From the Archives: Treating Opioid Addiction

It is estimated that between 26.4 million and 36 million people abuse opioids worldwide; the US government estimates that 2.1 million people in the United States have substance use disorders related to prescription opioid pain relievers in 2012 and another 467,000 are addicted to heroin. Consequences include a spike in the number of unintentional overdose deaths from prescription pain relievers (including the recent death of the musician Prince), and growing evidence to suggest a relationship between increased non-medical use of opioid analgesics and heroin abuse in the US.

OBrien_Charles_featWhat can we do to help? This spring, Charles O’Brien and colleagues reported results of the latest in a series of studies testing the drug naltrexone as a preventive against opioid relapse in people greatly at risk for relapse: formerly addicted convicts. “This U.S. multisite, open-label, randomized effectiveness trial showed that among adult offenders who had a history of opioid dependence, the rate of relapse was lower among participants assigned to extended-release naltrexone than among those assigned to usual treatment,” they write.

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National Recovery Month: Drug and Alcohol Addiction

OBrien_Charles_featThe month of September is dedicated to raising awareness about recovery from drug and alcohol addiction. This month, we interviewed Dana Alliance member Charles O’Brien, M.D., Ph.D., who founded the University of Pennsylvania’s Center for Addiction Treatment. For more than thirty years, O’Brien has worked to improve addiction treatment and has made many breakthroughs regarding the clinical aspects of addiction and the neurobiology of relapse.

In your opinion, what is the most common misconception about drug and alcohol addiction?

Most physicians learn very little about addictive disorders in medical school or residency. Rather than being considered a disease of the brain, most see it as bad behavior. They don’t know that there are FDA approved medications and that patients do respond to treatment, even though “cures” are rare.

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Drug Addiction and Incarceration

Last month, at a Capitol Hill briefing in Washington, D.C., experts gathered to address the surge in opioid drug abuse and fatal overdoses among people of all demographics within the United States. According to a 2010 study done by the Centers for Disease Control, prescription opioids accounted for 60% of overdose deaths, a statistic that has doubled in just over ten years. While there is work being done by federal and state agencies to deter future abuse of prescription painkillers, speakers of the event focused particularly on those who are imprisoned as a result of their addiction.

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Addiction Neuroethics

“Are ethical concerns impairing the treatment of opioid addicts with criminal history?” asked Charles O’Brien, M.D., Ph.D., at the International Neuroethics Society meeting’s opening panel on addiction neuroethics. O’Brien, a Dana Alliance member and a pioneer of addiction research, is working with the Philadelphia prison population, where 18 percent of parolees have an opioid addiction. To reduce reincarceration for these parolees, O’Brien supports the use of the drug naltrexone, FDA approved for alcohol addiction in 2006, and recently approved for opiates. It carries minimal side effects and no withdrawal symptoms, he said. By prescribing this drug to addicted parolees, “you’re guaranteeing they can’t become re-addicted,” stated O’Brien.

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International Neuroethics Society 2012 Annual Meeting

Paul Root Wolpe, Ph.D., is the Asa Griggs Candler Professor of Bioethics and the director of the Center for Ethics at Emory University. He is also the program committee chair of the International Neuroethics Society.

It is my great pleasure to invite you to join us at the 2012 International Neuroethics Society (INS) Annual Meeting in New Orleans, October 11th and 12th, right before the Society for Neuroscience Meeting. The INS is a society dedicated to exploring the ethical, social, and legal implications of neurotechnology and clinical neuroscience. Our website can tell you more about the society, and about the agenda of our program and how to register.

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