A weekly roundup on the latest research and news in addiction, treatment, medicine and science
By William Wagner
November 17, 2020Prescribing opioids to patients with psychiatric conditions can be a delicate and sometimes fraught process. After all, opioids are highly addictive. A newly published article in JAMA Psychiatry provides some guidance, outlining best practices for treating these patients. We also home in on the failure of “age gates” to keep teens away from alcohol-related websites, a forward-thinking partnership between Emory Healthcare and the Hazelden Betty Ford Foundation in treating SUD and the sharp rise of “diseases of despair” in Gen Y and Gen Z.
From JAMA Psychiatry:
Insights on How and When to Prescribe Opioids
There has been a pronounced increase in opioid-related addiction and overdoses over the past several years. “Nonetheless,” Roger Chou, M.D., writes in JAMA Psychiatry, “opioids remain a management option for chronic pain in selected patients. Because the prevalence of psychiatric conditions is high in those with chronic pain, psychiatrists often encounter patients prescribed opioids and can play an essential role in management.” Chou, a professor of medical informatics and clinical epidemiology at Oregon Health & Science University, outlines five steps psychiatrists should take in these situations:
- Explore a broader approach to treating chronic pain, one that involves psychological avenues such as cognitive behavioral therapy (CBT) and various relaxation techniques.
- Thoroughly manage the particular psychiatric conditions that exacerbate chronic pain.
- Address sleep issues, which often contribute to pain and the patient’s general ability to function.
- Take measures to ensure patients who are being prescribed opioids are avoiding alcohol, as the combination of these two substances increases the possibility of an overdose.
- Periodically test patients for opioid use disorder (OUD) utilizing criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Because the prevalence of psychiatric conditions is high in those with chronic pain, psychiatrists often encounter patients prescribed opioids and can play an essential role in management.”—Roger Chou, M.D., professor of medical informatics and clinical epidemiology at Oregon Health & Science University
From Alcohol and Alcoholism:
Internet “Age Gates” Don’t Work
Research out of Texas A&M research brings bad news to those hoping to prevent impressionable youths from being exposed to alcohol-related advertising content on the web. According to a recent study, so-called age gates, or virtual walls that stop people under the legal drinking age of 21 from going to sites that serve as advertisements for alcohol brands, are ineffective. Typically, these sites ask users to enter their birthdates, but many of them don’t have a way to verify that information. Adam Barry, Ph.D., an associate department head in Texas A&M’s Department of Health & Kinesiology and the leader of the study, says porous age gates are problematic because these online ads can help to shape a teen’s views toward alcohol consumption. As it stands now, there is no legislation on the books to strengthen age gates.
From the American Medical Association (AMA):
Emory Healthcare and Hazelden Join Forces against SUD
Georgia-based Emory Healthcare and the Hazelden Betty Ford Foundation have formed what could be a cutting-edge public-private partnership in the fight against substance use disorder (SUD). With the Addiction Alliance of Georgia, the two organizations are aiming to bring evidenced-based research and education to the fore across the Peach State. In an AMA news release, Justine Welsh, M.D., director of the Emory Healthcare Addiction Service, said, “We’re going to put treatment where it is needed most by building networks throughout the state. This partnership will help to reduce transit times to treatment, enhance telehealth options and help build community-based linkages.”
From BMJ Open:
Toll of “Diseases of Despair” on Younger Generations
Times have been tough for Gen Y and Gen Z, at least where the ability to cope is concerned. Data from health insurance claims published in the online journal BMJ Open reveals a stunning impact of “diseases of despair” on people ages 18 to 34 in the United States. Diseases of despair include substance and alcohol abuse and have climbed steeply over the past decade. According to the analysis, addictive behaviors among people in this age range shot up 210% between 2009 and 2018. Among the reasons cited are employment instability and a deteriorating social safety net.
Photo: Anirudh
