FDA Drug Safety Communication: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks. This provides updated information to the FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning issued on August 31, 2016.

To learn more click here: https://www.fda.gov/Drugs/DrugSafety/ucm575307.htm

Congratulations to Victoria S. Thieme, DO and the UNECOM students, who came in third place in their Research Day poster submission "Supportive or Stigmatizing: Health Professional's Attitudes in Caring for Substance Users in Maine."

The poster will be on display in the AOAAM room at OMED in Philadelphia. Stop by say hello and see the work of our students!

HELP

We Need YOU to complete this survey

            An estimated 25,000 to 30,000 Maine residents want treatment for Substance Use Disorders, but do not have access to it. Most states have similar statistics!  We need your valuable insight in identifying some of the barriers to care that people with substance use disorder are currently experiencing. We, at the University of New England College of Osteopathic Medicine, seek to gather information about health care practitioners’ perspectives regarding patients on the substance use disorder spectrum to identify challenges, barriers, and opportunities to improve the care model for both healthcare professionals and patients.

            Participation in this study is voluntary per our UNE IRB and involves a 10-minute online survey. After completing the online survey, we will reach out to you to schedule a phone or Skype interview that will take approximately 30 minutes. The follow-up interview will be recorded through our MP3 device, de-identified, and then transcribed for further analysis.

            Thank you in advance for your time! For your participation in this survey and follow up interview, you will be entered in a drawing for one of five $50 Amazon gift cards.

Click on this site:  https://goo.gl/forms/05An3W5sxfqxeeCP2 take the survey and provide us with your phone number or good email so that we can follow up with the phone interview.

Trends in the Use of Methadone, Buprenorphine, and Extended-Release Naltrexone at Substance Abuse Treatment Facilities: 2003-2015 (Update)

 Read the report: SAMHSA - The CBHSQ Report

The US Senate has approved Jerome Adams, MD, to be the next surgeon general.

Dr Adams, along with four other nominees for positions in the Department of Health and Human Services, were confirmed today without a full floor vote but with the Senate's full consent. The legislators were finishing up as much business as possible before leaving for an already-delayed summer recess.

The senators also approved Elinore McCance-Katz, MD, PhD, as the assistant secretary for mental health and substance use, a new position that has been called the mental health "czar"; Lance Robertson as assistant secretary for aging; Brett Giroir, MD, as assistant secretary for health; and  Robert Kadlec, MD, as assistant secretary for preparedness and response.

The full Senate's backing was not unexpected, as all the nominees made it through a Senate confirmation hearing relatively unscathed on August 2.

Dr Adams, currently Indiana's state health commissioner, also serves as an assistant professor of clinical anesthesia at the Indiana University School of Medicine and as a staff anesthesiologist at Eskenazi Health, both in Indianapolis. He told members of the Senate Health, Education, Labor and Pensions Committee that, if confirmed, one of his first priorities would be to address the opioid epidemic. As surgeon general, Dr Adams will oversee the 6600 uniformed health professionals in the US Public Health Service Commissioned Corps.

Dr McCance-Katz currently serves as the chief medical officer of Rhode Island's Department of Behavioral Health Care, Disabilities, and Hospitals and was the chief medical officer of the Substance Abuse and Mental Health Administration from 2013 to 2015. She will be the first to hold the position of assistant secretary for mental health and substance use, a position created by the 2016 Helping Families in Mental Health Crisis Act.

Dr McCance-Katz, a psychiatrist, was endorsed for the new position by the American Osteopathic Academy of Addiction Medicine and other prominent medical associations.

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.