Prescription Medication Misuse

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TIP 33: Treatment for Stimulant Use Disorders

This updated TIP reviews what is known about treating the medical, psychiatric, and SUD-related problems associated with the use of cocaine and methamphetamine, as well as the misuse of prescription stimulants. The TIP offers recommendations on treatment approaches and maximizing treatment engagement and retention, and strategies for initiating and maintaining abstinence.
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Drug Disposal: FDA’s Flush List for Certain Medicines

If you received specific disposal instructions from your healthcare provider (e.g., doctor, pharmacist) for your unused or expired medicine, you should follow those instructions to dispose of your medicine. The best disposal option is to find a drug take back location, which may be found in retail, hospital, or clinic pharmacies; and/or law enforcement facilities.
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HHS Announces Funding for Substance Use Treatment and Prevention Programs

Yesterday, the Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), is announcing two grant programs totaling $25.6 million that will expand access to medication-assisted treatment for opioid use disorder and prevent the misuse of prescription drugs. By reducing barriers to accessing the most effective, evidenced-based treatments, this funding reflects the priorities of HHS' Overdose Prevention Strategy, as well as its new initiative to strengthen the nation's mental health and crisis care systems.
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Non-Fatal Opioid Overdose and Associated Health Outcomes: Final Summary Report

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with RTI International to conduct a scoping review of the scientific literature on non-fatal opioidinvolved overdose (NFOO) to better understand the health outcomes and health care implications associated with opioid epidemic. NFOO is a significant cause of opioid-related morbidity in the United States, and is of heightened interest to ASPE given the sharp increase in fatal and nonfatal opioid overdoses as a result of the current fentanyl crisis. Compared to the first and second phases of the opioid epidemic, when the majority of opioid-related morbidity and mortality was associated first with prescription opioids and then with heroin, illicitly-manufactured fentanyl (IMF) is now the leading cause of fatal opioid overdoses (CDC, 2017; O’Donnell, Gladden, & Seth, 2017). People who consume IMF, either wittingly or unwittingly, are at higher risk for accidental overdose, experience comparatively atypical overdose-related side effects, have unique risk profiles, and are at higher risk for poorer health outcomes (Somerville, 2017). To our knowledge, no investigation has been conducted to examine whether the sharp increase in NFOOs over the last several decades is negatively impacting overdose victims’ chronic physical and mental health outcomes. To investigate the status of the scientific literature regarding the consequences of NFOO on victims’ physical and mental health, we conducted a scoping review of the existing knowledge in multiple stages: (1) publication identification; (2) selection of publications; and (3) data extraction, charting, and synthesis. Key findings from our review are presented below.
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The Impact of COVID-19 on Veterans Struggling with Substance Use

Since the beginning of the COVID-19 pandemic, its consequences have had a severe effect on mental health (Czeisler et al., 2020; Sher, 2020). Factors such as economic anxiety, social isolation due to necessary social distancing regulations, anxiety and fear regarding the virus, and chronic stress are factors that have contributed to the increase in mental health symptoms (Sher, 2020). Since the start of the pandemic, there have been notable increases in depression and anxiety and increased psychological distress in both the general population and among healthcare professionals (Sher, 2020). A large survey of adults in the U.S. found that there was a substantial increase in anxiety and depressive symptoms endorsed compared to the same time the previous year (Czeisler et al., 2020).
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Psychostimulant Drug Use in Rural Areas Amidst the Opioid Epidemic

This News Brief defines psychostimulants; explains why psychostimulant use disorder is under-addressed, particularly in rural areas; reviews the reasons why people use psychostimulants and the harms they can cause; and addresses the impact of COVID-19 on psychostimulant use.
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The Opioid Epidemic: A Geography in Two Phases

The Economic Research Service (ERS) at the U.S. Department of Agriculture details their research into contributing factors for geographic differences, with a focus on the widespread introduction of prescription drugs in rural and urban areas.  See the Events section below to register for an ERS webinar on this report, taking place at 1:00 pm ET today. 
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Drug Misuse: Most States Have Good Samaritan Laws and Research Indicates They May Have Positive Effects

The U.S. Government Accountability Office (GAO) recently published their Drug Misuse report to the Congressional Committees, which stemmed from a provision in the Comprehensive Addiction and Recovery Act of 2016 (CARA) requiring GAO to review Good Samaritan and Naloxone Access Laws. GAO examined which states and territories have Good Samaritan and Naloxone Access laws, the effects of Good Samaritan laws, and the efforts the Office of National Drug Control Policy (ONDCP) has taken to disseminate information on Good Samaritan and Naloxone Access laws. GAO found that 47 states and D.C. have enacted both Good Samaritan and Naloxone Access laws, Kansas, Texas and Wyoming only have Naloxone Access laws, and five U.S. territories do not have any Good Samaritan or Naloxone Access laws in place. They also conducted literature reviews of studies examining the laws’ effectiveness and ONCDP documents and found that, while there were lower rates of overdose deaths in states with Good Samaritan laws, awareness of Good Samaritan laws varied across states and territories.
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Take-Home Naloxone and the Need for a Publicly Funded Naloxone Supply

The opioid crisis continues to exact a heavy toll on the United States, and overdose deaths have only increased during the current global pandemic. One effective intervention to reduce overdose deaths is to distribute the opioid antagonist naloxone directly to persons actively using opioids (ie, “take-home naloxone”), especially at touchpoints with the potential for significant impact such as emergency departments and jails.  reliable funding for a naloxone supply. In this commentary, we establish the argument for a publicly funded naloxone supply to support take-home naloxone distribution in emergency department settings. We posit that the complex billing and reimbursement system for medication dispensing is impossibly burdensome during emergency care for an acute opioid overdose, and that the mounting death toll from this public health crisis demands a strong commitment to harm reduction. 
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