How can science combat the opioid crisis?

How Can Science Combat the Opioid Crisis?

IMAGE: University of Tennessee Extension has been awarded a grant for $324,841 to lead a joint effort to combat the opioid crisis in Tennessee via a pilot program called PROMPT TN… view more 

Credit: Image by Victor Moussa/Shutterstock.com

KNOXVILLE, Tenn. — University of Tennessee Extension will lead a new effort to combat the opioid crisis in rural Tennessee.

PROMPT TN (Preventing Rural Opioid Misuse Through Partnerships and Training) will combine the expertise of multiple institutions to develop opioid-specific resources designed to increase understanding of underlying causes of opioid misuse with the goal of preventing addiction.

With a grant of more than $324,000 from the USDA National Institute of Food and Agriculture, faculty from UT Extension, Tennessee State University and the East Tennessee State University Addiction Science Center will pilot the PROMPT TN program.

While existing programs address recognizing and preventing overdose and addiction treatment, PROMPT TN will focus on developing opioid-specific resources designed to increase understanding of the crisis's current underlying causes as well as work to prevent future addiction.

The opioid epidemic that is ravaging the nation is carving a particularly destructive path in rural communities in Tennessee, which has the third-highest per capita rate of opioid painkiller prescriptions in the country.

In 2017, 94 prescriptions existed for every 100 people–one and a half times greater than the national average. The Centers for Disease Control and Prevention identified 25 of the state's 51 rural counties as being in the top 5 percent of U.S.

counties vulnerable to rapid spread of HIV and hepatitis C, diseases that are often associated with illicit drug use.

With a long history of serving Tennessee's rural communities, UT Extension will lead the project and join forces with the partnering institutions in cooperation with the Tennessee Department of Health.

“The opioid crisis is unraveling the fabric of rural communities,” said Lisa Washburn, project leader and associate professor and UT Extension community health specialist in the Department of Family and Consumer Sciences.

“UT Extension is uniquely equipped to address this issue, as mobilizing communities to form local solutions is what we do.

Joining forces with our state and local partners, we expect this project will have a positive effect on this pressing need.”

PROMPT TN will use an innovative approach to address the opioid crisis. The project will work to enhance the ability of Extension educators, public health professionals and community members to address the opioid epidemic through training that addresses the complexities involved. Customizable templates will be developed for use in local efforts, and a resource hub will be established.

Next, faculty involved in PROMPT TN will identify factors that increase the risk of opioid misuse and abuse, as well as estimate the economic impacts.

“Opioid use and abuse have a profound effect on workforce productivity and availability which, in addition to increased hospitalization and emergency care costs, burden local economies of rural communities that are already struggling,” said Sreedhar Upendram, assistant professor with the UT Department of Agricultural and Resource Economics.

  • Lastly, the PROMPT TN project will help communities implement tested prevention programs that decrease risk factors such as community norms favoring drug use and low school commitment, while increasing protective factors such as strong family and neighborhood bonds and opportunities for prosocial behavior.
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  • Additional support for the two-year project will be provided by the Center for Communities That Care, an outreach effort of the Social Development Research Group within the School of Social Work at the University of Washington.

Through its land-grant mission of research, teaching and extension, the University of Tennessee Institute of Agriculture touches lives and provides Real. Life. Solutions. ag.tennessee.edu.

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HHS Awards Over $1 Billion to Combat the Opioid Crisis

This week, the U.S. Department of Health and Human Services awarded over $1 billion in opioid-specific grants to help combat the crisis ravaging our country. The awards support HHS's Five-Point Opioid Strategy, which was launched last year and enhanced this week. New data unveiled recently by HHS suggests that efforts are now yielding progress at the national level.

“Addressing the opioid crisis with all the resources possible and the best science we have is a top priority for President Trump and for everyone at HHS,” said Secretary Alex Azar. “The more than $1 billion in additional funding that we provided this week will build on progress we have seen in tackling this epidemic through empowering communities and families on the frontlines.”

“This week, HHS updated its strategic framework for tackling the opioid crisis, which uses science as a foundation for our comprehensive strategy,” said Admiral Brett Giroir, Assistant Secretary for Health and Senior Advisor for Opioid Policy. “With these new funds, states, tribes, and communities across America will be able to advance our strategy and continue making progress against this crisis.”

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How Can Science Combat the Opioid Crisis?

The 2017 National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), found that the number of Americans initiating heroin use dropped by around half from 2016 to 2017. The number of Americans misusing opioids also dropped for the second year in a row, and the number receiving specialty treatment for heroin use increased.

From January 2017 through August 2018, the amount of opioids prescribed in America has dropped by 21 percent. In the same time, the number of prescriptions filled for naloxone has increased 264 percent, while the number of prescriptions for buprenorphine, one form of medication-assisted treatment, has risen 16 percent (data from IQVIA's Total Patient Tracker).

  • The Trump Administration will continue working to make progress against the opioid crisis, which in 2017 claimed more than 130 lives per day.
  • This week's major grant announcements, most of them made possible by funding secured from Congress by President Trump in March 2018, are as follows:  
  • Substance Abuse and Mental Health Services Administration
  • SAMHSA awarded more than $930 million in State Opioid Response grants to support a comprehensive response to the opioid epidemic and expand access to treatment and recovery support services.
  • The grants aim to address the opioid crisis by increasing access to medication-assisted treatment using the three Food and Drug Administration (FDA) approved medications for the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder.

Columbia Creates New Center to Combat Opioid Epidemic

How Can Science Combat the Opioid Crisis?

Data Science Institute (DSI) researchers will be an integral part of a new center that unites experts from across Columbia University to combat the opioid crisis.

The Center for Healing of Opioid and Other Substance Use Disorders-Enhancing Intervention, Development, and Implementation (CHOSEN) will draw upon the expertise of faculty, researchers, and practitioners at Columbia to develop ways to treat opioid addiction in New York State.

“The misuse of and addiction to opioids and other substances is a public health emergency,” said Nabila El-Bassel, University Professor, Willma and Albert Musher Professor of Social Work, and a director of the new center. “The time has come to bring together the power of Columbia’s experts to create a university-wide approach to treating and healing addiction.”

Two DSI researchers are using statistical and data science techniques to understand the breadth and scope of New York’s opioid crisis.

 Smaranda Muresan, a research scientist at DSI and adjunct associate professor in the Department of Computer Science, collects and studies data from social media channels where opioid users discuss addiction, treatments, and related issues.

She uses Natural Language Processing to find patterns in the data and make predictions that will help understand why and how people use opioids and what can be done to help them.

Vincent Dorie, an associate research scientist at DSI, uses statistical models to estimate the effectiveness of opioid treatments. Eventually, he and other researchers will have granular data on where users receive treatment, whether at clinics, hospitals, or prisons. That data will help him and collaborators understand which treatments are most effective, he said.

“We’ll also have information on the services those institutions provide, e.g., naloxone, counseling job programs, etc.,” Dorie added. “Our goal will be to attempt to identify which kinds of treatments would yield the greatest impact at an individual level. And at a higher level we will be able to see which services, in conjunction, lead to the fewest overdoses.”

In 2017, more than 70,000 drug overdose deaths occurred in the United States, according to the Centers for Disease Control and Prevention. Opioids were involved in 47,600 of the overdose deaths and an estimated 2.5 million people have opioid-use disorder.

To help mitigate the epidemic, the new center will draw upon Columbia’s myriad strengths, with participation from Columbia’s School of Social Work, the New York State Psychiatric Institute’s Division on Substance Use Disorders, the Irving Institute for Clinical and Translational Research at Columbia University Irving Medical Center, Columbia Business School, and Columbia Engineering.

“It is just this sort of interdisciplinary approach, bringing in expertise from across Columbia’s campuses, that is needed to address such a major challenge,” said Ira Katznelson, Columbia’s interim provost. “It also provides tangible proof of the University’s commitment to the application of academic rigor to advance our efforts to tackle a significant societal problem.”

— Robert Florida, Data Science Institute

How Analytics Can Combat the Opioid Crisis

More than 2 million Americans are addicted to prescription pain pills and street drugs. Opioids now kill more Americans than car accidents or guns. The epidemic has reached crisis mode — the U.S. Department of Health and Human Services declared a public health emergency in 2017.

How do we combat a crisis of these growing proportions? Some of the smartest minds in the world are using data science and analytics to reduce opioid usage and treat addiction.

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In this 13-minute highlight reel of a South by Southwest (SXSW) panel on “Using Data Analytics to Combat the Opioid Crisis,” hear from Dean Stoecker, CEO and Chairman of Alteryx, as well as experts in healthcare, public sector, and analytics for a candid discussion around the positive impact of data analytics on the opioid epidemic and their respective approaches to fighting this crisis.

This panel recap covers:

  • How Intermountain Healthcare, a not-for-profit healthcare system, rose to its CEO’s challenge to reduce opioid prescriptions by 40 percent
  • What the Department of Health and Human Services is doing to move from “what happened” to “what is happening” with timelier data
  • How the Colorado Hospital Association is putting data into the hands of providers to drive action on the ground

When it comes to solving a crisis of this proportion, it’s either all of us or none of us. See how communities of healthcare and analytics professionals have come together to help their communities combat the crisis.

“More than 200 people die every day from the opioid addiction problem, and we are here to leverage data science and analytics to deal with this issue once and for all.”
— Dean Stoecker, CEO, Alteryx, Inc.; Panel Moderator

US health agency pours $350 million into fight against opioid crisis

A man says goodbye to his girlfriend before leaving for opioid addiction treatment.Credit: Todd Heisler/eyevine

The US National Institutes of Health (NIH) has awarded more than US$350 million to four research teams that will test ways of reducing accidental deaths from opioid use. The scientists will conduct their work in four states: Kentucky, Massachusetts, New York and Ohio. A fifth group, at RTI International in Research Triangle Park, North Carolina, will coordinate the overall effort.

The goal is to reduce opioid-overdose deaths by 40% in 3 years, and to create a blueprint that communities across the United States could use, NIH director Francis Collins said at a press conference on 18 April.

The effort is part of the opioid-research strategy that the NIH introduced in 2018. Researchers who received the latest grants will work with public-health agencies, the criminal-justice system, schools, pharmacies and other groups in the study communities.

They will test the effectiveness of several strategies for curbing opioid abuse and deaths; these include distributing drugs that can reverse opioid overdoses —such as naloxone — and programmes that connect people who have been convicted of drug crimes with addiction treatment.

Working simultaneously with different community groups — including government agencies, medical professionals and citizens — could help to curb the opioid crisis, Collins said. “This approach of trying to optimize one component at a time hasn’t solved the problem.”

doi: 10.1038/d41586-019-01288-2

Understanding, Preventing and Treating Opioid Abuse

More than 4 million Americans take opioid prescription pain relievers for nonmedical uses. More than 400,000 Americans use heroin, a powerful opiate drug. Many people report misusing prescription opioids before starting to use heroin. Each year, more than 28,000 Americans die from opioid overdoses.

Prescription opioids, such as hydrocodone, oxycodone, morphine and codeine, play a critical role in helping millions of people effectively manage chronic pain. But for some, opioids have become a complex, tangled cycle of misuse and abuse that has led to a devastating costs both to human life and economic impact of addiction.

For more than 30 years we’ve studied the use of illegal drugs, including heroin and the nonmedical use of opioid pain relievers.

We have collaborated with the Substance Abuse and Mental Health Services Administration (SAMHSA) on the National Survey on Drug Use and Health (NSDUH) since 1988 and have recently worked with SAMHSA to update and improve survey questions on opioid use in the United States.

With decades of NSDUH experience as a foundation, we are exploring multidisciplinary approaches to addressing the scope of the opioid epidemic from a number of key angles.

Our experts are studying prevention and public communication tactics, strategies to reach out to at-risk and vulnerable populations, the scope of the opioid overdose epidemic and its economic impact, and the cost-benefits of various treatment programs. Our experts are also conducting research into cutting-edge treatments for habitual opioid users as well as those dealing with chronic, unmanageable pain.

We are uniquely equipped to support the full spectrum of efforts to combat this epidemic—including treatment, prevention, intervention, pain management, and public communication. We believe there’s only one way to successfully handle a situation this complex: with a coordinated response from every angle.

Reversing the opioid epidemic | American Medical Association

The AMA Opioid Task Force recognizes the need for increased physician leadership, a greater emphasis on overdose prevention and treatment, and the need to coordinate and amplify the efforts and best practices already occurring across the country. Much more work remains to reverse the nation's opioid epidemic, and the AMA Opioid Task Force is committed to doing what is necessary to end the epidemic. 

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Read the latest “National Roadmap on State-Level Efforts to End the Opioid Epidemic” (PDF) from the Task Force, or read a short summary (PDF) of the report. The roadmap brings together the lessons learned through four individual state spotlight analyses and identifies best practices happening in the states to address the opioid epidemic.  

Download the 2019 Opioid Task Force Progress Report (PDF) to find out how physicians are progressing toward ending the nation's opioid epidemic.

New opioid task force recommendations

  • Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for U.S. Food and Drug Administration (FDA)-approved medications used as part of medication-assisted treatment for opioid use disorder.
  • Support assessment, referral and treatment for co-occurring mental health disorders, as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
  • Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
  • Support maternal and child health by increasing access to evidence-based treatment, preserving families and ensuring that policies are nonpunitive.
  • Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.

Goals of the task force

The AMA Opioid Task Force encourages physicians to take six actions:

To learn more about what the AMA is doing to combat the opioid epidemic, access additional resources or hear what other physicians are doing to improve and increase access to care, visit the End the Opioid Epidemic website.

Novel Treatment Strategies Could Help Combat the Opioid Crisis

Concerns over the opioid epidemic have sparked a strong scientific interest in why some people become addicted while others don’t. Now, researchers are proposing novel treatment strategies that could help prevent abuse of opioids and other substances.

In a report published in Psychological Science in the Public Interest, scientists in health behavior, neuroscience, pain management and addiction describe advances in brain science that can explain an individual’s vulnerability to substance abuse and dependency. Those discoveries hold implications for the opioid crisis in the United States and beyond, the authors say.   

“Addiction is a disease of decision-making; the majority of people have intact brain mechanisms of decision-making that keep them resilient to succumbing to an addiction,” says Antoine Bechara, lead author on the report and a psychological scientist at the University of Southern California. “But a small percentage have a weakness in this mechanism and they are rendered more vulnerable.“The advancement in science can help identify who those individuals are before exposing them to medications that have addictive potential,” Bechara adds. “The science can also help understand how we may treat those affected individuals.”Co-authors on the report are Kent C. Berridge, a professor of psychology and neuroscience at the University of Michigan; Warren K. Bickel, a behavioral health research professor, and assistant professor Jeffrey S. Stein, both at Fralin Biomedical Research Institute at Virginia Tech Carilion, and Jose A. Morόn, a professor of anesthesiology, neuroscience and psychiatry, and postdoctoral fellow Sidney B. Williams, both at Washington University in St. Louis.The article examines various neuroscientific findings and theories about drug-use behavior. It summarizes the role of the brain pathways involved in pain, pleasure, decision-making, craving and addiction. These include individual neurobiological characteristics that may impair self-control, reward-seeking and decision-making. Research on these mechanisms, the authors say, is spawning novel interventions for addiction. Clinicians are testing cognitive training approaches designed to temper a patient’s impulsive reward-seeking.  Scientists are also testing the use of non-invasive brain stimulation to reduce urges and drug craving.The authors say they were compelled to write the article because of the rise in addictive disorders, particularly opioids that are prescribed for acute and chronic pain. They point out that studies examining the brain mechanisms underlying opioids’ pain-relieving effects have largely been conducted with healthy participants exposed to pain in lab settings. They call for more research involving people experiencing chronic pain to better understand the neurological response to opioids. 

In an accompanying commentary, world-renowned cognitive neuroscientist Trevor W. Robbins, a professor of cognitive neuroscience at the University of Cambridge, agrees that neurobehavioral research is needed to investigate the underlying mechanisms of drug abuse and considers it particularly timely in the context of the opioid epidemic.

Robbins points to some aspects of the report that he believes need clarification, such as the environmental stimuli and different predisposing factors for different drugs.

He suggests that, besides the interventions suggested by Bechara and his colleagues, a neurosurgical procedure called deep-brain stimulation may be a viable treatment for addiction.

Reference: Bechara, et al. A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction. Psychological Science in the Public Interest DOI: https://doi.org/10.1177/1529100619860513 

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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