This Week's News in Substance Use: 1/5/18

This Judge Has a Mission: Keep Defendants Alive, New York Times

“Unlike typical drug courts, which can end in punishment if defendants relapse, this one recognizes that failure is part of the recovery process.

Its measure of success — preventing death — is arguably a low bar. Then again, few initiatives have made much of a dent in an epidemic that is killing more people each year than car accidents do. The criminal justice system may not be the ideal place to address addiction, but the reality is that it is a place where drug users are a captive audience. And the court, by linking with nonprofits, offers treatment for those who could not otherwise afford it. Court systems around the country are watching Buffalo as a potential model.”

State Bans Opioids from Courtrooms Over Exposure Fears, Associated Press

“Some law enforcement officers have reported falling ill after routine exposure to the drug, like when merely brushing the substance off a uniform, but experts have said that’s not medically possible. While the potent drugs are dangerous if they’re inhaled or find another way into the bloodstream, toxicologists say even accidental skin exposure shouldn’t make someone sick. They say properly packaged drugs would pose no danger in a courtroom.”

US Millennials Were Almost 20% More Likely to Die in 2016 Than 2014, Quartz

“The US is one of the wealthiest countries in the world. It’s the world’s center of innovation and medical science, yet the country can’t keep their youth from dying. US millennials are now dying at such high rates that it’s driven life expectancy in the country to decline for two years in a row, the first time that’s happened since the early 1960s. The primary cause for the trend is the opioid crisis.

“According to recently released data from the US Centers for Disease Control and Prevention (CDC), 129 out of every 100,000 25-34 year old US adults died in 2016. Not since 1995, at the height of the HIV/AIDS epidemic, have death rates been so high among this group.”

We Can’t Measure Pain. Is That Fueling the Opioid Crisis? The Daily Beast

“A patient could be suffering from anything between mild discomfort and irascible torture, but an opioid painkiller is almost certainly going to provide some relief. The dose, however, should vary—but often does not, leading to some people to get addicted to drugs that might have been way too powerful for their pain needs.

The current system leaves much to be desired in terms of scientific accuracy: Doctors simply ask patients to rate their pain on a numerical scale or something similar, and use that information to determine what kind of painkiller prescription would work best.“

Washington’s Gutless Approach to Our Addiction Crisis, The American Conservative

“Trump has not embraced modern approaches to treating addiction. During his first White House meeting with the opioid commission that covered many of the aforementioned harm reduction practices, he focused more on his own obsession—a border wall. This aversion to progressive ideas was highlighted by a decision last week by the Trump administration to ban the CDC from using seven specific words, including ‘evidence-based’ and ‘science-based.’

“This flies in the face of the recommendations from our country’s top health officials. Last year, the surgeon general of the United States released a first-of-its-kind report on drug addiction that called for an ‘evidence-based public health approach’ to drug addiction. This is of the utmost importance because our government does not prioritize prevention and treatment. Case in point: A study found that 65 percent of America’s prisoners need substance [misuse] therapy, but only 11 percent actually get it. Likewise, less than five percent of court-ordered drug rehab appointments meet the appropriate medical standard.”

We Mobilized Against Flu, Cancer and Heart Attacks. Where's The Urgency on Opioids? USA Today

“Our country deserves the same medical urgency today in addressing addiction as we had for H1N1, Ebola, cardiovascular disease or any other illness for which we’ve mobilized a national response. We have the tools we need to both prevent and treat opioid use disorders; we have the science and the interventions. We need to move forward with urgency to implement them.

Neuroscience has established how addiction hijacks key functions of the brain, replacing our natural, healthy instincts with a compulsion for the drug. Science has also yielded new medicines to treat opioid addiction, new technologies to support recovery, and new tools for clinicians. It’s time we put them to use in a large-scale effort to reimagine how we treat this disease, prioritizing a medical model of care for patients that addresses the long term needs of each patient to help them achieve and maintain recovery.”

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