This Week in the ASAM Weekly

According to results from the 2021 National Survey on Drug Use and Health, nearly 1 in 3 adults in America had either a substance use disorder (SUD) or any mental illness (AMI) in the past year, almost half of all young adults had either a SUD or AMI, and for many with either (SUD or AMI) the COVID pandemic was a global stressor (NSDUH). Not often captured by NSDUH surveys, incarcerated individuals represent a broad population at high risk for opioid use disorder (OUD) and opioid-overdose deaths. Providing them with best practices in a continuum-of-care model would save many lives and reduce recidivism, which is especially important for counties highly impacted by the opioid epidemic (Health & Justice). 

Individuals with OUD have unique perspectives on OUD treatment success, but study measures may not capture their quality of life concerns and so there is still much to learn by simply asking “are you happy?” (Substance Abuse Treatment, Prevention, and Policy). Contingency management (CM) works on the seemingly simple principle of operant conditioning yet has historically been held back by the complexities of human leadership. As such, Northwest ATTC developed an online training course that helps community-based programs implement this empirically supported, yet under-utilized therapy (JSAT).

Just in time for people to break their Dry January fasts from alcohol (NY Times), leading experts discuss how mocktails and fake beer can be a healthy choice for many but a cue-induced risk for individuals with AUD (Washington Post). Whether these alcohol-free trends will sustain healthier outcomes remains to be surveyed. 

Thanks for reading,

Nicholas Athanasiou, MD, MBA, DFASAM
Editor in Chief

with Co-Editors: Brandon Aden, MD, Debra R. Newman, PA-C, MSPAS, MPH, Jack Woodside, MD, John A. Fromson, MD

Lead 

Availability of best practices for opioid use disorder in jails and related training and resource needs: findings from a national interview study of jails in heavily impacted counties in the U.S. 🔓

Health & Justice

This study investigated OUD best practices in US jails in those counties heavily impacted by overdose. Core best practice domains included screening, clinical assessment by qualified treatment provider, medically managed withdrawal, medication for opioid use disorder (MOUD) administration, services for pregnant women, counseling/wrap-around services, collaboration with community MOUD providers, assistance with Medicaid/insurance coverage, re-entry services, and overdose prevention. Some 92% reported some MOUD availability, but only 20% provided it to persons assessed with OUD. Best practices were more common in counties with larger populations, a higher percentage of Hispanic residents, fewer people living below the poverty line, and fewer jail admissions. A number of challenges including MOUD funding, training, and addressing stigma were reported. This study highlights the impact of lost opportunities for reducing disease, death, and recidivism that result from the lack of greater MOUD availability and accessibility.

Mark Your Calendars for this Annual Conference 2023 Session

Bridging the Gap between Science and Clinical Practice in Addiction Medicine

Saturday, April 15, 2023 | 3:45 PM – 5:00 PM

Dr. Geetha A. Subramaniam, MD,  DLFAPA, DFAACAP, will provide a brief overview of the National Drug Abuse Treatment Clinical Trials Network. In this presentation, she will review ongoing and recently completed trials in the area of treatment and early intervention of substance use disorders.

Learn More and Register Here.

Research and Science

Cannabis companies and the sponsorship of scientific research: A cross-sectional Canadian case study 🔓

PLOS ONE

This cross-sectional, descriptive, meta-research study describes the characteristics of research that reports funding from, or author conflicts of interest with, Canadian cannabis companies. The companies were found to likely be analogous to peer industries by sponsoring research related to product development, expanding indications of use, and supporting key opinion leaders. Given the recent legalization of cannabis in Canada, there is ample opportunity to create a policy climate that can mitigate the harms of criminalization as well as the impacts of the “funding effect” on research integrity, research agendas, and the evidence base available for decision-making.  Importantly, policies should promote high-priority and equity-oriented independent research.

Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program 🔓

Substance Abuse Treatment, Prevention, and Policy

This study conducted semi-structured interviews with 28 people receiving MOUD in Philadelphia. The authors note that traditional measures of success for MOUD include retention in treatment, adherence to MOUD, and refraining from use of opioid and other drug use. This study identified items the people in MOUD themselves felt were indicators of success. Items identified as having high importance included stable housing, not using opioids, being happy, and a sense of self-worth. Items identified as of low or no importance included abstinence from all drugs, decreasing OD, and decreasing ED or hospital visits. The authors conclude that measures of success for people in MOUD are complex and multi-dimensional.