Amid the growing opioid crisis in the United States, the capacity of available treatment programs is falling short of demand. As a result, people needing treatment for dependence on heroin or prescription painkillers have to wait for months, sometimes even years, to get appointments with certified doctors or to find slots in rehabilitation programs. While waiting to consult the experts, they are at risk of contracting HIV or hepatitis infections, as well as dying from a drug overdose.
To address the opioid-related risks in people waiting for addiction treatment, Dr. Stacey Sigmon and her colleagues at the University of Vermont’s College of Medicine have come up with a new therapeutic approach. They have developed an interim dosing treatment that can help reduce use of illicit opioids and injectable drugs among waitlisted patients.
The intervention suggested by Sigmon would save patients from frequent visits to a doctor or a clinic. The opioid addiction treatment combines buprenorphine, a medication approved by the U.S. Food and Drug Administration (FDA), and an electronic dispenser that provides a single daily dose on its own. The mechanism involves locks and alarms to ensure medical adherence and prevent tampering. It also has an automated phone-based monitoring system and random callback visits for pill counts and urine testing. This is a temporary arrangement for waitlisted patients seeking opioid treatment, allowing them to start taking medication immediately while they wait for a community-based comprehensive program and medication assisted treatment in patients with opioid use disorder.
The 12-week trial focused on establishing the efficacy of the intervention showed positive results. The study found that the interim buprenorphine helped waitlisted opioid-dependent participants experience abstinence from illicit drug use. The researchers recommended the interim therapy as an effective approach to help patients prevent the potentially fatal dangers of illegal opioid use while they await an intensive-care program.
Opioid crisis and Medication assisted treatment in patients with opioid use disorder
The opioid epidemic has been affecting millions in the country. The 2016 National Survey on Drug Use and Health (NSDUH) suggests that 11.8 million Americans aged 12 or older misused opioids in the year. The country reported highest opioid misuse among young adults aged 18 to 25, recording an annual incidence of 7.3 percent in the past year. The opioid epidemic has been claiming thousands of lives each year. According to the Centers for Disease Control and Prevention (CDC), misusing opioids – heroin, fentanyl and prescription drugs – led to 33,091 deaths in 2015. Moreover, non-fatal unintentional opioid poisoning contributed to around 53,000 hospitalizations and 92,262 emergency department (ED) visits across the country.
Heroin, in particular, wreaked havoc in the past years. The CDC reported a two-time increase in heroin use among young adults aged 18 to 25 in the past decade. With increased use of the drug, heroin-related overdose deaths have also grown significantly, witnessing a four-fold increase since 2010. Heroin-related overdose death rates saw a 20.6 percent increase between 2014 and 2015, with around 13,000 people dying from the same in 2015 alone.
Dealing with heroin abuse
Researchers indicate a strong association between past misuse of prescription opioids and initiating heroin use. Besides, official data shows that more than 90 percent of people who used heroin also reported use of at least one other drug. Increased availability and relatively low price (compared to prescription opioids) are some common factors contributing to the rising use of heroin. Taking strict action against drug dealers and educating people about dangerous consequences of heroin use can help deal with the problem.