September is Recovery Month: What’s New in Recovery News?

September is Recovery Month, sponsored by the Substance Abuse and Mental Health Services Association (SAMHSA). So it is a good time to check out some new developments happening in the addiction and recovery field.

“Smarter” Drug Testing Guidelines Just Released

In July, the American Society of Addiction Medicine (ASAM) announced the release of new Evidence-Based Recommendations Guidelines aimed at “Smarter” Drug Testing.

Guidance was given regarding the usage of drug testing in clinical settings where addiction treatment is provided. Based on evidence from more than 100 research studies, the ASAM’s recommendations were developed by a multidisciplinary panel, combining scientific evidence with the collective judgment of experts.

Consensus of expert opinion determined that drug testing should be a routine part of initial and ongoing patient assessment in all addiction treatment settings. The ASAM report addressed many elements of testing programs, including documentation and patient confidentiality, practitioner education and expertise, as well as testing facilities and testing devices. Issues in inpatient and outpatient treatment as well as opioid treatment services were included in the guidelines, as well as issues related to special populations such as adolescents, pregnant patients, people in recovery, and health and other professionals.

What’s Happening With the Comprehensive Addiction and Recovery Act (CARA)?

The Comprehensive Addiction and Recovery Act (CARA) is legislation that was signed into law by President Obama on July 22, 2016. This law was the first major federal addiction legislation to be passed in 40 years, and is the most comprehensive effort undertaken to date to address the growing opioid epidemic. The law received strong support from the incoming president, Donald Trump.

Summary of Main Provisions of CARA

• Expand prevention and educational efforts – particularly aimed at teens, parents and other caretakers, and aging populations – to prevent the abuse of methamphetamines, opioids and heroin, and to promote treatment and recovery.
• Expand the availability of naloxone (a synthetic narcotic antagonist) to law enforcement agencies and other first responders to help in the reversal of overdoses and save lives.
• Expand resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment.
• Expand disposal sites for unwanted prescription medications to keep them out of the hands of children and adolescents.
• Launch an evidence-based opioid and heroin treatment and intervention program to expand best practices throughout the country.
• Launch a medication-assisted treatment and intervention demonstration program.
• Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

In May 2017, SAMHSA announced grants totaling $2.6 million to be awarded to recovery community organizations to build addiction recovery networks and engage in public education, as authorized by CARA.

Under CARA, some – but not all – nurse practitioners and physician assistants were sanctioned as prescribers of the drug buprenorphine, or Subutex, which is used in “medication-assisted treatment” to treat opioid and heroin addiction. An important goal in this program is to better reach those in need of such treatment in rural areas. However, restrictions, such as those in place in 28 states that limit nurse practitioners prescribing buprenorphine to those who are working in collaboration with a physician who has a license to prescribe it, reduce the effectiveness of the intended goal.

Take the 2017 National Drug & Alcohol IQ Challenge

How much do you know about current trends in addiction and recovery? Below are sample questions & answers adapted from the 2017 Drug & Alcohol Challenge, sponsored by the National Institute On Drug Abuse (NIDA). The IQ Challenge is aimed at teens, but the information is useful for all ages.

See how you do:

1. What percentage of teens who start using e-cigarettes are likely to begin smoking cigarettes within 6 months?

a) 7 percent

b) 31 percent

c) 52 percent

d) 79 percent

2. About how many people in the U.S. die every year from overdosing on prescription painkillers (opioids)?

a) 750

b) 2,300

c) 9,500

d) 19,000

3. The chemical in the marijuana that causes the “high” is:

a) delta-9-tetrahydrocannabinol

b) dronabinol

c) cannabidol

d) cannabis sativa

4. Which is a symptom of alcohol overdose?

a) irregular breathing

b) confusion

c) vomiting

d) all of the above

5. Marijuana affects memory because it alters how information is processed in what part of the brain?

a) parietal lobe

b) corpus callosum

c) pituitary gland

d) hippocampus

6. How do inhalants affect the brain?

a) They protect you from nausea and vomiting.

b) Most depress the central nervous system.

c) They increase oxygen in the brain, causing a stimulant effect.

d) They can damage protective sheaths around nerve fibers in the brain.

Answers

1. b) About 31% (compared to 8 % who had not previously used e-cigarettes)

2. d) About 19,000 people died from a prescription pain reliever overdose in 2014, more than 3 times the number in 2001.
3. a) Delta-9-tetrahydrocannabinol, or THC, is the ingredient in marijuana that causes the “high.” Marijuana strains with greater concentrations of hash oils and resins contain more THC than other strains.
4. d) Symptoms of alcohol overdose include confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, clammy skin, dulled responses (such as no gag reflex to prevents choking), and extremely low body temperature.
5. d) THC, the ingredient in marijuana that can cause the “high,” alters how information is processed in the hippocampus, a brain area responsible for memory formation.
6. b) and d) Most inhalants depress the central nervous system and affect the brain in ways similar to alcohol, including slurred speech, lack of coordination, euphoria, and dizziness. Chronic abuse of volatile solvents, such as toluene or naphthalene (used in mothballs), damages the protective sheath around certain nerve fibers in the brain, causing nerve damage similar to that caused by multiple sclerosis.