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This Week's News in Substance Use: 1/11/18

An Opioid Remedy That Works: Treat Pain and Addiction at the Same Time, Kaiser Health News

“Upstairs, Gersch’s colleague Amanda Bye, a clinical psychologist, highlighted a key element of the program: It’s integrated. For patient care, there’s a doctor, a clinical pharmacist, two mental health therapists, a physical therapist and a nurse — all on one floor. Patients can meet with this team, either all at once or in groups, but they do not have to deal with a series of referrals and appointments in different facilities. A spokesperson for Kaiser Permanente said researchers tracked more than 80 patients over the course of a year and found the group’s emergency room visits decreased 25 percent. Inpatient admissions dropped 40 percent, and patients’ opioid use went way down.”

Desperate Cities Consider 'Safe Injection' Sites for Opioid Users, NPR

“The city's new district attorney, Larry Krasner, has promised he would not prosecute users at the safe-injection site.

‘Supervised injection sites are a form of harm reduction,’ says Krasner, who was sworn into office just last week.

The rise in opioid deaths in Philadelphia reflects a nationwide epidemic; the size and lethality of the problem, Krasner says, should be shifting the conversation away from the country's long history of responding to drug users with criminal punishment.

‘The only way to get people to turn their lives around,’ he says, ‘is to keep them alive long enough so they can do that. And we're going to do that.’”

Senate Dems Seek $25B in Opioid Funding, The Hill

“Senate Democrats are pushing for an extra $25 billion to be included in any final budget agreement to combat the opioid epidemic.

“Sens. Jeanne Shaheen and Maggie Hassan, a pair of New Hampshire Democrats who are leading the effort, said during a press conference Tuesday that the federal response to the crisis has been insufficient and negotiations over a long-term spending deal are an opportunity to change that.

‘Make no mistake: This is a national public health emergency, and we still don’t see a robust federal response,’ Shaheen said. ‘The current federal budget negotiations give us an opportunity to right this wrong.’”

Federal Judge Seeks Speedy Resolution of Opioid Lawsuits, The Wall Street Journal

“A federal judge is pushing for a swift resolution to hundreds of lawsuits filed by cities and counties over the opioid crisis, saying Tuesday that too many people are dying each year from opioid [misuse].

‘I don’t think anyone in the country is interested in a whole lot of finger pointing at this point, and I’m not either,’ U.S. District Judge Dan Polster said Tuesday at the first gathering, in a Cleveland courtroom that was packed, of lawyers involved in the sprawling opioid litigation.

Judge Polster is overseeing the consolidation of more than 200 cases filed in federal court by local governments, hospitals and other parties, all seeking to recoup the costs of opioid addiction from the manufacturers and distributors of the painkillers.”

Hospitals Brace Patients for Pain to Reduce Risk of Opioid Addiction, NPR

“Opioid addiction is a reality that has been completely disconnected from where it often starts — in a hospital.

“Anesthesiologist David Alfery says he was rarely stingy with opioids. ‘If I could awaken them without any pain whatsoever, I was the slickest guy on the block and it was a matter of enormous pride,’ he says.

Alfery is part of a working group at the Nashville-based consulting firm Health Trust. It's helping hospitals to set aside some of their competitive interests to swap ideas about a top priority — reducing opioid use.

‘It starts with patient expectations, and I think over the years, patients have come to expect more and more in terms of, 'I don't want any pain after surgery,' and it's an unrealistic expectation,’ Alfery says.”