Pubdate: Sun, 15 Apr 2018
Source: Houston Chronicle (TX)
Copyright: 2018 Houston Chronicle Publishing Company Division
Author: Keri Blakinger


SAN DIEGO - Support for drugs like Suboxone, Vivitrol and methadone
was one of the rallying cries at the annual American Society for
Addiction Medicine conference this week in California.

Broadly known as medication-assisted treatments, the drugs are
sometimes-controversial tools for battling the growing opioid
epidemic. Though they work in different ways, all three can be taken
long-term to reduce the chance of relapse into drug use.

"It's not a matter of ideology," said ASAM president Dr. Kelly Clark.
"It's a matter of the facts show a person's risk of dying is higher
when they don't take medication."

Dr. Elinore McCance-Katz, assistant secretary of the Substance Abuse
and Mental Health Services Administration, touted the use of
addiction-fighting medications during a Friday opening plenary in
front of some 2,000 doctors and other event attendees.

"Medication assisted treatment is the standard of care for opioid use
disorder," she said forcefully, drawing applause.

One of the success stories highlighted repeatedly at the conference
was Rhode Island's progressive approach to addiction treatment in its
combined prisons and jails.

The Rhode Island Department of Corrections in 2016 became the first
prison system in the country to offer all three addiction medications
to prisoners still serving their sentences - a move that generated a
61 percent reduction in overdose deaths among those recently released
from prison, according to study published in JAMA Psychiatry.

Though the New England state's approach was heralded as
forward-thinking, the Harris County jail has already taken steps in
the same direction.

Late last year, Harris County launched what officials touted as the
first jail Vivitrol program in the state.

"We're trying to be more innovative as an agency," Sheriff Ed Gonzalez
said in November. "Incarceration only is not an effective solution."

Vivitrol, also known as naltrexone, is a non-addictive, non-narcotic
monthly shot designed to reduce cravings and block users from getting
high. Suboxone (also known as buprenorphine) and methadone are also
intended to fight addiction, and they work by latching onto the body's
opioid receptors and prevent the heroin from attaching.

Unlike naltrexone, the other two drugs also deliver a little bit of
their own painkilling effect. And they're both considered narcotics,
which has been a source of some discomfort among corrections officials
and some in the recovery community.

In addition to pushing for medication-assisted treatment, experts at
the annual conference pushed back against the move toward medical
marijuana approval in a growing number of states.

"It is not a health product, and it has adverse effects," McCance-Katz
said. "For too many years a multibillion-dollar unopposed industry has
presented this drug as a healthy pastime - it isn't."

Specifically, McCance-Katz said, the drug is linked to increased risk
for later psychotic disorder and IQ losses.

The use of medical marijuana has long been a source of debate among
medical experts, and some studies have offered support for its
efficacy in treating specific conditions like chronic pain and
chemotherapy-induced nausea.

"Is x, y, or z a gateway drug? The answer is yes, every drug is a
gateway drug," she said. "Youth who are using cannabis are more likely
to then use opioids. Every drug that is available is a gateway drug.
Alcohol is a gateway drug, nicotine is a gateway drug."

This comes just two months after the first delivery of prescription
pot hit the market in Texas, where the new Compassionate Use Program
allows patients to qualify for low-THC cannabis medications. The
program is limited only to patients with intractable epilepsy who have
run out of other medicinal treatment options.

In 2017, the Texas Department of Public Safety licensed just three
dispensaries, move that sparked concern among advocates and patients.

Unlike in other states, Texas requires doctors to prescribe the drug
instead of simply recommending it.
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