Summary: Ketamine is an anesthetic and can also reduce pain sensation. However, its use to treat depression is new. Studies show that few ketamine infusions can provide prolonged relief from depression. However, some doctors have raised concerns regarding the risk of ketamine abuse. Fortunately, a new study in rodents shows that ketamine is not addictive. It does cause an increase in dopamine. However, any such upsurge is short-lived and thus does not appear enough to cause addiction.

Ketamine is an anesthetic, and it is also known to help with pain. However, its use in managing depression is new. There is significant interest in ketamine treatment for depression as the studies show that it may help provide prolonged relief, unlike traditional antidepressants.

However, conversely, it is no secret that ketamine is also a club drug, a substance of abuse. It causes euphoria at higher dosages. Therefore, doctors worry that its frequent use may put their patients at risk, and many might become addicted to it. 

But some experts think that though it is psychotropic, it does not appear addictive. After all, it has been available for a long time, and there are not many people addicted to ketamine. Now, a new study shows that though it may stimulate the reward pathway, it also affects some other brain pathways that help prevent ketamine abuse.

Addiction vs. Dependence

Before discussing the risk of addiction further, it is vital to understand that addiction and dependence are two different things. Addiction is when one seeks a substance despite its negative health consequences. Addiction is a kind of behavioral disorder. For instance, opioid addiction treatment is carried out when abuse of opioids begins to produce negative effects on the body.  

Dependence, on the other hand, causes withdrawal syndrome on discontinuation of the use of the substance. In addition, dependence often causes severe physical signs. Drugs that cause dependence may affect most people who use them regularly.

Although most people may become dependent on some substances after their prolonged use, the same is not true for addiction. Studies show that only some people become addicted. Moreover, addiction only affects a small number of people.

For example, studies show that only one-fifth of cocaine users are really addicted to it. And for opiates, this rate is about 30%. In a recent study, researchers tried to understand the risk of addiction to ketamine.

Ketamine has a short-lived impact on the reward pathway

Generally, people get addicted to substances as they increase the levels of the pleasure molecule dopamine. For example, cocaine can boost the brain’s dopamine level for a long time. However, after some time, it would start falling, and thus a person would seek the drug to increase dopamine level again.

In the new study, researchers used a special device that allowed mice to self-administer ketamine. They found that it increased dopamine levels in mice, so they repeated the self-administration. However, they found dopamine levels elevated due to ketamine also falling quite quickly, unlike many other drugs of abuse.

Ketamine also seems to have the effect that prevents reward pathway stimulation

Researchers wanted to know why, unlike other drugs of abuse, ketamine treatment for depression causes such a short-lived increase in dopamine levels. They found that ketamine increased dopamine by inhibiting NMDA receptors. However, it also modulated other receptors, called the D2 receptors, that act as a brake on the rapidly increasing dopamine. 

Hence, they found that it is this dual mechanism that helps prevent permanent changes in the brain, unlike other drugs. Therefore, ketamine does not cause long-term behavioral changes. The increase in dopamine levels is for such a short time that it is not enough to cause addiction. The researchers concluded that there is almost zero addiction risk of ketamine in rodents.

Of course, these are still early findings. Nonetheless, it provides the basis for further studies. There is a need to find out if this is also true for humans. Considering that quite often, what works in rodents also works in humans, it is likely that it does not cause addiction. Even if it does cause, any such effect is probably quite low.

Summary: Opioid epidemic has been causing more deaths in the last few years than street drugs. Thus, everyone has quickly blamed doctors and pharmaceutical companies for this epidemic. Opioids are the most potent painkillers; without them, patients may suffer from severe pain. However, law enforcement agencies have been pressurizing doctors to reduce opioid prescriptions. Now, new studies suggest that medical prescription of these drugs may not have anything to do with the opioid epidemic. Even if opioids become hard to get, those prone to substance abuse would switch to other drugs. Therefore, there is no evidence that reducing opioid prescriptions would reduce drug overdose-related deaths. It will only result in the change of name of the substance that causes an overdose crisis.

Prescription drugs have been responsible for many deaths in the last decade or so. Almost all of these deaths have occurred due to drug overdose and misuse. Everyone seems to be blaming doctors and the pharmaceutical industry for the epidemics. However, many think that this epidemic has occurred due to widespread prescription of these medications, causing opioid addiction and increased misuse of these medications.

Opioids are one of the most potent painkillers. And in many clinical conditions, managing pain without these powerful pain killers is challenging. If doctors completely stop prescribing these drugs, it would result in poorly managed pain and other health harms.

However, new studies suggest that doctors prescribing opioids may have nothing to do with the epidemic. In one of the studies, researchers followed patients who were prescribed opioids for the first time to control severe pain. After six months of follow-up, less than one percent of the patients used opioids consistently.

People prescribed opioids are not likely to abuse them significantly

This is not the first study to show that opioid prescription is not to be blamed for the present epidemic. In one of the more extensive studies published in the reputed journal BMJ, researchers analyzed the data of 560 000 opioid naïve patients who were prescribed opioids for pain relief. The study found that in the long run, just about 0.6% were found to be misusing opioids.

Many studies show that there is no correlation between opioid misuse and prescription by doctors. It means that if doctors prescribe these drugs for pain relief, this does not contribute much to opioid epidemics. However, this also means that there are other less-known factors causing this epidemic.

However, despite the emerging data that doctors have nothing to do with an opioid epidemic, policymakers and law enforcement agencies are continually pressuring the medical community to stop prescribing these drugs or use them sparingly. However, doctors think that reducing their prescriptions would reduce their patients’ quality of life. In many cases, the situation in the US may become like that in some developing nations.

Since law enforcement agencies are pressuring doctors, CDC has even come up with a statement that agencies should stop misinterpreting its guidelines. Although CDC suggests that doctors should practice caution when prescribing these medications, doctors are in the best situation to decide when to prescribe and when not.

However, things in practice are quite complicated. For example, despite the clarification from CDC, pharmacies are not dispensing opioids in sufficient amounts to the patients.

Researchers further noted that restricting opioid use may help reduce opioid overdose rates. However, it would not result in a decline in substance abuse and related deaths since most people who misuse substances would switch to something else like fentanyl or heroin.

Also, since the regulatory agencies have started discouraging doctors from prescribing opioids, many other street drugs have come back. Thus, methamphetamine misuse has risen considerably in the last few years.

Experts suggest that law enforcement agencies should focus on their war on drugs instead of pressuring doctors and pharmacists. Since pressurizing, doctors would not result in less substance abuse. All it will cause is that addicts or those living with substance misuse disorder would shift to another substance. Hence, the name of the substances causing harm would keep changing, but the overall mortalities caused by substance misuse or overdose would not change.

Summary: ADHD is quite a common brain disorder. However, it remains poorly understood, and there are very few drugs that can help with the condition. Moreover, the mechanism of action of some drugs commonly used to manage the condition, like methylphenidate, remains poorly understood. The new fMRI study could confirm the pre-existing hypothesis that the drug acts on dopaminergic pathways and modulates the nucleus accumbens (NAc) activity.

Brain disorders are relatively difficult to diagnose and highly challenging to manage. Even healthy brains are prone to make errors. However, if the brain makes too many errors, that is a pathology. However, researchers often struggle to define boundaries between what is normal and what is not.

Even when brain disorders are diagnosed, they remain challenging to manage. Tweaking brain function is highly challenging. Science still has a limited understanding of the working of the human brain and, thus, challenges in tweaking its operations.

Nonetheless, science is making progress in understanding brain health. It is becoming better at diagnosing more complex disorders like ADHD Attention-deficit hyperactivity disorder. It is a relatively mild brain disorder and thus often overlooked. Studies now show that more than 5% of Americans are living with ADHD, and these are massive numbers.

If ADHD is not managed well, it may put individuals living with the condition at a disadvantage, as they struggle to perform and finish tasks, think clearly, concentrate, and so on. Fortunately, there are already a few drugs that can help those living with ADHD. Still, their mechanism of action is poorly understood yet.

Suppose science wants to make progress in treating more subtle brain disorders like ADHD. In that case, it needs to develop a better understanding of the disease. It needs to understand better how various drugs help in the condition and their exact mechanism of action.

Among various drugs used to manage ADHD, methylphenidate remains the drug of choice, a first-line treatment option, which means that millions of individuals are taking this drug to stay calm and enhance focus. It is a drug thought to influence dopaminergic pathways in specific brain centers like the nucleus accumbens (NAc). However, this is still a hypothesis, something not confirmed by high-quality studies.

Thus, in one of the first studies of its kind, researchers decided to confirm the mechanism of action of methylphenidate. For the study, they carried out a randomized, placebo-controlled, double-blind clinical study on 27 children living with ADHD. These children were given methylphenidate and a placebo, and their brains were scanned with a special focus on NAc and some other brain regions.2

The study found that the drug increased the neural activity in the NAc and the salience and default mode networks. However, more importantly, it could increase individuals’ response to variability during tasks requiring sustained attention. In addition, the study found that NAc and the salience and default mode networks showed replicable changes induced by the drug. Thus, the study confirmed its mechanism of action.

Researchers say that their study confirms that methylphenidate increases the activity of NAc and cognitive networks in those living with ADHD, which significantly increases attention span and focus.

Researchers say that these findings have multiple implications. It may help develop more effective medications for the condition. It may also help develop clinically valuable tests (biomarkers) for ADHD, which would help in a more accurate diagnosis of the condition.

Summary: Many people are living with chronic pain and need opioids to manage their condition. However, if, for some reason, they need to find a new physician, it becomes very difficult. People find it hard to find a physician who is ready to prescribe opioids for their chronic pain. A new survey of 452 primary clinics confirms that almost half of all clinics in the US do not want to take patients who use opioids to manage their pain. There are worries that they might have legal problems. They also think that patients must be abusing opioids leading to some serious opioid addiction. However, even if the patient is abusing opioids, it is not the reason to refuse care, as refusal may result in patients turning to illicit drugs.

Most Americans already know that it is pretty hard to find a physician who would readily treat their chronic pain, especially if they are on opioids. People often have to call many clinics before getting an appointment or finding a physician ready to help them. However, this is not just an imagination of some patients. A new study now confirms that it is a significant problem for those living with chronic pain and requiring opioids for pain treatment. If they need to change their physician for some reason, they are in trouble.
The new study shows that almost half of all clinics in the US are hesitant to treat patients living with chronic pain if they are on opioids. In the new study carried out by researchers at the University of Michigan, researchers used a technique called “secret shopper.” In the study, one poses as a female patient living with chronic pain and taking opioids. Then, experts called 452 primary clinics in nine states to ask if they were taking new patients.

Finding medical care for those using opioids for their chronic pain is challenging

If the clinic said “yes, ” the person would say that she is covered by insurance and looking for a new healthcare provider to treat her chronic pain, as her earlier physician has retired or stopped prescribing opioids. So the researchers made two calls to each clinic and talked about one of the scenarios.

To the researchers’ amazement, 43% of all clinics said they would not prescribe opioids in both scenarios (early physician retirement or physician stopped prescribing opioids). Only about 32% said that their primary care providers (PCPs) might prescribe opioids in these scenarios. However, another 25% gave mixed signals.

Here it is clear that doctors are hesitant to take patients that are taking opioids, and they are rejecting them without even considering their health condition. The study also found that clinics were twice more likely to reject these patients if they said their doctor stopped prescribing them opioids for some reason. In such instances, clinics assume that a person might be having problems related to opioid misuse.

The study suggests that there is a significant challenge in finding the proper medical care for living with chronic pain. However, the chances of finding care for chronic pain are further reduced if there are some indications that a person may abuse opioids. Healthcare experts warn that such a kind of refusal may significantly increase the risk of a patient’s conversion to illicit substances.

Researchers went further to explore why some clinics are so hesitant to treat such patients. They said that it is due to new legal norms and fear that they may get into some kind of trouble for prescribing these drugs.

The study results are consistent with another study done in 2019, in which researchers also found that 40% of primary care physicians are highly reluctant to treat patients who need opioids for their chronic pain.

However, this discrimination against opioid users is incorrect and poses some significant problems. Therefore, this study aims to show the existence of so-called bias towards opioid users and poor healthcare access.

Health experts say that even if a person is using opioids for other reasons than pain management, they still need medical help. In fact, those addicted to opioids need greater medical assistance, and those are the patients that primary care physicians must be treating.

Summary: Despite declining opioid prescriptions, opioid overdose-related events are increasing. Buprenorphine is among the first and most effective drugs to treat opioid use disorder (OUD). Unfortunately, a new study shows that those with a treatment gap are almost three times more likely to overdose on opioids. Thus, buprenorphine noncompliance must be regarded as a significant red flag.

Opioid use may be declining, but not opioid abuse. As pressure on doctors mounts, they are increasingly hesitant to prescribe opioids. However, data shows that this did not result in a decline in opioid abuse and opioid overdose-related deaths. In fact, opioid overdose deaths in 2021 were almost 50% more than in 2020, causing more than 70,000 fatal outcomes.

It means that there is still a need to understand or identify the causes of opioid overdose. It is essential to provide proper treatment to those living with opioid addiction. There must be more effort to prevent opioid overdose-related deaths. One of the ways to prevent these deaths is to identify the red flags and individuals at the greatest risk of overdose. Now the study shows that those who do not use buprenorphine medication regularly are considerably more likely to die of opioid overdose.

Buprenorphine is also a kind of opioid, but a safer opioid used to treat opioid use disorder (OUD). It is often prescribed as a part of opioid addiction treatment and is quite good. It is among the first medications approved for treating OUD. However, treatment outcomes depend on how regularly one uses any medicines. Thus, compliance is the key, and OUD treatment with buprenorphine is no exception.

In the new study published in one of the most reputed journals JAMA Psychiatry, researchers analyzed the data of 34,505 patients receiving buprenorphine medication under the Medicare scheme. They found that the treatment gap was more common in young males and those living with disabilities. However, more importantly, researchers found that the risk of opioid overdose in such individuals was 2.89 times higher than in nontreatment gap beneficiaries.

The difference of almost three times higher risk in different groups is massive and considerable. It is something vital to know. There were some other interesting findings in the study. The treatment gap increased the risk by 2.84 times in those prescribed 16mg/d of buprenorphine. However, this risk was 3.62 times in those taking 8mg/day or less. It means that the risk was higher in young patients or those in whom treatment had not been started long ago. 

These are interesting findings in many aspects. It is among the few studies that could identify a major red flag pointing to the risk of opioid overdose and related deaths. It shows that there is an urgent need to improve compliance in those taking opioid addiction treatment.

Of course, compliance is important in any treatment. However, no one imagined that noncompliance with buprenorphine treatment might be associated with such a massive opioid overdose risk. 

These findings are relevant both for the doctors and those living with OUD. For patients, it is vital to understand that they are risking their lives by not following the treatment. Therefore, one should avoid the casual approach, avoid seeking opioids, and instead try sticking to the treatment.

It is a wake-up call for doctors, healthcare workers, and policymakers to start taking opioid addiction treatment compliance more seriously. It is evident from the study that nontreatment compliance is one of the most significant overdose risk factors. Unfortunately, in many cases, identifying noncompliance is not an issue, especially in the age of electronic health records. Hence, steps must be taken to identify such patients and provide greater medical care to such individuals to prevent unfortunate events.

Summary: It is no secret that socially deprived people are more likely to abuse drugs. However, the study shows a massive difference between drug overdose-related deaths among the rich and poor. Poor people are almost six times more likely to die of drug and alcohol abuse. These findings are worrisome, as drug use has risen during a pandemic. Further, researchers think reducing social inequality is vital to prevent these deaths.

Although people of different backgrounds abuse drugs, poor people are more likely to die from a drug overdose. Data analysis from England shows that this risk is almost six times higher in poor people when compared to rich people.

Their findings are relevant and worrisome. Moreover, the same data shows that the number of deaths is mounting at an incredible pace. For example, in England, deaths due to substance use disorder have risen five times in just a decade, that is, between 2010 to 2020. Of course, a similar kind of trend is seen in the US and many other nations. Thus, these findings have global relevance.

Further, it is worth noticing that these findings are from the pre-covid era. Studies in all EU nations, the UK, and the US show that drug use rose considerably during the pandemic. It means that drug addiction and drug overdose-related deaths will only climb at an even faster pace. It is a health emergency in developed nations and many parts of the world.

It is also essential to note that these findings matter due to rising social disparity. Pandemics have especially hit the poorest people in society. Thus, it means that drug use is also more likely to increase in more impoverished people compared to rich people.

Be it in the US or in the UK, opioids remain the leading cause of drug dependency-related deaths. In the UK, street drugs like heroin are more likely to cause deaths. However, in recent years, the trend is also changing in the US, where prescription drugs remain the leading cause of overdose-related deaths. In the US, street drug overdose-related deaths are rising as prescription opioids are becoming less accessible.

This UK study shows that there is a very clear and visible relationship between the economic status of people, regions, and drug overdose-related deaths. Thus, for example, people living in the most deprived areas of England are several times more likely to die of a drug overdose. It means that healthcare efforts and addiction treatment must also focus on specific geo-locations where people are more likely to abuse and overdose on drugs.

Some efforts are already being made in the US. However, many researchers have shown that in any given state, most drug overdose-related deaths occur in a few counties in the states. Hence, one of the good ideas to reduce these deaths is to create risk maps, and concentrate drug overdose-related death prevention measures in those areas, rather equally in all counties. Coming up with such risk maps is not complex, and both the financial data and data regarding drug overdose-related deaths are readily available.

There is a need to understand that, for many, drug use is just a reaction to changing the environment. They often start using drugs to overcome stress, anxiety, and other mental health issues. Many of these issues are made worse by joblessness and rising homelessness.

Additionally, it is also worth understanding that the choice of drugs by economically deprived people differs. They are more likely to use drugs that pose a greater health risk. Additionally, they are also more likely to combine multiple drugs, thus increasing the risk of a drug overdose.

Experts say that some small changes in policies are not going to help. Most of these small changes may make it harder to get drugs and reduce drug-related crime a bit. However, the impact of most such measures is small and often temporary. Addressing these economic disparities is essential to lower the risk of drug overdose-related deaths.

Therefore, if we need to overcome this issue, we need to have a broader outlook. Opioids addiction treatment will require a 360 degree approach to tackle issues at societal level. Telemedicine Addiction Treatment is one such approach that can address the issue of drug abuse economically while maintaining the comfort and privacy of a person.

Summary: Opioid addiction is a significant health threat. However, not all opioids are equally addictive. It means that making changes to the chemical structures of existing opioids may make them less addictive. Researchers think that they have found a way to do so. It appears that introducing the fluorine atom to various opioids may make them less addictive and yet ensure that they work well at the site of injury.

Opioid epidemics are showing no signs of receding. However, on the other side, we cannot negate that opioids are among the best painkillers. It means that giving up opioid use altogether may cause specific issues. Doctors may find it hard to manage moderate to severe pain without opioids. The Lives of those living with chronic pain may become miserable.

On the other hand, it has long been known that various opioids differ significantly, and some of them are not addictive at all. For example, codeine used to treat pain and dry cough has a low probability of causing addiction. Likewise, the anti-diarrheal drug loperamide does not cause addiction at all. Finally, even the synthetic opioid painkiller tramadol does not appear to cause addiction. Hence, why not try to create potent opioid painkillers that might lack any addictive effect?

There is a need to make some minor changes in the existing opioids so that they stop penetrating the blood-brain barrier and causing euphoria. This is possible, though challenging. However, considering the rise in opioid overdose and painkiller abuse, it is also a need of time. Moreover, opioids are almost irreplaceable in many clinical conditions.

Of course, chemists could have done it a long time back if it was that simple. Nonetheless, in recent years, there have been many technological advances. Thus, for example, computational chemistry has provided greater power to chemists.

Understanding Opioid Chemistry

Though there are many types of opioids, as one can see in the image above, they share some basic structures. However, though they have minor differences, they result in entirely different chemical and even biological properties.

Of course, one of the issues is that one cannot make significant structural changes to opioids, as it may result in reduced efficacy. However, suppose we want to reduce addictive effects of opioids. In that case, we need to find ways of making more significant changes to opioids and yet ensuring that their pain-killing effect is preserved.

This subject is not new. There are already some opioids that have a pretty different chemical structure when compared to morphine or other classical opioids. One such example is fentanyl.

Studies show that one of the ways in which opioids work is by becoming positively charged upon coming in contact with body fluids.

This positive charge helps opioids to bind on the target site. However, the problem with the existing opioids is that they become positively charged in all body fluids, in different organs, including the brain. So, it means that if we could find some way of preventing it or ensure that it only becomes charged at specific sites, this can help overcome addiction and many side effects of opioids.

Making Opioids Less Addictive

Researchers think it is necessary to change the opioid structure so that they become positively charged only in high-acidity environments. Studies show that injured tissues or inflammation sites have higher acidity than other body parts due to lactic acid accumulation. It means that any opioid requiring a greater acidic environment for activation will have a greater effect on the target site and will be less likely to cause euphoria.

Researchers have found this is possible, especially with the introduction of a fluorine (F) atom near the nitrogen, in the amine group of fentanyl. This will ensure that fentanyl remains less active in various body fluids but gains a higher activity level at the sites of inflammation and pain. What is exciting about this finding is that new studies show that introducing the fluorine molecule into morphine may also alter its characteristics. Thus, morphine will need a bit higher acidity to become active and start acting. This will help produce morphine that is more active in injured tissues, and thus less active in the brain and other sites, and hence less likely to cause addiction.

Now-a-days, the opioid treatment programs have started to utilize suboxone in their treatment, which is another potential medication. Researchers think they can explore an approach to alter the working of oxycodone and hydrocodone further. However, to date, this approach has only been tested in labs and appears to work. Thus, now there is a need to evaluate it in clinical trials.

Summary: More than 85% of US adults report drinking alcohol, and data suggests that about 25% of the population engages in binge drinking. Additionally, it appears that about 6% of adults are addicted to alcohol. Prolonged alcohol abuse causes premature death due to many causes like a motor vehicle accident or liver disease. The new study suggests that Covid-19 intake has increased alcohol-related deaths. This may be due to increased mental stress, work-from-home culture, and other reasons.

Alcohol consumption is pretty common and is a part of western culture. Thus, no surprise that all reputed localities are laced with pubs, bars, and more. It is common for people to have a drink after a hard working day. A drink helps relax and communicate and is an enjoyable activity. Though most people know that excessive alcohol can harm health, many do not realize the scale of the problem. This may explain the rate of increasing deaths due to alcohol addiction.

US data shows that about 85% of all adults drink alcohol. However, casual alcohol drinking is not an issue. But US statistics are alarming as they show that one-fourth of US adults engage in binge drinking. As a result, one-fourth of the population is at the risk of developing excessive alcohol consumption-related disorders and premature death.

Studies also suggest that about 7% of adults in the US are living with alcohol addiction. An estimated 14.5 million people older than 12 years of age have alcohol abuse disorder (AUD). AUD or alcohol addiction is a disease that must be treated; else, it may harm health severely. But, regretfully, only about 10% of those living with AUD or alcohol addiction seek treatment for the condition. Instead of seeking for their alcohol addiction treatment, people are more likely to seek treatment for health disorders caused by excessive drinking.

Alcohol addiction or excessive drinking may cause premature death for many reasons, like motor vehicle accidents, homicides, alcohol overdose, suicides, liver disease, kidney failure, and cancer. What is worrisome is that people of working age are more likely to consume alcohol excessively. Excessive alcohol use now causes more than 140,000 deaths in the US annually. It means about one in ten deaths among working-age adults is due to excessive alcohol use.

What the new studies add to the current understanding of alcohol addiction is that excessive alcohol use-related deaths are rising. It confirms the worrisome trend. Although in the last few decades, there is not much change in the rate of alcohol consumption, but more people are engaging in binge drinking.

The study was especially done by keeping in mind the impact of the Covid-19 epidemic on alcohol consumption habits. Covid-19 caused significant stress. Additionally, more people started working from home. The study confirmed that this resulted in excessive alcohol intake. This resulted in a slight increase in alcohol-related deaths in the US from 2.8% in 2019 to 3% in 2020.

Although data may show only a minor increase in alcohol-related deaths, nonetheless, the numbers are significant. Moreover, it shows an upward trend, something that cannot be neglected.

Alcohol consumption in moderation does pose many health threats. However, binge drinking (four or more drinks) or heavy drinking (eight or more drinks) can significantly harm health. To prevent deaths associated with excessive alcohol consumption, people should seek attention for alcohol use disorder (AUD) and not for health complications arising from alcohol addiction.

Treating alcohol addiction or AUD is different from treating drug addiction. AUD is often the result of years of alcohol use. Quite often, a person may not even realize that he or she is living with the condition. Most such individuals start by drinking alcohol in moderate amounts. However, with time or due to stress, they might begin abusing alcohol.

Summary: Those living with opioid use disorder are generally hesitant to seek medical help. However, covid-19 epidemic has only made things worse. Thus, policymakers legalized providing medical care to those living with OUD via telehealth. However, there have been some concerns regarding the decision. The new study shows that telehealth is beneficial for those living with OUD and is associated with a reduced risk of overdose events. This underscores the importance of telehealth in providing treatment and care for opioid addiction treatment.

The scale and extent of covid-19 pandemic took everyone by surprise. The world was not ready for the pandemic. This created many challenges. It made providing medical help to a specific group of patients more difficult. Moreover, due to covid-19, people got confined to homes and traveled less often. It also means that covid-19 related restrictions created a barrier to seeking medical help.

 

It is no secret the those living with opioid use disorder (OUD) are less likely to seek medical help. There are many reasons, from social stigma to disbelief in the system. For such individuals, things became even more difficult during the pandemic times.

Fortunately, US policymakers realized this challenge faced by people living with OUD and legalized telehealth for OUD. It means that for the first time, doctors could legally prescribe opioids used to manage OUD without seeing a patient. However, this change in policy was not well received by everyone. Many were skeptical of such a change and worried that it might even make the ongoing opioid overdose epidemic worst, as opioids would become more accessible for many.

Fortunately, a new study shows that these policy changes have been beneficial and resulted in reduced risk of overdose. The study was carried out by researchers from CDC, NIDA, NIH, and CMS. The results of the study were published in the journal JAMA Psychiatry.

In the study, researchers analyzed the data of 175,778 Medicare beneficiaries from September 2018 to February 2021. They focused on analyzing the events of an overdose in those who received medications for opioid use disorder (MOUD) through telehealth during the pandemic.

They had several interesting findings:

• They found that there was a sudden upsurge in people seeking telehealth services for OUD. Thus, these numbers increased from 0.6% to 19.6% during the pandemic.
• Interestingly, they also found that people receiving telehealth care were more likely to receive MOUD, which was 12.6% for telehealth. In contrast, these numbers were 10.8% for those who visited the doctors.
• Telehealth services had many positive effects on patient care. Thus, those treated for OUD were more likely to stick to their treatment. In addition, patients were less likely to overdose on their drugs.

Researchers say that their findings show that telehealth services helped overcome the barrier to medical care for addiction. This barrier to seeking medical help is among the most important reasons why many do not seek medical help. Lack of treatment and support naturally means a greater risk of a drug overdose. 

Researchers say that there is clear evidence of the benefit of telehealth. It is not just good for patients; it can be lifesaving for many. In addition, it is clear that telehealth can have many long-term positive effects on patients.

The study also noted some disparities due to an existing digital divide. Thus, non-Hispanic black people were less likely to seek tele help. Therefore, countering this digital divide is vital for fully exploiting the benefits of telehealth.

Researchers say that though the covid-19 pandemic has created many challenges for the healthcare system, it has also provided opportunities for investigating various ways of providing healthcare.

To sum up, this study is supportive of telehealth for OUD, and it shows that these services must be continued even in the post-pandemic era. 

Summary: Since Purdue Pharma, the manufacturer of OxyContin, agreed to close their company by paying $8 billion in compensation, several other investigations and legal battles have begun. The Justice Department has filed a legal case against Walmart retail and wholesale for dispensing opioids without taking a good look at prescriptions, thus blaming it for having played a role in the opioid epidemic. However, Walmart disagreed, saying it could not come in between the doctor and patients and reported suspicious prescriptions to DEA. Ultimately, such legal battles might also impact patients who need opioids to control their chronic pains.

Since the opioid epidemic has come into the limelight, things have been changing fast. New regulations and prescription guidelines have been introduced by different stakeholders. However, due to pressures from various groups, multiple investigations have also begun, and so has the blame game.

Thus, the Department of Justice now alleges that Walmart has played a significant role in the opioid crisis. Moreover, the department says that Walmart’s retail chain and distribution unit are to be blamed for the epidemic.

The Justice Department says that Walmart did not pay adequate attention to many things, and thus they broke the law. They continued to dispense opioids to hundreds and thousands of people with invalid prescriptions and failed to report suspicious opioid orders. The department has filed a legal case against Walmart in the US District Court for the District of Delaware.

The department says that as the largest pharmacy chain, it has the means to prevent violations. However, they did not take appropriate measures.

However, Walmart has blasted the Justice Department for inventing some kinds of theories. They say that doctors prescribed, and Walmart pharmacies were bound to fulfill prescriptions. Therefore, Walmart cannot come in between the doctor and the patient.

However, the Justice Department did not agree with Walmart’s explanation, saying that Walmart knew that many of those prescriptions were not for true medical purposes. Not only that, but the Justice Department also blames Walmart for failing to report these issues to the Drug Enforcement Agency (DEA).

However, Walmart did not agree with most of this, as it says there has been a failure at the end of regulatory agencies, including DEA. They say they have empowered their pharmacists to refuse to fill prescriptions if they find them doubtful or if the opioids were not prescribed for the right reasons. On its end, Walmart claims it has sent tens of thousands of investigative leads and blocked thousands of questionable doctors. However, DEA failed to act on these leads.

The Justice Department has been pursuing all the companies it deems responsible for the opioid epidemic. However, things changed after Purdue Pharma, the maker of OxyContin, pleaded guilty and agreed to pay more than $8 billion to close the company.

However, all these legal tussles and blame games are not good news for people living with chronic pain and struggling with opioid addiction. It means those who need opioids for chronic pain treatment would now struggle to get prescription refills and those seeking opioid addiction treatment may face difficulty as well.

There is no doubt that doctors and pharmacists should take extra care when prescribing and dispensing controlled substances. However, abuse of specific medications by some individuals should not result in the inaccessibility of these beneficial remedies for those who need them most, including those seeking chronic pain treatment or opioid addiction treatment.

It is true that the opioid epidemic has caused many issues. However, if opioids become difficult to get, many of those addicted to opioids will start using other substances. However, when it comes to people living with chronic pains, they have limited options, as in many cases, opioids are irreplaceable. Thus, if the industry becomes too hesitant to produce, pharmacies reluctant to dispense, and doctors unwilling to prescribe, millions of people would suffer from pain and other severe health issues.