescribed at high doses for too long which only increases the vulnerability to addiction.
The result is deadly.
There were more than 30,000 fatalities in the United States in 2015, the federal government said.
“I think that first and foremost we have known that one of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” said Michael Botticelli, former director of the White House Office of National Drug Control Policy, and now executive director of the Grayken Center for Addiction Medicine at the Boston Medical Center.
According to Botticelli, the answer is independent education, free of the need to promote a specific product.
“At the federal and state level (we may need to) move toward mandatory prescriber education to counteract industry’s influence over prescribing behavior,” he said. “Clearly, guidelines are not enough.”
For a long time, prescribing opioids was one of the first responses to pain management. Now other alternatives are being promoted such as pain management devices and holistic alternatives.
Botticelli agrees that while pain is a major problem, the answer is not more opioids.
“Yes, we want to make sure people’s pain is appropriately treated, but we know that longer and higher doses have significantly added to the addiction problem that we have in the United States,” he continued.
What are your thoughts? Did you know about these incentives? More studies are coming out revealing the back story to what led to the prescription opioid epidemic.
Opioid addiction has become a public health crisis. Now, more than ever is the time to seek treatment. Recovery is possible. You do not have to feel out of control. There is a solution. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Shernide Delva
The controversy surrounding the Megyn Kelly Sunday Night show continues. The first investigation piece on drug addiction focused on issues plaguing the South Florida recovery community.
Now, Megyn Kelly returns to cover addiction treatment, and this time her show is highlighting another polarizing subject: harm reduction programs. On Sunday night, Megyn Kelly’s shows featured The Sinclair Method. The Sinclair Method is a harm reduction treatment program that allows patients who struggle with alcohol use disorder to continue drinking.
The segment introduces viewers to Marisa, a 25-year-old binge drinker. The crew follows Marisa around for day one of her introduction to The Sinclair Method.
First Marisa sees a doctor, who gives her a prescription. Shortly after taking the prescription, she has a drink. According to Marisa, her intense cravings to binge disappears.
“I feel like I could have another drink or not have another drink and be totally fine,” she tells the camera.
The apparent miracle pill is naltrexone, a commonly used opioid antagonist typically used to treat heroin addiction. However, under The Sinclair Method, the drug is used to treat alcoholism.
“The drug blocks pleasure receptors in the brain―a buzzkill,” Melvin explains in a voiceover. “And when combined with psychotherapy sessions, the theory goes, eventually the cravings go away.”
Essentially, the idea behind the program is patients take naltrexone before drinking and over time, the desire to excessively drink diminishes. For Marisa, the unorthodox treatment seems to have worked. Only three months after starting the treatment, she told NBC she had lost her drive to drink.
Still, this approach is far from traditional. The 12-step model of addiction promotes abstinence only treatment. The show highlighted an interview with Hazelden Betty Ford’s executive director, Chris Yadron.
“The 12 steps are crucial because it’s a spiritual program of recovery,” he told Melvin.
Dr. Mark Willenbring who once ran the NIH’s alcohol recovery research defended The Sinclair Method, added that 12-step approaches do not rely on modern science.
“We don’t send someone with diabetes to a spa for a month, teach them diet and exercise and then say, ‘Go to support groups, but don’t take insulin.’ I mean, that’s the absurdity of what we’re doing now,” he said. “We’re still providing the same pseudo treatment that we provided in 1950. And 85% of rehabs in the country are 12-step rehabs. People don’t have any choice.”
The tension between abstinence-based and harm-reduction approaches to treatment has created a long-standing controversy in the recovery community. Throughout the segment, tweets were displayed from people who were for and against harm reduction strategies.
“This is very troublesome to see that some doctors are giving people with a thinking disease a “magic” pill,” tweeted one user.
Others felt the treatment option provides another solution than the standard abstinence-only approach. We’ve seen harm reduction programs like Moderation Management receive massive criticism, specifically after the founder, Audrey Kishline, killed a 12-year old girl and her father while driving in an alcoholic blackout.
Overall, programs like these remain controversial and risky. It is best to get treatment to address the underlying issues behind your addiction. If you are struggling with mental illness or addiction, please call now.
CALL NOW 1-800-951-6135
Author: Shernide Delva
Each year, more than 300 million people are affected by depression. Depression is a debilitating illness that is difficult to treat.
What if there was one gene that played a key role in depression? Furthermore, what if that gene could be identified and even manipulated to actually treat depression?
Shockingly, this could all be a possibility. Researchers have discovered a gene that may play a central role in depression. This gene either protects us from stress or triggers a downward spiral depending on its level of activity.
The study was conducted by researchers at the University of Maryland School of Medicine (UM SOM). It was the first to pinpoint in detail how one particular gene, known as Slc6a15, is a key role in depression. The study found the same link in both animals and humans.
“This study really shines a light on how levels of this gene in these neurons affects mood,” said the senior author of the study, Mary Kay Lobo, an assistant professor in the Department of Anatomy and Neurobiology.
“It suggests that people with altered levels of this gene in certain brain regions may have a much higher risk for depression and other emotional disorders related to stress.”
Potential Treatment Solution?
A study like this could help with treating depression in the future, and that help is desperately needed.
Nearly 800,000 people die annually from suicide. It is the second leading cause of death among people between the ages of 15 to 29. Beyond that, depression destroys the quality of life for tens of millions of patients, and their families suffer too. Although environmental factors play a significant role in many cases of depression, genetics are equally as important.
This is not the first time this gene was studied. Back in 2006, Dr. Lobo and her colleagues found that the Slc6a15 gene was common in specific neurons in the brain. They recently demonstrated that these neurons were important in depression.
Connection to Anhedonia
Her lab decided to investigate the specific role these neurons have in depression. In the latest study, she and her team focused on a particular area of the brain called the nucleus accumbens. This region is crucial in the brain’s “reward circuit.”
When you eat a delicious meal or participate in any kind of enjoyable experience, neurons in the nucleus accumbens are activated letting you know the experience is enjoyable. When a person is depressed, it ‘s hard to experience any kind of enjoyment, a condition known as anhedonia.
Researchers discovered subset neurons in the nucleus accumbens called D2 neurons. These neurons respond to the neurotransmitter dopamine, which plays a central role in the reward circuit.
Mainly, these subset neurons responded to feel good chemicals like dopamine which is lacking in those with depression. Next, they studied mice susceptible to depression. These mice tended to withdraw from activities and exhibit behavior indicating depression such as social withdrawal and lack of interest in the food they would normally enjoy.
Dr. Lobo found that when the mice were subject to social stress, the levels of the Slc6a15 gene in the D2 neurons of the nucleus accumbens was noticeably reduced. The researchers also studied mice in which the gene had been reduced in D2 neurons. When those mice were subjected to stress, they also exhibited signs of depression. Furthermore, when researchers increased the levels of Slc6a15 levels in D2 neurons, the mice showed a resilient response to stress.
So what does this mean?
Next, Dr. Lobo looked at brains of humans who had a history of major depression and who had committed suicide. In the same region of the brain as the mice, the gene Slc6a15 was reduced. This indicates that the link between gene and behavior is found in both humans and mice.
In the future, manipulating these genes could help improve depression. While it is still unclear how Slc6a15 operates in the brain, Dr. Lobo states it may work by altering neurotransmitter levels in the brain.
This research could lead to therapies that focus specifically on this particular gene to treat depression. If you are struggling with substance abuse or mental illness, call now. Do not wait.
CALL NOW 1-800-951-6135
Author: Shernide Delva
In the past, we’ve talked about the effects opioids have had on the workforce. We’ve analyzed issues such as how employers handle addiction and how to take time off to seek treatment.
However, a recent article delved further into the complications opioid use have on the workforce.
What if I told you that fewer people were looking for a job or had a job because of opioid addiction?
It turns out, this is a real possibility.
Workforce participation is defined as the number of people working or actively looking for work. Workforce participation has decreased significantly, despite increases in job creation and decreases in unemployment.
One economist points out this decrease may be due to an unlikely cause: opioid addiction.
“Use of both legal prescription pain relievers and illegal drugs is part of the story of declining prime-age participation, especially for men, and this reinforces our doubts about a rebound in the participation rate,” said David Mericle, senior U.S. economist at Goldman Sachs, who prepared a report on the issue earlier this week.
This belief is contrary to recent CBS reports which noted that the decline in workplace participation was due to less demand for lower skilled workers and rising disability rates.
On the contrary, David Mericle argues the reduction in workplace participation has more to do with opioid abuse.
“Data on substance abuse treatment episodes also reinforce the narrative: Of admissions of individuals not in the labor force, 58% described themselves as being out of the labor force for ‘other’ reasons—meaning they aren’t students, disabled, retired, inmates or homemakers—and 47% of these admissions were for opioids, well above the average rate,” he wrote in the report.
This issue simply cannot be ignored.
The opioid crisis has a clear impact on workplace participation because those who struggle with opioid addiction may quit their jobs or get fired. Then, those same people will not apply for other jobs due to their concerns regarding their ability to meet the demands of the work or even pass a drug screening.
“Especially in companies that hire drivers, we hear a lot about how the drug tests are a problem there,” Gad Levanon, chief economist for North America of The Conference Board told CBS. “Many of [the applicants] don’t pass it, so they can’t hire them—and they don’t know many aren’t even trying.”
Opioid abuse is rampant in the same demographic that has seen the largest decline in workforce participation. Opioid use is prevalent in rural areas which commonly struggle economically. A report stated that 22 out of 25 most impacted by opioid abuse are in rural areas or the South.
Which Came First: Economic Hardships or Opioid Abuse?
Mericle did not elaborate on how economic hardships may have influenced opioid abuse in these rural areas or vice versa. He concluded that the opioid epidemic “is intertwined with the story of declining prime-age participation, especially for men.” Essentially, it is hard to determine what led to what.
What do you think? Should we blame the decrease in workforce participation on opioid abuse or do other factors play a more significant role? Regardless of the effect opioids have on the workforce, the reality remains that it is a serious problem.
People who struggle with addiction often quit their jobs, or refuse to look at all because of their addiction. Therefore, a push for treatment is critical. If you are struggling with substance abuse or mental illness, call now. Do not wait.
CALL NOW 1-800-951-6135