Nuggets from AATOD: New CSAT director comments

Here are more reports from last month's American Association for the Treatment of Opioid Dependence (AATOD) conference in Orlando — in particular, insights from Louis Trevisan, M.D., the new director of the Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA).     

Talbott,patient advocate and OTP owner,leaves BayMark

Zac Talbott's last day with BayMark Health Services, which bought his opioid treatment programs (OTPs), Counseling Solutions Treatment Centers, in Chatsworth, Georgia, and Brasstown, North Carolina, last year (see “From starter OTP to acquisition by BayMark: A 3‐year journey,” ADAW, Sept. 8, 2018, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32095 ), was May 24. He had various options and opportunities that could have resulted in him leaving earlier, but he did not want to leave in the midst of so much change. He opened the first Counseling Solutions clinic in 2015 (see “Methadone patient and advocate to open own OTP in Georgia,” ADAW, Aug. 17, 2015, https://onlinelibrary.wiley.com/doi/10.1002/adaw.30292 ).     

Koob addresses RSA meeting with NIAAA update

Last week, the Research Society on Alcoholism (RSA) held its annual scientific meeting, opened by an address from George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The researchers and others in attendance heard an update of NIAAA's program efforts. NIAAA funds much of the alcoholism research in the United States, with a budget of $525 million for FY 2019 (the budget for 2020 is still under development). Would‐be grantees are very interested in this funding. Grant awards and start dates are based on the budget process and fund availability, Koob said.     

EMTs authorized to carry buprenorphine in New Jersey

Last month, the New Jersey state health commissioner issued an executive directive allowing medical directors of New Jersey's 21 Mobile Intensive Care Unit (MICU) programs to carry buprenorphine, which can be used to mitigate opioid‐withdrawal symptoms following an overdose reversal with naloxone. People who are revived with naloxone after an overdose go through withdrawal, which can be intense and painful. Only an opioid, like buprenorphine, can reverse these symptoms.     

The other side: Pro‐cannabis physicians dispute SG advisory

Last week (see ADAW, Sept. 9), we wrote about the advisory from U.S. Surgeon General Jerome Adams, M.D., recommending against marijuana use by pregnant women or adolescents ( https://www.hhs.gov/surgeongeneral/reports‐and‐publications/addiction‐and‐substance‐misuse/advisory‐on‐marijuana‐use‐and‐developing‐brain/index.html ).     

As HIPAA changes loom,patients demand continued confidentiality for SUD records

In last week's issue, we wrote about the plans by the federal Department of Health and Human Services (HHS) to weaken the Health Insurance Portability and Accountability Act (HIPAA), citing regulatory burdens and the need for information‐sharing (see ADAW, Jan. 21). The plans, detailed in a request for information (RFI) issued Dec. 12, throw a wrench into the plans by the “make 42 CFR Part 2 like HIPAA” movement, which would erase the federal confidentiality regulation protecting substance use disorder (SUD) treatment records by watering it down to HIPAA standards. Now, with even HIPAA seeming too burdensome, the need is even greater to protect the consent provision of 42 CFR Part 2 — which is basically all that's left after the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed information‐sharing for the vague “health care operations” without consent last year (see ADAW, Jan. 8, 2018). Last week, H. Westley Clark, M.D., J.D., dean's executive professor at Santa Clara University and former director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, made this abundantly clear in his comments to ADAW.     

ADA settlement exposes liability when providers refuse MAT patients

Gov. Andrew Cuomo of New York has added opioid use disorders (OUDs) to the list of approved conditions for which medical marijuana could be prescribed in the state, following the lead last month of New Jersey Gov. Phil Murphy, who limited such use as an “adjunct” to medications like methadone and buprenorphine (see ADAW, Jan. 28).     

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.     

Alcoholism starts in youth,so it should be screened for

Alcohol use disorder (AUD) — what used to be called alcoholism, but a condition which by definition is sometimes used to apply to everyone who drinks alcohol and is underage — is not a disease of adults only. It starts in childhood, and that's why Scott E. Hadland, M.D., and colleagues argue for screening in the February issue of Pediatrics.