Is naloxone really needed in buprenorphine product?

The word on the street has been out for some time — it's not true that the naloxone in the buprenorphine combination product (Suboxone, for example) prevents euphoria if the opioid, which is meant to be dissolved in the mouth, is ingested. More than 20 years ago, this was the premise when the federal government subsidized the development of the first buprenorphine‐naloxone product, paving the way for Reckitt Benckiser Pharmaceuticals — now Indivior — to make a fortune on its Suboxone product. There was yet another delay when the patent expired, but generic manufacturers couldn't break the code for blending the naloxone with the buprenorphine, furthering the fortunes of RBP/Indivior.     

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For Teens with Opioid Use Disorders, Bupe Better than Detox‐Rehab‐Relapse Providers Should Use Insurance Mandate in Pennsylvania DEA Investigates NFL Teams for Painkiller Abuse Medicaid Expansion Enabled More Recovery Services in Ohio For Suboxone, Goodbye Reckitt, Hello Spinoff Indivior Coming up     

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Illicit Methadone and Buprenorphine Use by Teens Minimal in Sweden Centers Forge Productive Presence in Nonservice Locations Patients Who Get into Trouble with Pain Meds Cost More Offices of Reckitt Benckiser Raided by Feds Murphy Mental Health Bill Would Weaken SAMHSA Authority Briefly Noted Names in the News Coming up     

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Abuse in South Florida may be Tied to Buprenorphine Expansion Vermont Grant Project Seeks Family‐Driven Adolescent Treatment Opioid Treatment Programs and Buprenorphine The Baltimore Studies Reckitt Benckiser on Possible Buprenorphine Abuse Similarities between Obesity and Addiction under Study at NIDA Disrupted Brain Functions Implicated in Behavioral Phenotypes of Obesity/Addiction Oregon to Design Prevention Strategy Based on New Data Briefly Noted Call for Applicants Grants and Funding Resources Coming up     

Indivior CEO steps down,pleads guilty over Suboxone

On June 30, the federal Department of Justice announced that Shaun Thaxter, CEO of Indivior, pleaded guilty for misrepresenting Suboxone's safety. Suboxone is buprenorphine combined with naloxone. Briefly, Indivior was trying to promote its new film, saying that its tablets caused a risk of pediatric exposure (see “Reckitt Pulls Suboxone Tablets, Citing Pediatric Exposures,” ADAW, Sept. 12, 2012, https://onlinelibrary.wiley.com/doi/10.1002/adaw.20347 ). It had just discontinued its own tablets and was trying to convert its patients to its patented film, because the tablets were off patent and it wanted to keep market share, crowding out any generics in a scheme commonly known as “evergreening.” Medicaid formularies in Massachusetts and Virginia were sold on the idea, and therefore agreed to approve Suboxone even to patients with children under the age of 6 living in the home. The interstate commerce made this a federal case.     

FDA relents on Brixadi,competitor to Sublocade

Last week, Braeburn won its fight against Indivior to bring its injectable form of buprenorphine, Brixadi, to the U.S. market. The Food and Drug Administration (FDA) granted Braeburn's request to the FDA to revoke the orphan drug designation for Indivior's Sublocade. However, the FDA has reaffirmed exclusivity for Sublocade until next November.     

Sublocade trial data published: Better than placebo

Sublocade, a buprenorphine injection that lasts a month, was approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorder more than a year ago (see ADAW, Dec. 11, 2017), but the data that led to the approval was not public. It was made public in an article by Sublocade manufacturer Indivior published Feb. 18 in The Lancet.     

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NSDUH: Heroin Increase Correlated with Rx Opioid Abuse Decrease N.J. Center Moves to Diversify but Sees Incremental Change Marijuana Use Increasing, Other Highlights Reckitt Pulls Suboxone Tablets, Citing Pediatric Exposures Handful of Biased Journalists Threaten Treatment Industry CAARR Responds to ‘Rogue Rehabs’ Report Coming up     

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Reckitt Strikes Out with FDA on Bupe; Now Faces FTC Inquiry More Diversified Revenue Picture Prepares Missouri Provider for ACA Parity Linked to More SUD Treatment in Hospital Study A Confidentiality Manual for the Digital Age Final Rule on Health Insurance Exchanges: Parity is Key Odyssey House Grant Focuses on Teens and Their Families Changes in New York Sequestration to Cut HHS by $15.5 Billion March 1 Briefly Noted Coming up     

Is generic buprenorphine film as good as Suboxone?

When Indivior's popular Suboxone film went off patent, Dr. Reddy's was ready with the generic, and there are more companies now providing it as well — including Indivior itself (distributed by Sandoz). The point of generics, from a patient or payer point of view, is that they are less expensive than brand. But there can be problems — with quality, including of active ingredients. Patients frequently complain when their agonist medications are switched — whether it's from one type of methadone to another or, now, from Suboxone film to a generic.     

The Anglican clergy and the early development of British sociology

The theoretical bias evident in histories of sociological thought and practice has tended to minimise some other important influences on its development. One such is the relationship between ‘Christian Sociology’ as articulated by the writers of such Church of England organisations as the Christian Social Union and the Christendom Group. A reading of the early journal publications of early twentieth century British sociology suggests an inter-relationship between the input of the Anglican clergy and the emergence of a scientific, university-based discipline. With particular reference to the sociological intentions of the 1924 Conference on Politics, Economics and Citizenship (COPEC) and to the writings of the Christian Sociologist, Maurice B. Reckitt, this article suggests that the view that the relationship between Christian and academic sociology can be interpreted simply as a ‘phase’ in sociological history does less than justice to the complexities of a neglected aspect of the professionalisation of the discipline.     

The E.S.S.E. Group Model

Social work practitioners today are having to deal with ever-increasing numbers of families falling into the at risk category. At the same time, the issues and problems facing these family units are often overwhelming and challenging to resolve. The E.S.S.E. Group Model, outlined in this article, is a new research based approach that was designed to address the most relevant concerns facing families today. It is a unique program that combines family life education within a support group framework. Initially, the model was developed for several school districts in the midwest. Counseling personnel had identified a need for a parent training program that would elicit higher levels of participation. The E.S.S.E. Model accomplishes that goal through its structured yet individualized curriculum along with its parallel and conjoint group set-up. The specific content and process guidelines of this new approach make it easy for clinicians to duplicate in a wide variety of settings. One of the model's curriculums is outlined in detail in this article. Readers will find that the E.S.S.E. program serves as an excellent example of the type of group intervention needed today to help revitalize at-risk families.     

Elder Abuse Detection and Intervention: A Collaborative Approach by B. Brandl,C. B. Dyer,C. J. Heisler,M. J. Otto,L. A. Stiegel,and R. W. Thomas

Mediation has recently been developed in America to help seniors deal with their disputes. Some Long Term Care Ombudsmen and their volunteers have also been trained in mediation for use in institutional conflicts. This paper suggests that elder mediation, through its voluntary, non-coercive process, has the potential for enhancing elder rights, providing an acceptable form of minimal social intervention, and contributing to the prevention of elder abuse at early stages of relational conflicts between elders and their carers.     

Models for theory-based M.A. and Ph.D. programs

In response to growing demand for advanced public relations education, this article suggests integrated models of outcomes, curriculum, pedagogy and assessment for theory-based M.A. and Ph.D. programs. Because public relations has commonly been approached as a professional rather than theoretical subject, this article begins with a short explanation of why theoretical education is becoming an increasingly important part of public relations education. It then reports the integration team's recommendations for a flexible educational framework allowing for practical constraints and providing for institutional individuality at both the M.A. and Ph.D. levels. Assumptions underlying efforts of the team are outlined and specifics that might be included in M.A. and Ph.D. programs are presented with rationales for each.     

U.N.H.C.R. as a bulwark against violations of migrants’ rights. Dialogue with Stephane Jacquemet

Stephane Jacquemet, Regional Representative for Southern Europe of the Office of the United Nations High Commissioner for Refugees (U.N.H.C.R.) since April 2016, agreed to answer some questions regarding U.N.H.C.R.’s mandate and positions in relation to the so-called ‘European migration crisis’. Mr Jacquemet is a Swiss Lawyer who has been working with the U.N.H.C.R. for 24 years. In 1992 he was called as Head of Operations in Croatia, and during his career he served in Togo, Indonesia, Lebanon, Nepal, Burkina Faso, and Colombia. Between 1997 and 2002 Mr Jacquemet held a number of senior positions in the Division of International Protection at U.N.H.C.R. Headquarters in Geneva. This rare and invaluable combination of legal and practical expertise makes Mr Jacquemet a first-class interlocutor whom to ask some questions concerning, on the one hand, the E.U. policies towards migrants, and, on the other, U.N.H.C.R.'s strategies in relation to the promotion of refugees’ and statelessness persons’ rights.     

Kapoor,Ria. Making Refugees in India. Oxford University Press. pp.272

Ria Kapoor's book, Making Refugees in India, explores the history of refugees in India, tracing the way the figure of ‘refugee’ makes its appearance in the subcontinent since colonial times. The motivation for the book stems from the Citizen Amendment Act passed in the Indian Parliament in 2019, and through the book, Kapoor explores the past histories and the struggles of refugees in independent India for last seventy-five years. Through the historicizing of the concept of refugee, Kapoor touches on various periods of history within the subcontinent.     

Seclusion. The nursing challenge.

The research to date shows that there is not much data to guide nursing decisions about the use of seclusion. The justification for its use is not always as clear as one might hope. Although many patients are secluded for violence against themselves or others, there are others who have not been violent who are secluded. There may be justification for secluding violent patients, but, as indicated earlier, it may reinforce the behavior it is designed to stop. There probably is no justification for secluding patients who make loud noises, refuse to take medication, or refuse to participate in activities. In addition, it is disconcerting that a large percentage of patients are secluded for "escalating agitation," that is, they have not acted violently against themselves or others. What is problematic is that staff are undoubtedly predicting violent behaviors in these patients--predictions that might be erroneous. Thus, there is ample room for injustice to occur. The potential for injustice is even greater if certain patients are singled out for seclusion or if patients are secluded longer than they or the staff think that they need to be, as is indicated in some of the studies to date. Moreover, if unit variables are associated with seclusion activity, this too, may be indicative of decision making at certain times of the day or by certain staff members that may not be in the best interest of the patient. What seems fairly clear is that secluding a patient is a distressing event for staff and is viewed extremely negatively by some patients and as a reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)     

Social Action and Social Work. Benjamin E. Youngdahl. New York: Association Press, 1966. 190 pp. $5.95 Hardbound

Social work field instructors are responsible for the gatekeeping function of evaluating student performance and determining practice readiness. Yet little empirical literature elucidates how field instructors of graduating BSW students judge competence, suitability, or readiness for practice. This qualitative study reports findings from 6 focus groups attended by 28 experienced BSW field instructors aimed at (a) exploring criteria used to judge student readiness for entry-level practice and (b) examining differences in expectations based on micro and macro placements. Two capacities emerged as being paramount in supporting the development of practice skills, personal attributes, and areas of practice in both micro and macro placements: conceptualization and self-reflection. Implications for evaluating student competence and supporting student learning in the field are discussed.