When alcohol withdrawal has to be treated on an inpatient basis

Contrary to popular belief, alcohol withdrawal does not have to be treated on an inpatient basis. Two cardinal signs — a history of alcohol‐withdrawal delirium or alcohol‐withdrawal seizures — indicate hospitalization. So do certain comorbidities. Most cases can indeed be treated on an outpatient basis, according to two top experts: Lorenzo Leggio, M.D., Ph.D., senior investigator with the joint National Institute on Alcohol Abuse and Alcoholism (NIAAA)‐National Institute on Drug Abuse (NIDA) Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, and Mark Willenbring, M.D., founder and CEO of Alltyr in St. Paul, Minnesota and former director of the Division of Treatment and Recovery Research at NIAAA. However, even though it can be treated on an outpatient basis, it often isn't, and there's a good reason for that — better safe than sorry, to sum it up.     

NIDA: How parents can talk to children about opioids

The National Institute on Drug Abuse (NIDA), part of the federal National Institutes of Health, has advice for parents in the midst of the opioid epidemic: “[T]alk openly about the effects of opioids and other drugs with your children and stay actively engaged in their lives.”     

Vaping nicotine and marijuana more than doubled

Last week, the annual Monitoring the Future (MTF) report from the National Institute on Drug Abuse (NIDA) revealed dramatic increases in vaping of marijuana and nicotine among college students and young adults. The study shows that marijuana use is almost at its highest level in the past four decades.     

NASADAD calls for nominations for annual SSA award

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) is requesting nominations for the annual Ramstad/Kennedy Award, presented to a single state agency (SSA) — the state director who is responsible for the Substance Abuse Prevention and Treatment block grant (and STR and SOR grants, now).     

NIDA: Daily marijuana use at 13% in noncollege young adults

The latest Monitoring the Future (MTF) survey results on teens transitioning to adulthood shows that more than 13 percent who are not in college are using marijuana on a daily basis. Conducted for the National Institute on Drug Abuse (NIDA), MTF is a national survey released in December every year, with a specialized focus on 19‐ to 22‐year‐olds released in the following September.     

NIDA: Plethora of treatments for SUDs,regardless of substance

When people refer to “evidence‐based” treatment, they mean treatment that has been proven to be effective and has been incorporated into strict protocols via manuals, so they can be replicated. The National Institute on Drug Abuse (NIDA) has been tracking the many treatment models for general substance use disorders, as well as for specific substances. Motivational interviewing (MI), medication‐assisted treatment (MAT), contingency management (CM) and cognitive behavioral therapy (CBT) are all evidence‐based modalities, explained Ruben Baler, Ph.D., NIDA health scientist, in an email to ADAW.     

More than a funder,the SSA needs community providers

The Single State Authority — SSA — is an office, but, in reality, is actually a person. This person is in charge of the ongoing Substance Abuse Prevention and Treatment (SAPT) block grant. There is one in every state. This person is also in charge of the STR and SOR grants for opioid use disorder treatment. For this story, we interviewed four longtime former SSAs about their lessons learned and their advice to new SSAs in a role that is in the spotlight both within state government and in the community, as billions of new dollars flow out to their systems. Each SSA is a member of the National Association of State Alcohol and Drug Abuse Directors (NASADAD).     

NASADAD report shows benefits of data mapping

Geographic information system (GIS) technology — a combination of maps and data — is helping state agencies decide how to plan and monitor their prevention, treatment and recovery activities. A new issue brief from the National Association of State Alcohol and Drug Abuse Directors (NASADAD) focuses on how two states — Washington and Pennsylvania — have made GISs a part of their operations, to the benefit of communities.     

Table of Contents

National Strategy Focuses on Screening Seabrook House Will Establish Facility for Transitional Care by Summer Drug Control Funding: Agency Summary FY 2006 – FY 2008 The Addiction Project Combines Film, Host of Activities NIDA Releases Booklet on Addiction to Complement HBO Release CADCA and CHPA Launch Cough Medicine Abuse Campaign Parity Update: Insurance Discrimination Tracked Licensing of Transitional Centers Differs Among States Briefly Noted Resources Names in the News Coming up     

DRUG POLICY IN THE TIME OF AIDS:

In 1985, the National Institute on Drug Abuse (NIDA) funded an ethnographic research project in San Francisco to study the needle sharing behavior of injection drug users (IDUs). The goal of the research was to develop a strategy to slow the spread of HIV among this hidden and hard to reach population of drug users and their sexual partners. This small-scale project grew into a model intervention in which bleach, condoms, and street-based education by outreach workers were employed to inform IDUs of the risk of AIDS and of methods for protecting themselves. The "reach and teach bleach" model was adopted by NIDA and implemented in a number of American cities. This study describes the development of the model intervention, the adoption of the model by NIDA as part of its National AIDS Demonstration Research (NADR) project, and the political circumstances under which the city of San Francisco applied for the NADR grant. Drawing on Social Worlds/Arena theory, and based on extensive interviews and participant observation, a sociohistorical analysis examines the initial development, implementation, and disintegration of the model outreach project and the impact of the program on drug policy in the city of San Francisco.     

Transitioning SOR to the SAPT BG: Why not?

It's time to think about transitioning the State Opioid Response (SOR) grants to the Substance Abuse Prevention and Treatment (SAPT) block grant, Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), told the House Energy and Commerce Committee at its March 3 hearing on opioid legislation. The STR and SOR grants went directly to single state authorities (SSAs) in charge of the SAPT block grants — NASADAD members — so this makes perfect sense. These are the officials who best know how funding should be spent in their states — on what substances, including alcohol. Instead of having a designated amount set up for opioids — although that was expanded to include stimulants as well (see “FY 2020 Appropriations: Stimulants added to SOR's $1.5 billion,” ADAW, Dec. 23, 2019, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32573 ) — each SSA should just have this funding added permanently to the block grant.     

Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.     

NASADAD: The view from SAMHSA,from a state and from CMS

Last week, state directors and other attendees of the annual meeting of the National Association of Alcohol and Drug Abuse Directors (NASADAD) were treated to a stunning opening reception by the delegation from Hawaii, including entertaining, dancing, music and delicious food. The next morning, they heard from federal and state officials about important issues they are dealing with — starting with how to use the STR and SOR grants.     

Pharmacy model for methadone,NAS link to demographics

In “Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction,” senior author Jeffrey H. Sabet, M.D., and colleagues write about the lack of access to methadone treatment, in particular, for opioid use disorder (OUD) in the United States. They look at three pharmacy‐based models that exist in other countries. In their article, published online Feb. 6 in the Journal of General Internal Medicine, they promote the model of patients picking up methadone from pharmacies, as is done in, for example, Canada. The study was funded by the National Institute on Drug Abuse (NIDA) (from the United States) and cited by many as a call to reform the current opioid treatment program (OTP) system in the United States, where patients often prefer buprenorphine simply because they don't have to abide by methadone regulations.     

President's proposed budget would slash treatment and prevention funding

We had a feeling of déjà vu when the White House sent its proposed budget to Congress last week. Similar to past years, the Office of National Drug Control Policy (ONDCP) would be decimated, moving the $100 million Drug‐Free Communities program to the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). There's no additional money in the Substance Abuse Prevention and Treatment (SAPT) block grant and cuts to the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, CSAP and SAMHSA's Center for Substance Abuse Treatment.     

State profiles on STR and SOR spending released by NASADAD

The Substance Abuse and Mental Health Services Administration (SAMHSA) is keeping its evaluations under wraps, but the National Association of State Alcohol and Drug Abuse Directors (NASADAD) has released a state‐specific list of how the State Targeted Response to the Opioid Crisis (STR) and State Opioid Response (SOR) grants are being spent.     

Study: Elevated risk of substance use if parents use marijuana

Last month, JAMA Network Open published a study indicating that recent and past parental marijuana use confers a heightened risk for use of marijuana — and other substances — by their adolescent and young adult offspring who live in the same household. The article from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse and McLean Hospital is in line with federal anti‐marijuana policy (marijuana is still illegal under federal law, although states have legalized it, both recreationally, in some cases, and medically, in more).     

Attitudes about addiction: a national study of addiction educators

The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the Addiction Belief Inventory (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n=215). Results suggest that addiction educators view substance abuse as a coping mechanism rather than a moral failure, and are ambivalent about calling substance abuse or addiction a disease. Most do not support individual efficacy toward recovery, the ability to control use, or social use after treatment. Modifiers of addiction educator attitudes include level of college education; teaching experience; licensure/certification, and whether the educator is an addiction researcher. Study implications, limitations, and directions for future research are discussed.