Search

In an atmosphere of great uncertainty over the direction drug policy will take in a new administration in Washington, there remains at least some speculation that a likely de‐emphasis on harm reduction could result in a greater focus on primary prevention. [ABSTRACT FROM AUTHOR]

As always, ADAW's Preview issue includes this review of stories in the previous year. We couldn't include everything in the 48 eight‐page issues, but rather focus on some significant areas. The dates refer to the issue the articles appeared in. Click on the links for the abstracts. [ABSTRACT FROM AUTHOR]

As harm reduction – with its varied definitions – becomes more mainstream, establishment medical journals are providing information to help clinicians. In the November 18 issue of the Journal of the American Medical Association (JAMA), one article focuses on how to tell patients who have opioid use disorder (OUD) about harm reduction and another provides an overview of different strategies to achieve this. [ABSTRACT FROM AUTHOR]

ADAW attempted to get a nice definition of "safe supply" last month; typically a quiet news time, August is perfect for delving into such projects. Safe supply has apparently been rejected as a phrase because even the harm reduction community recognizes that opioids are not "safe," but that drugs which do not contain illicit fentanyl, for example, are "safer" than those that do. The entire question arises as a response to the opioid overdose epidemic which shows little sign of abating in the United States. [ABSTRACT FROM AUTHOR]

Last year, 5.9 million people initiated vaping nicotine — more initiation than of any other substance — according to the National Survey on Drug Use and Health (NSDUH). The results, released last week by the Substance Abuse and Mental Health Services Administration (SAMHSA), also show that 9.4% of people ages 12 or older vaped nicotine in the past month, which is up from 8.3% in 2022. Also, people under age 21 are using marijuana even more than alcohol on a regular basis despite it being illegal. [ABSTRACT FROM AUTHOR]

Last month's release of the 2024 National Drug Control Strategy appears to have created barely a murmur so far in the policy community — there isn't even a formal media announcement about the strategy's availability on the Office of National Drug Control Policy (ONDCP) website. Besides its usual focus on past progress and future priorities in interdiction, prevention, treatment, harm reduction and data collection, the newly published strategy addresses the broader social initiatives that can have an impact on the trajectory of addiction and recovery, from housing policy reform to job creation. [ABSTRACT FROM AUTHOR]

In February of 2017, when President‐Elect Donald Trump was just into his first month in office, he proposed eliminating the Office of National Drug Control Policy. We covered this story in depth (see ADAWhttps://onlinelibrary.wiley.com/doi/10.1002/adaw.30864), and one former federal employee told us at the time: "Elections have consequences. Fundamentally, it's a Trump administration now." It's true again, but this time, addiction treatment and prevention groups are better organized. The message is not one of gloom and doom: it is one of how to show that your programs have impact, a different former federal employee – who was with the government for almost four decades and whose boss changed with every new administration (and who survived every change) – told ADAW last week. [ABSTRACT FROM AUTHOR]

The article discusses the coverage and prior authorization parts of the Medicare Advantage (MA) Rule in 2024 and their impact on physical therapy (PT) services. Topics covered include the MA plan's need to demonstrate an appropriate termination of coverage, scrutiny of MA plans on medical necessity decisions, and the definitive establishment of criteria in original Medicare. Also noted is the limiting of prior authorization in confirmation of diagnoses to ensure continuity of care.

The article discusses the spread of misinformation about marijuana and THC, particularly in relation to mental health. The author argues that the belief that marijuana is safe and has medicinal benefits is misleading and can have negative consequences, especially for vulnerable individuals seeking relief from mental health issues. The article highlights the increase in THC potency and its association with worsening depression, anxiety, psychosis, and suicidal behaviors. It also addresses the lack of FDA approval for cannabis and cannabinoids as medical treatments and the limited control physicians have over the type and potency of cannabis products. The author emphasizes the importance of providing accurate information to clients so they can make informed decisions about drug use. [Extracted from the article]

A bill introduced this month in the California State Assembly would end harm reduction's exclusivity as the approach to addressing persons with substance use issues who live in housing developed under state's Housing First guidelines. If approved, the legislation would allow up to 25% of state housing funds to be allocated to drug‐free housing under an abstinence model. [ABSTRACT FROM AUTHOR]

"Yikes." That is the most common reaction from experts in the field to the revelations of a transcript, leaked by the Greater Harlem Coalition, of an interview between the organization's president, Shawn Hill, and researchers from Yale University. The transcript is of more than the interview; it is of a "hot mic" recording when the researchers — Ryan McNeil, Ph.D., director of Harm Reduction Research, Program in Addiction Medicine at Yale University and his colleague, Lisa Bonilla — apparently didn't realize they were being recorded and made disparaging remarks about Hill (ADAW quotes from the transcript below). Both researchers publicly apologized. However, a deeper concern is the possible subversion of research, in which a predetermined result is manipulated. [ABSTRACT FROM AUTHOR]

New York Governor Kathy Hochul has proposed cutting the budget of the state's Office of Addiction Services and Supports (OASAS) by more than 13% and supplanting the funding with money from the opioid settlement fund. This, according to treatment providers and other experts, is not good policy. [ABSTRACT FROM AUTHOR]

The parting comments of British Columbia's former chief coroner about the region's continued increase in drug‐related deaths have reignited an already heated debate over the province's much‐watched harm reduction strategies for combating the opioid crisis. [ABSTRACT FROM AUTHOR]

Proposed legislation that has been introduced in both houses of Congress would establish the first dedicated stream of federal funding for gambling addiction treatment, prevention and research. Supporters of the measure acknowledged that the effort to pass it likely will extend beyond the current session of Congress, given an overall lack of movement on new legislation and the reality of a national election this year. [ABSTRACT FROM AUTHOR]

A registered nurse and lead author of a journal article on skin wounds associated with the increasingly prevalent street drug adulterant xylazine said she was motivated to publish on this topic because of a disturbing "catch‐22" her patients experience. Among people who use drugs, the presence of these skin lesions often will shut them out of admission to an inpatient detox or rehabilitation program. At the same time, they are often denied entry to a skilled nursing facility for wound care because they are actively using. [ABSTRACT FROM AUTHOR]

The co‐author of a widely shared article in which he argues that the move to destigmatize the use of hard drugs has gone too far said many field professionals have told him that he has aired concerns they have been afraid to voice. [ABSTRACT FROM AUTHOR]

Along with the new money and attention that has been devoted to the addiction crisis have come new players and new opportunities for competition and, in some cases, conflict. As 2023 came to a close, ADAW asked leaders representing diverse sectors of the field to characterize the landscape in advocacy, and most reported seeing at least an honest attempt to find areas around which the prevention, harm reduction, treatment and recovery communities can coalesce. [ABSTRACT FROM AUTHOR]

As always, ADAW's Preview issue includes this review of stories in 2023. We couldn't include everything but did focus on the areas that required in‐depth reporting, including methadone reform, which is a moving and controversial target. Click on the links for the abstracts. Subscribers can read full articles. [ABSTRACT FROM AUTHOR]

Overdose deaths tripled among 35 to 44‐year‐old pregnant and postpartum women (PPW) from 2018–2021 and rose markedly in all pregnant and postpartum girls and women ages 10 to 44, a new study by the National Institute on Drug Abuse (NIDA) has found. The study, "Pregnancy and Postpartum Drug Overdose Deaths in the US Before and During the COVID‐19 Pandemic," was published Nov. 22 in JAMA Psychiatry by Beth Han, M.D., Ph.D., and colleagues from NIDA. [ABSTRACT FROM AUTHOR]

Observing a need to combat youth mental health crises linked to social media, California lawmakers have introduced legislation to require social media platforms to prominently display black box warning labels consistent with recent calls to action by the U.S. Surgeon General, according to a news release from the office of California Attorney General Rob Bonta. [ABSTRACT FROM AUTHOR]

The oft‐cited statistic of 100,000 overdose deaths a year in the United States has an oft‐unspoken hidden additional tragedy: the children left behind when a parent dies. [ABSTRACT FROM AUTHOR]

In a Morbidity and Mortality Weekly Report (MMWR) released last week, the federal Centers for Disease Control and Prevention (CDC) reported that overdose (OD) deaths from smoking illegally manufactured fentanyls and fentanyl analogs have increased dramatically, from 13.3% to 232.1% from 2020 to 2022. The study, "Routes of drug use among drug overdose deaths — United States, 2020‐2022" is by Lauren J. Tanz, ScD, and colleagues at the CDC and the Oak Ridge Institute for Science and Education. [ABSTRACT FROM AUTHOR]

The article discusses the concept of harm reduction as a foundational philosophy of care in addressing the opioid crisis. Harm reduction interventions aim to minimize the risks associated with drug use and lessen the trauma caused by drug policies and laws. These interventions are available to people who use drugs whether they want to stop using or not. The article argues that harm reduction should be prioritized over residential treatment programs, as it provides support, respect, and love to individuals struggling with drug use, and promotes a sense of security and value that is necessary for success in any type of treatment program. [Extracted from the article]

Results of a new study suggest that more comprehensive care for justice‐involved individuals with opioid use disorder (OUD), including mental health treatment, could prove critical to reducing the high risk of post‐incarceration overdose. [ABSTRACT FROM AUTHOR]

In a 1959 article, John C. Ford, SJ (1902–1989), proposed the existence of a new virtue to regulate recreational drug use which he names "pharmacosophrosyne." This article analyzes the soundness of Ford's proposal and extends it by providing a mereological analysis of how pharmacosophrosyne relates to the virtues of temperance and sobriety. It then shows how understanding both pharmacosophrosyne and sobriety can inform a moral evaluation of recreational drug use. [ABSTRACT FROM AUTHOR]

With fentanyl's influence accounting for most of the changes in local and national drug trends, it should come as no surprise that fentanyl appears to be responsible for a major shift in the profile of methamphetamine‐related deaths in Los Angeles County. A significant increase in deaths in which opioids were a contributing factor has been accompanied by a drop in deaths with associated cardiovascular factors, a primary danger of stimulant use. [ABSTRACT FROM AUTHOR]

A Massachusetts policy that mandates child abuse/neglect reporting when a mother has taken medication for opioid use disorder (MOUD) during her pregnancy causes tangible harms to these women and their families, a newly published analysis suggests. The report's gripping comments from women who were subjected to child protection system (CPS) investigations illustrate the sharp contrast between the medical advice they had received during their pregnancy and the way that state child welfare officials treated them. [ABSTRACT FROM AUTHOR]

The interview with Kit Regan, a care worker and housing activist, delves into their experiences of homelessness in Melbourne and the impact of heat on unhoused individuals. Regan discusses the challenges faced during summers, such as lack of access to cool places and the compounding effects of heat on isolation and mental health. They emphasize the importance of outreach work and systemic change to address housing injustice and support marginalized communities in public spaces. The interview highlights the need for equitable access to public spaces and challenges the power dynamics that perpetuate inequities for unhoused individuals. [Extracted from the article]

Copyright of Reflet de Societe is the property of Reflet de Societe Plus and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recovery housing, aka sober living facilities, have long existed as safe, supportive places designed for people with severe substance use conditions to live while they build recovery capital. In recent years, shifts in drug use patterns and changing public policy definitions have created challenges to the safe environment within recovery housing. One example of how this is unfolding is the California Sober Lifestyle in which people stop all drug use but cannabis. [ABSTRACT FROM AUTHOR]

Last month, harm reduction experts, politicians, and academics joined to call for overdose prevention centers (OPCs) in a "virtual press conference" hosted by the Drug Policy Alliance (DPA). "As we have seen here today, the movement to expand OPCs is strong and gaining even more momentum across the country," said Kellen Russoniello, DPA's director of public health, on Aug. 27. "We know we cannot wait any longer. Our community members, our friends, our families continue to die while policymakers fail to support proven public health interventions. It is not acceptable to let stigma, fear mongering and politics continue to prevent the approaches that will save our loved ones. Every day that our elected leaders delay action on evidence‐based solutions to the overdose crisis, more lives are needlessly lost. We need decisive action in support of OPCs now." OPCs, also known as safe consumption sites, are places where drug users can go to inject or otherwise self‐administer their drugs, and be rescued if they overdose. They can also get many other services there, but there are only a handful operating in the United States. [ABSTRACT FROM AUTHOR]

The WHO differentiate between HRTS and HRPS calling the latter novel and emerging tobacco and nicotine products including heated tobacco products (HTPS) electronic nicotine delivery system (ENDS) electric non - nicotine delivery system (ENNDS) and other products. The Royal Collegeof Physician RCPS UK recently released their UK report Smoking and health 2021. Pakistan has serious problem of tobacco addiction. [Extracted from the article]

Results of a new study suggest that a sufficiently resourced syringe services program (SSP) could become an ideal venue for improving buprenorphine initiation and retention in patients with opioid use disorder (OUD). Researchers for the study's pilot program at a Miami‐based SSP credit the removal of common barriers to care for the successes of the initiative's harm reduction‐focused approach. [ABSTRACT FROM AUTHOR]

The American Society of Addiction Medicine (ASAM) is not in favor of opioid treatment programs (OTPs) being in charge of methadone treatment and instead wants its members — office‐based prescribers — to treat patients. This is not news; several years ago, ASAM's president sat on the dais with AATOD (American Association for the Treatment of Opioid Dependence) president Mark Parrino at the AATOD conference, and buprenorphine was still highly restricted. Those days are long gone. Fresh from its victory in removing the X‐waiver for buprenorphine, ASAM is now demanding that methadone be prescribed by physicians who are not OTPs, and is doing so at the exact time that the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a clear proposal for making methadone treatment easier to access (https://onlinelibrary.wiley.com/doi/10.1002/adaw.33643). [ABSTRACT FROM AUTHOR]

Making more high‐quality treatment available for individuals with substance use disorders (SUDs) might be a top priority, but it will not in and of itself stem the tide of overdose deaths in the U.S., a new report suggests. The RAND Corporation's comprehensive report states that policymakers must embrace novel, even unconventional, strategies that acknowledge the effects that an initiative in one system can have on outcomes in another. [ABSTRACT FROM AUTHOR]

The article discusses the impact of disruptive innovations, specifically electronic cigarettes, on health regulation in the European Union. It explores how technological changes challenge the institutional arrangements of professions, focusing on the framing contests between professionals and non-professionals. The study highlights the challenges faced by medical and public health professionals in regulating electronic cigarettes, as they were contested by industry representatives, users, and politicians advocating for harm reduction in tobacco control. The implications of this research are discussed for researchers and policymakers in the field of health regulation. [Extracted from the article]

Researchers from the Georgia Institute of Technology have conducted a study on the consumption patterns of alcohol, cannabis, and opium in Bengal, India, from 1911 to 1925. The study found evidence of substitution between alcohol and cannabis bud, with cannabis leaf acting as a complement for alcohol but a substitute for cannabis bud. Additionally, the research revealed negative income elasticity for alcohol, cannabis bud, and opium consumption, which can inform harm reduction strategies. Financial support for the study came from the National Institutes of Health (NIH) in the USA. [Extracted from the article]

A recent study conducted at Washington State University focused on the perceptions of combined pharmacobehavioral treatment for American Indian individuals with opioid use disorder (OUD). The research highlighted the importance of culturally appropriate and patient-centered approaches to OUD treatment, emphasizing the need for interventions that are compassionate and aligned with Native heritage and traditional medicine. Participants in the study expressed satisfaction with the Tribally run treatment program, which made treatment more accessible and emphasized the importance of clear communication and tailored, holistic care. The study concluded that treatment providers, researchers, and policymakers should consider integrating more culturally aligned interventions for American Indian patients with OUD. [Extracted from the article]

Researchers at the University of British Columbia Okanagan campus have developed an Index of Cannabis Equivalence (ICE) to standardize cannabis dosing across different consumption methods. Published in the Journal of Psychoactive Drugs, the study aims to establish guidelines for cannabis dosing comparable to the standard drink for alcohol. The ICE proposes equivalencies for "low-dose" cannabis consumption, such as two puffs from a joint, one 5 mg THC edible, a quarter dab of concentrate, or one bong hit, based on user-reported experiences. These guidelines prioritize safety and accessibility, particularly for new or infrequent users, and aim to support harm reduction, public health initiatives, and consumer education. [Extracted from the article]

A recent study conducted by researchers at California State University focused on advancing equitable access to harm reduction supplies, including naloxone, in Kern County, California, to reduce opioid-related morbidity and mortality. The researchers collaborated with local coalitions and secured funding to implement an outdoor harm reduction vending machine (HRVM) in Bakersfield. Through community engagement, consultation with experts, and securing grant funding, the researchers successfully launched the county's first HRVM and ordered two additional machines, aiming to enhance health equity through improved feasibility, acceptability, and sustainability of community-based harm reduction initiatives. [Extracted from the article]