Opioid Dependence Treatment in the Emergency Department

To the Editor In the article about emergency department (ED)–initiated buprenorphine/naloxone treatment for opioid dependence, Dr D’Onofrio and colleagues omitted important information and then focused on the most optimistic outcomes to infer a benefit. (Source: JAMA)

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Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = −0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increa…

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Why Incarceration Is Not the Solution to the Opioid-Addiction Epidemic

By Aaron Fox, M.D., M.S.

Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison.

Incarceration Undermines Recovery
Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the att…

Why Incarceration Is Not the Solution to the Opioid-Addiction Epidemic

By Aaron Fox, M.D., M.S.

Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison.

Incarceration Undermines Recovery
Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the att…

Why Incarceration Is Not the Solution to the Opioid-Addiction Epidemic

By Aaron Fox, M.D., M.S.

Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison.

Incarceration Undermines Recovery
Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the att…

Why Incarceration Is Not the Solution to the Opioid-Addiction Epidemic

By Aaron Fox, M.D., M.S.

Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison.

Incarceration Undermines Recovery
Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the att…

Why Incarceration Is Not the Solution to the Opioid-Addiction Epidemic

By Aaron Fox, M.D., M.S. Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison. Incarceration Undermines Recovery Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the attent…

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Feds Now Pushing States Toward Medical Treatment For Heroin Addicts

WASHINGTON — For the first time, the federal agency responsible for most public funding of drug addiction treatment has added language to its grant applications designed to push the treatment industry away from the abstinence model. Treatment for substance abuse disorders in the United States widely follows this model, which rests on the belief that abstaining from all drugs, including medications prescribed specifically for addiction, is the only acceptable route to recovery. The new grant language from the Substance Abuse and Mental Health Services Administration encourages states to reject the status quo and to require the option of medication-assisted treatment in clinical settings. The new language appears in SAMHSA’s block grant application for fiscal years 2016-2017. The money…

Feds Now Pushing States Toward Medical Treatment For Heroin Addicts

WASHINGTON — For the first time, the federal agency responsible for most public funding of drug addiction treatment has added language to its grant applications designed to push the treatment industry away from the abstinence model. Treatment for substance abuse disorders in the United States widely follows this model, which rests on the belief that abstaining from all drugs, including medications prescribed specifically for addiction, is the only acceptable route to recovery. The new grant language from the Substance Abuse and Mental Health Services Administration encourages states to reject the status quo and to require the option of medication-assisted treatment in clinical settings. The new language appears in SAMHSA’s block grant application for fiscal years 2016-2017. The money…

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