New Guidelines for Treating Opioid Addiction

opioid guidelines

Plus: Overprescribing opioids for back pain, and weed’s deleterious effect on memory

By William Wagner

As the opioid epidemic evolves, so do the guidelines for addressing it. Along those lines, Canada’s Centre for Addiction and Mental Health (CAMH) has released a compendium of the latest information for curbing the opioid crisis.

People can achieve sustained long-term remission from OUD with effective treatment and follow-up. The first-line treatment for moderate to severe OUD is opioid agonist therapy (OAT).”—report from the Centre for Addiction and Mental Health

We also delve into how a lack of knowledge among doctors can lead to bad practices when prescribing opioids for back pain, and what high-potency marijuana does to memory.

From the Centre for Addiction and Mental Health (CAMH):
An Updated Opioid Plan

In its recently released “Opioid Agonist Therapy: A Synthesis of Canadian Guidelines for Treating Opioid Use Disorder,” CAMH is attempting to produce better outcomes for opioid addiction. “People can achieve sustained long-term remission from OUD [opioid use disorder] with effective treatment and follow-up. The first-line treatment for moderate to severe OUD is opioid agonist therapy (OAT), ideally combined with behavioural and social supports to optimize the determinants of health and address other psychosocial factors that influence substance use and quality of life,” write the authors.

By incorporating information that has been validated by some of Canada’s foremost addiction experts, the opioid guidelines aim to help the treatment community get a handle on a problem that has become ever more slippery. And while the document comes out of Canada, it has value for any country that has been hit hard by opioid addiction. It covers 26 topics, including harm reduction and medication-assisted therapy (MAT), two treatment approaches that have gained considerable traction.

From the JAMA Network:
Opioid Prescribing Practices for Back Pain

Back pain hobbles a considerable portion of the population, which makes research into opioid prescribing practices for the ailment all the more important. An expansive new study led by researchers from Harvard University and published on the JAMA Network reaches a conclusion that seems rooted in common sense: Physicians who stay up-to-date on the latest medical information are less apt to overprescribe opioids for back pain. The study states, “[W]hen the standard of care shifted away from routine opioid prescribing, physicians who performed well on an ABIM [American Board Internal Medicine] examination were less likely to prescribe opioids for back pain than physicians who performed less well on the examination.”

From Scientific Reports:
Marijuana and Memory Loss

Washington State University researchers were able to see firsthand the effect high-potency marijuana can have on a person’s memory. For a groundbreaking study published in Scientific Reports, the team observed participants via Zoom as they smoked or vaped high-potency marijuana they had purchased at dispensaries in Washington, a state where recreational use of weed is legal. After consuming the marijuana, the participants were given cognitive tests. The results suggested memory impairment, raising concerns about the potency of the marijuana that is readily available to consumers. “The goal of this study was to examine acute effects of high-potency cannabis flower  … and concentrates … on everyday life memory and decision making using a novel methodology that bypasses DEA prohibitions, including those that require researchers to utilize relatively low-potency … whole-plant cannabis from the NIDA drug supply,” the authors write in Scientific Reports. This is believed to be only the second study to focus on the impact of high-potency weed.

Photo: Hansjorg Keller

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