Plus: A possible upside to vaping; teen opioid misuse and suicide; and a state-run hospital program aimed at improving OUD outcomes
By William WagnerMarch 16, 2021
New research in The Lancet Psychiatry adds to the immense body of evidence that harm reduction works in treating alcohol use disorder (AUD). In this week’s “From the Journals,” we also look at whether e-cigarettes really do help people stop smoking, the suicide risks for teens who misuse prescription opioids, and an opioid use disorder (OUD) treatment program in Pennsylvania.
We found participants didn’t have to stop drinking to start recovery. We didn’t ask participants to change their drinking in any particular way.”—Susan Collins, Washington State University psychology professor
From The Lancet Psychiatry:
Treatment Beyond Abstinence
Abstinence isn’t the only answer for those suffering from AUD. According to the results of a randomized clinical trial out of Washington State University—as well as reams of previous research—harm reduction is a viable path toward long-term recovery. The Washington State team studied 300 people from three homeless shelters in Seattle to test the efficacy of harm reduction in that population. Participants who received harm reduction treatment, especially in combination with counseling and the anti-craving medication naltrexone, improved their overall health significantly over a three-month period.
“We found participants didn’t have to stop drinking to start recovery,” Susan Collins, Ph.D., a psychology professor at Washington State and the leader of the study, said in a news release. “We didn’t ask participants to change their drinking in any particular way, but looking at the averages generated in our statistical models, we found that people who got the combined counseling and medication experienced a 59% reduction during their treatment in the number of drinks consumed on their heaviest drinking day.”
E-cigarettes Might Help with Smoking Cessation
Every week, it seems, an ominous study is published about the health effects of vaping. But the vaping scene isn’t all doom and gloom, researchers from King’s College London in the United Kingdom tell us. They report that e-cigarettes have at least some benefit for people who are trying to stop smoking. “When used daily,” the study’s authors write in the journal Addiction, “electronic cigarettes appear to facilitate abstinence from smoking when compared with using no help.” With financial support from Cancer Research UK, the group surveyed 1,155 smokers, former smokers of up to one year and e-cigarette users.
The Link Between Teen Suicide and Opioid Misuse
A new report in the journal Pediatrics isn’t surprising—that high school students in the throes of misusing prescription opioids are at particular risk for suicide—but it’s nevertheless jarring, especially since the opioid epidemic continues to rage. Digging into data from the 2019 Youth Risk Behavior Survey, researchers unearthed information indicating that teenagers who are currently misusing prescription opioids (defined in the study as within the previous 30 days) are much more likely to attempt suicide than those who aren’t. The researchers hope their findings translate to proactive intervention strategies that help decrease teen suicide rates.
From Psychiatric Services:
Incentivizing OUD Treatment
If states dangle extra money in front of hospitals, will it lead to better OUD outcomes? Pennsylvania has put that question to the test. In 2019 the state enacted the Opioid Hospital Quality Improvement Program (O-HQIP), which offers financial incentives to hospitals that improve access to treatment for OUD, such as increasing rates of follow-up care for Medicaid patients. While it’s still early, the program shows promise, according to researchers from the Perelman School of Medicine at the University of Pennsylvania. “Analysis of treatment outcomes is needed to further evaluate this policy initiative,” the researchers write in an article in Psychiatric Services, “but new delivery and payment models may improve systems to treat patients who have an opioid use disorder.”
Photo: Brett Jordan