A history of opioid addiction would be required to be displayed in medical records of individuals who have consented. It would also be shared with clinicians and pharmacists, according to a bill approved by the US Senate.

The Senate passed the so-called "Jessie's Law" (S. 581) by unanimous consent on August 3 during a marathon session to tie up loose ends before legislators broke for their previously delayed summer recess. The unanimous consent procedure eliminated the need for debate or a vote.

The bill followed a remarkably fast track after it was introduced in March by Democratic Senator Joe Manchin of West Virginia. A companion proposal was introduced at the same time in the US House of Representatives by two Michigan lawmakers, Democrat Debbie Dingell and Republican Tim Walberg.

The law is named for Jessie Grubb, a recovering addict who experienced relapse and overdosed after being given a large quantity of opioids following a surgical procedure by a clinician who said he was unaware of her history.

"We must ensure physicians and other medical professionals have full knowledge of a patient's previous opioid addiction when determining appropriate medical care," said Manchin, in a statement issued after the Senate approval.

The bill calls on the Secretary of Health and Human Services to develop standards that could be used by hospitals and physicians to "prominently" display a patient's history of opioid addiction in his or her medical record, but only if the patient has consented to providing the history to a clinician.

The idea is that the opioid addiction history would be considered on par with allergies and other contraindications when a clinician is considering prescribing an opioid. The proposal states that the information should be available to all providers, including physicians, nurses, and pharmacists.

"Jessie's Law" still needs to be taken up by the House.

The AOA has approved as eligible for AOA Addiction Medicine subspecialty certification those osteopathic physicians who hold the following credentials:

1. Active AOA primary certification, current in OCC, if applicable; and
2. Active American Board of Addiction Medicine (ABAM) certification, current in ABAM MOC.

Applicants who meet these two requirements will be granted subspecialty/CAQ certification in Addiction Medicine, with a requirement that Diplomates maintain their certification through the AOA's Addiction Medicine Osteopathic Continuous Certification (OCC) process.  

Once certified, examination will occur at the appropriate interval based on the date of initial certification or re-certification by ABAM. Other OCC requirements will apply as adopted by the Bureau of Osteopathic Specialists (BOS). Please note that, at this time, the OCC process is under review by the BOS and AOA Board of Trustees (BOT). Details will be forthcoming.

The application fee is $295.

Apply at AOCCAM.ORG

You may also contact AOAAM's Executive Director, Nina Vidmer, at nvidmer@aoaam.org or 708-572-8006 if you have any questions.

The American Osteopathic Academy of Addiction Medicine (AOAAM) and the American Osteopathic Association (AOA) held a meeting on April 7, 2017 to discuss the mechanism to attain a subspecialty certification in addiction medicine. 

The meeting was a follow-up to the AOA resolution that was passed on April 12, 2016 that provides DOs who are ABAM diplomates with a process to attain an AOA subspecialty certification in addiction medicine.

Osteopathic physicians who are ABAM diplomates have 3 possibilities for certification in addiction medicine:

1. If you hold a current, primary AOA certificate, you should have been offered an automatic AOA certification in addiction medicine-. There is a $295 processing fee. Contact addictionmedicine@osteopathic.org for additional information.
2.  If you are a DO and hold a current ABMS certificate, you are eligible for the new ABMS certification examination being offered via the American Board of Preventive Medicine. As an ABAM diplomate, you will not need to list and have verified your practice experience, or provide a reference letter. Go to: www.theabpm.org
3.  If you do not hold a current AOA or ABMS certificate, your status as a current ABAM diplomate remains unchanged, if you are continually registered in the ABAM MOC program.

The AOA recognizes that the opioid epidemic has had a tremendous impact on families, and therefore they are considering a practice pathway for the future to allow for even more DOs to combat the increase of substance use disorder among our patients. 

Attached are slide sets from the AOA and ABAM that outline the pathway to certification. We will keep our members apprised of any news as it becomes available.

• Slides
• Chart

Fighting substance use disorders is a big challenge for American veterans and their communities.  AOAAM past President, Anthony Dekker, DO, was a recent contributor to the article in Media Planet, “Help is on the Way for Veterans Caught in the Opioid Crisis.”  Read the article.

Apr 17, 2017 Clinical Essentials from MMWR Morb Mortal Wkly Rep

Takeaway

• Fentanyl is involved in the majority of opioid overdose deaths in southeastern Massachusetts, according to the Morbidity and Mortality Weekly Report (MMWR).

• The majority of respondents who survived overdose had administered or observed administration of naloxone (Narcan).

Why this matters

• Health officials should expand existing overdose education programs to include fentanyl-specific messaging.

• Access to naloxone should be increased.

Study Design

• 196 overdose deaths were investigated in 3 counties with serious opioid overdoses in southeastern Massachusetts (2014-2016).

• Researchers also interviewed 64 adults who had used opioids in the last year and had observed or experienced an overdose in the past 6 mo.

•  Funding: Massachusetts Department of Public Health and US Centers for Disease Control and Prevention.

Key results

• Among 190 opioid overdose deaths, the proportion involving fentanyl increased from 32% during 2013-2014 to 74% in the first 6 mo of 2016.

• 82% of fentanyl-involved deaths were from illicitly manufactured fentanyl.

• 36% displayed evidence that overdose occurred within seconds or minutes.

•  7 5% of living respondents reported successful reversal of overdose with naloxone.

Limitations

• Because the study was restricted to 3 counties in southeastern Massachusetts, results may lack generalizability to other US counties.

References

Somerville NJ, O'Donnell J, Gladden RM, Zibbell JE, Green TC, Younkin M, Ruiz S, Babakhanlou­Chase H, Chan M, Callis BP, Kuramoto-Crawford J, Nields HM, Walley AY. Characteristics of Fentanyl Overdose - Massachusetts, 2014-2016. MMWR Morb Mortal Wkly Rep. 2017;66(14):382-386. doi: 10.15585/mmwr.mm6614a2. PMID: 28406883

Disclaimer

© 2016 Univadis International, Inc. All rights reserved.

 Psychological Consequences of the American Civil War

Author: R. Gregory Lande

The conclusion of America's Civil War set off an ongoing struggle as a fractured society suffered the psychological consequences of four years of destruction, deprivation and distrust. Veterans experienced climbing rates of depression, suicide, mental illness, crime, and alcohol and drug abuse. Survivors, leery of conventional medicine and traditional religion, sought out quacks and spiritualists as cult memberships grew. This book provides a comprehensive account of the war-weary fighting their mental demons.

Paperback: 256 pages / Publisher: McFarland (December 20, 2016) / Language: English

ISBN-10: 1476667373 / ISBN-13: 978-1476667379

Available at McFarland Books (http://www.mcfarlandbooks.com/), Amazon and many leading retailers.

Click here to view the October 2016 Addiction Education News - COPE

Click to view SAMHSA’s presentation on “Understanding the Buprenorphine Final Rule for a Patient Limit of 275”.

Physicians who have prescribed buprenorphine to 100 patients for at least one year can now increase their patient limits to 275 under new federal regulations. Read CSAT's Dear Colleague Letter (PDF | 234 KB) on the new rule.

The Understanding the Final Rule for a Patient Limit of 275 (PDF | 163 KB) guidance document will help you determine whether you are eligible to request the new, higher limit on the patients that you may treat based on your credentials or features of your practice setting. You may also review the final rule in the Federal Register for further information.

If you wish to be considered for the higher limit please complete the online Waiver Notification Form SMA-167. SAMHSA reviews applications within 45 days of receipt. For more information, send an email to info@buprenorphine.samhsa.gov  or call 866-BUP-CSAT (866-287-2728).

The Senate earlier this week passed the Comprehensive Addiction and Recovery Act (CARA). 

The bill, which focuses on treating substance use disorder as a chronic illness rather than a criminal offense, expands education and prevention efforts, strengthens prescription drug monitoring programs, and increases first responder access to naloxone. The bill also allows nurse practitioners and physician assistants to prescribe buprenorphine with some restrictions.