• Methadone
• Buprenorphine
• Naltrexone

MAT programs with methadone are part of a harm-reduction approach to fentanyl addiction treatment. Programs with MAT prioritize treating the whole person in a collaborative, patient-centered environment. In MAT programs, mutual cooperation between patient and provider is essential. These programs stress individual input, personalized treatment based on self-identified goals, and an effort to help each patient to improve overall health and wellbeing by facilitating engagement in significant lifestyle changes and accessing all possible avenues of social support services available.

People in comprehensive, harm-reduction oriented, whole-person MAT programs experience:

• Reduction in opioid use
• Reduction overdose fatality
• Improved treatment retention/adherence
• Increased social and family function
• Increased work and school function
• Decreased rates of relapse
• Decreased rates of criminal behavior

That’s why it’s called the gold standard treatment for OUD. We know from firsthand observation that methadone:

• Stabilizes brain chemistry
• Eases physiological cravings
• Normalizes physiological functioning
• Allows a person to successfully initiate and engage in counseling/therapy

Opioid use disorder (OUD) appears in many forms. People may develop addiction to illicit opioids like heroin, prescription medications that contain opioids, and other street drugs and/or illicitly manufactured drugs designed to look like legitimate prescription medication. In recent years, a dramatic influx of an opioid called fentanyl has complicated efforts to mitigate the harm caused by the ongoing opioid crisis in the U.S.

To learn more about the risks associated with fentanyl, please read this article on our blog:

Why is Fentanyl So Dangerous?

Spoiler alert: fentanyl is 50 times stronger than heroin, 100 times stronger than morphine, and so powerful that a single dose of only 2 mg can cause fatal overdose.

Methadone Treatment: More Effective Than Other MOUDs for Fentanyl Addiction

There are two primary reasons methadone treatment works best or fentanyl addiction:

1. The strength of fentanyl
2. The way methadone works

We mention above that fentanyl is a powerful opioid, significantly stronger than heroin, morphine, and all the common prescription opioids that carry risk of misuse, disordered use, and addiction, such as oxycontin, Percocet, Vicodin, and others.

What we don’t mention above is that among the FDA-approved medications for opioid used disorder (MOUD), methadone is a full opioid receptor agonist. Opioids achieve their effect by binding to opioid receptors in the brain, which results in significant pain reduction and euphoria, among other effects. When a person stops taking opioids, withdrawal symptoms appear within hours, including:

• Nausea
• Chills
• Sweating
• Vomiting
• Agitation
• Cravings for opioids
• Insomnia
• Anxiety

Among the opioids of misuse and disordered use driving the opioid crisis, fentanyl – aside from a far less common variation, carfentanil – is the most powerful. Treatment professionals and addiction scientists now know that because of its increased strength, withdrawal from fentanyl is more intense and severe than withdrawal from other opioids.

This brings us to why methadone works best for fentanyl addiction.

As we mention above, methadone is a full opioid agonist, meaning it binds fully to and completely occupies opioid receptors in the human body. On the other hand, buprenorphine – a MOUD currently in widespread use for people with OUD – is a partial opioid agonist. This means it binds to and partially – but not completely – occupies opioid receptors in the human body.

For patients with a history of high dose, chronic fentanyl use with severe fentanyl addiction, the difference in the effectiveness between methadone and buprenorphine can be the difference between a successful recovery and relapse.

Many patients with severe fentanyl addiction report methadone is more effective at reducing the symptoms of withdrawal compared to buprenorphine, and is particularly effective in reducing opioid cravings, compared to buprenorphine.

Methadone: The Gold Standard for Fentanyl Addiction

Evidence published in a report called Methadone Treatment for People Who Use Fentanyl shows people on methadone with OUD had a lower risk of opioid related mortality compared to patient with OUD on buprenorphine:

• Methadone treatment: adjusted hazard rate (AHR) of 0.41
• Buprenorphine treatment: AHR of 0.61

Evidence from the same report shows that patients on methadone stay in treatment longer, compared to patients on buprenorphine. The longer a person stays in treatment, the lower their risk of relapse, complications associated with fentanyl use and accidental overdose.

Researchers and treatment professionals indicate that both methadone are first-line options for people with OUD. However, people with OUD who may benefit from methadone rather than buprenorphine include:

• New patients at high risk of early treatment drop-out
  • All patients with a history of severe/high fentanyl use are at increased risk of early treatment drop-out
• Patients at high risk of relapse
  • All patients with a history of severe/high fentanyl use are at increased risk of relapse
• Patients who’ve had success with methadone in the past
• New patients who do not want buprenorphine
• Patients who have had no success in previous treatment with buprenorphine

There’s another danger associated with fentanyl we haven’t addressed yet: its presence in illicit, non-opioid drugs. The DEA reports the presence of fentanyl in drugs such as methamphetamine, cocaine, and Adderall. A person taking these drugs – and the people around them – may not recognize the signs of opioid overdose because they don’t know they – and the people around them – may not be aware they ingested an opioid.

Signs of fentanyl overdose include:

• Slow breathing/no breathing
• Slow heartbeat/no heartbeat
• Loss of consciousness/unresponsive to attempts to waken
• Pale, clammy face/skin
• Blue/purple lips or fingernails
• Vomiting
• Trouble breathing/gurgling noises while breathing

If you observe these signs in someone, don’t wait to see what happens, think about it, or worry you’ll get in trouble. Administer naloxone immediately, if on hand, and call 911. Good Samaritan laws protect people who administer naloxone in an overdose emergency.

Advice for Patients Considering Methadone Treatment for Fentanyl Addiction

First, it’s important to understand that methadone treatment is one component part of a harm reduction approach to addiction treatment. Other components include therapy, counseling, lifestyle changes community support, and accessing social services to support improvements in all areas of life.

Second, it’s important to understand that any kind of MAT – including methadone treatment for fentanyl addiction – is not simply trading one addiction for another. It’s an evidence-based approach to addiction treatment that increases overall chances at long-term, sustainable recovery.

Third, new rules around methadone treatment instituted during COVID may soon become permanent, which means the barriers to access to methadone may soon be a thing of the past, increasing the availability of methadone for patients who need it most.

Finally, understand that methadone is the first and most widely studied form of MAT known. The first methadone clinic opened in New York City in 1964. Over the past 60 – yes, sixty years – countless studies demonstrate that MAT with methadone is safe and effective.

Treatment and Support for Fentanyl Addiction

If you or someone you love needs professional support for fentanyl addiction, evidence-based support –is available now. Treatment professionals committed to a compassionate, empathetic, harm reduction approach can help, no matter who you are. We understand taking the first step is often the most difficult, and we’re here to help as soon as you’re ready to ask for help.

We commit to helping you through your entire treatment journey. Our nationwide alumni network is strong, and our case management and peer support specialists can help you manage your recovery, keep you on track, and give you the best possible chance of sustainable, long-term recovery.

Remember: the earlier a person who need professional addiction treatment gets the treatment they need, the better the outcome.

The post Why Does Methadone Treatment Work Best for Fentanyl Addiction? appeared first on Pinnacle Treatment Centers.

This article examines new research on the effectiveness of a substance use disorder-specific acupuncture protocol for people with OUD currently participating in a medication-assisted treatment program. The study we discuss, published in China in August 2021, explored a simple research question:

Can adjunctive acupuncture therapy reduce the amount of medication needed for people participating in an MAT program?

Before we share the results of that study, we’ll offer a brief overview of the use of acupuncture in addiction treatment and mainstream medical practice the U.S.

Note: in the context of this article, and in treatment for OUD in general, the words adjunctive and complementary mean in addition to. In other words, acupuncture and other adjunctive or complementary therapies never replace primary, evidence-based modalities, but rather support them and improve outcomes as part of an integrated, holistic approach to treatment.

Now, back to our topic.

Does Acupuncture Really Work?

For most people in the West – meaning Western Europe and the U.S. – that’s the million-dollar question. We know a little about acupuncture, know it’s been used in China for thousands of years, and know it became relatively common here in the second half of the 20^th century.

We know people swear by its effectiveness – but is there a solid clinical evidence base for the use of acupuncture?

Let’s take a look.

Acupuncture in the West: An Overview

• 1970s:
  • Treatment providers at Lincoln Detox Center in New York City developed a protocol to mitigate the symptoms of withdrawal for heroin users
• 1985:
  • The Lincoln Protocol became the National Acupuncture Detoxification Association (NADA) Protocol, was approved for use in addiction treatment, and is now in use in hospitals across the U.K. and U.S.
• 1996:
  • The Food and Drug Administration (FDA) removes barriers to the use of acupuncture for medical treatment
• 1997:
  • The National Institutes of Health (NIH) approve acupuncture as an acceptable complementary therapeutic technique for use alongside Western medicine
• 1997-2005:
  • Evidence indicates acupuncture as an effective complementary treatment for:
    • Chronic pain
    • Fibromyalgia
    • Headaches
    • Parkinson’s disease
    • Schizophrenia
    • Depression
  • 2005-Present
    • A growing body of evidence indicates acupuncture is an effective complementary treatment for mitigating withdrawal symptoms and reducing rates of relapse for people in treatment for:
      • Opioid use
      • Cocaine use
      • Alcohol use
      • Nicotine use

That’s the current state of acupuncture as an official medical treatment in the U.S.

While it’s neither accepted nor recommended as a primary therapeutic technique for medical conditions or mental health disorders, its effectiveness as a complementary, supportive approach – especially during detoxification from substance of misuse – is gaining acceptance by the substance use disorder treatment community.

Now let’s look at the research from China we mention in the introduction to this article, and learn whether acupuncture may also be a practical, effective, complementary treatment for people with OUD on MAT.

Does Acupuncture Help People With Opioid Addiction in Medication-Assisted Treatment?

The study, called “Clinical and Economic Evaluation of Acupuncture for Opioid-Dependent Patients Receiving Methadone Maintenance Treatment: The Integrative Clinical Trial and Evidence-Based Data,” examined the effect of adjunctive – a.k.a. complementary – acupuncture on medication dosage for 135 patients in a methadone-based MAT program in the Substance Dependence Department of Guangzhou Huaiai Hospital in Guangzhou, China.

To justify the research, study authors cite several data sources:

• A random control trial in China that showed acupuncture decreased methadone dosage in patient on MAT for OUD
• Another random control trial in China that showed acupuncture reduced opioid cravings for people on MAT for OUD
• A retrospective analysis on U.S. Air Force personnel showed reductions in opioid prescriptions for servicemembers who received acupuncture treatment
• A meta-analysis that identified four trials in which adjunctive acupuncture treatment improved treatment retention and decreased methadone maintenance dosage for people on MAT for OUD

In this study, researchers divided participants into two groups. One group engaged in methadone-based MAT as usual, and the other received acupuncture in addition to MAT. Next, researchers collected data on methadone dosage, drug cravings, sleep quality, and quality of life at baseline, four weeks, and six weeks after the initiation of the experimental protocol.

Here’s what they found.

The Effect of Acupuncture on Methadone Dosage and Quality of Life for People With Opioid Use Disorder in Medication-Assisted Treatment

Compared to the control group, patients on MAT for OUD showed:

• Decreased daily methadone dosage:
  • By week six, daily dosage for the acupuncture group decreased by 17.68 mg
  • By week six, daily dosage for the non-acupuncture group decreased by 1.07 mg
• Decreased drug cravings:
  • By week six, drug cravings for the acupuncture group improved significantly
  • By week six, drug cravings for the non-acupuncture group did not improve
• Improved sleep quality:
  • By week six, sleep quality for the acupuncture group improved significantly
  • By week six, sleep quality for non-acupuncture group did not improve
• Quality of life:
  • Quality of life did not differ at statistically significant levels for the acupuncture group compared to the non-acupuncture group

Those results add to the growing body of evidence confirming the effectiveness of acupuncture as a complementary therapy for people with opioid use disorder on medication-assisted treatment. People in recovery from OUD often cite the intensity of cravings and sleep problems as primary drivers or relapse. This data suggests that acupuncture can improve cravings and sleep quality while simultaneously reducing daily methadone dosage. The combination of those findings tells us that acupuncture fits well with other complementary therapies. Therefore, like yoga, exercise, and meditation, it can improve outcomes across several key recovery metrics.

Complementary, Adjunctive Supports in Practical Application

The evidence base for the use of complementary supports in treatment for substance use disorder grows more robust every day. The study we discuss here addresses acupuncture for people with opioid use disorder in the context of medication-assisted treatment. This is important because of its timeliness. As the opioid crisis continues to have a negative impact on individuals, families, and communities across the U.S., we need to employ every tool at our disposal to mitigate that impact.

This study suggests that acupuncture is one tool treatment professionals can use – in the context of an integrated, comprehensive, holistic approach to treatment – to help improve outcomes for people in recovery from opioid use disorder.

In our effort to mitigate the harm caused by the opioid crisis, that’s good news. It’s an indication that innovation and tradition can work side-by-side to create new, effective therapeutic approaches that promote long-term, sustainable recovery.

The post Can Acupuncture Help People with Opioid Use Disorder (OUD) on Medication-Assisted Treatment (MAT)? appeared first on Pinnacle Treatment Centers.

• Heroin addiction
• Opioid addiction
• Prescription opioid addiction
• Fentanyl addiction

The opioid overdose crisis in the United States is in its third decade, and no one in our country is immune. Rich, poor, young, old, white, black, Hispanic – this crisis has had a negative impact on every demographic group, with no exceptions. In order to address the crisis and the ongoing yearly increase in opioid overdose deaths, providers offer a life-changing, lifesaving approach to treatment called medication-assisted treatment (MAT) with medications for opioid use disorder (MOUD).

What is a Suboxone Clinic?

A suboxone clinic is a treatment center that’s licensed and approved by the Drug Enforcement Agency (DEA) and the Food and Drug Administration (FDA) to use MAT to treat patients with OUD.

MAT programs use three medications, depending on their licensure and patient needs:

• Buprenorphine
• Methadone
• Naltrexone

Suboxone clinics specialize in treating patients with OUD with Suboxone, a medication that contains buprenorphine and naltrexone. Our Suboxone Clinic in Somerdale, NJ treats patients with Suboxone every day. Data shows MAT with Suboxone is the most effective treatment available for people the lives of people with opioid use disorder.

Suboxone Clinic in Somerdale NJ: Treatment for Heroin Addiction and Fentanyl Addiction

We mention above that the DEA and FDA approved three medications for OUD: methadone, buprenorphine, and naltrexone. Suboxone is a specific formulation of buprenorphine and naltrexone that’s designed to maximize the benefits of treatment and reduce risk of relapse and overdose.

Buprenorphine: What You Need to Know

Buprenorphine works by occupying receptors in our brain called opioid receptors. Because buprenorphine has a partial affinity for opioid receptors, it’s known as a partial opioid agonist. It occupies the receptors, but it’s not a perfect fit. However, it prevents other opioids from binding to the the receptors, which prevents them from causing the euphoria associated with opioid. It not only prevents euphoric effects, but also reduces the intensity of withdrawal symptoms, and decreases the severity of opioid cravings.

Naltrexone: What You Need to Know

Whereas buprenorphine is called a partial opioid receptor agonist because it partially occupies opioid receptors in the brain, naltrexone is called an opioid receptor antagonist because it completely prevents any opioid – illicit, prescription, or other – from occupying opioid receptors. If naltrexone is in the bloodstream, opioids don’t work at all, in any way. In addition, if a person takes naltrexone while using any opioid, it can cause that person to enter opioid withdrawal. In this way, the naltrexone acts as a deterrent for the use of other opioids, and the diversion or improper use of Suboxone.

Why MAT? Harm Reduction Improves Heroin Addiction, Fentanyl Addiction Treatment

The harm reduction approach to addiction treatment is not new, but it wasn’t widely utilized in the U.S. until the 2010s, when policymakers nationwide realized our old approach to drug addiction and treatment – loosely known as The War on Drugs – wasn’t working.

Harm reduction began around thirty years ago in Europe. In countries like Portugal, France, and the Netherlands, several types of programs appeared, including:

• Medication-assisted treatment programs
• Clean syringe programs
• Naloxone access programs

The success of these programs in reducing overdose rates and increasing treatment adherence got the attention of lawmakers in the U.S. While officials implemented the first harm reduction programs in California in 2019 – aside from methadone clinics in New York City – the State of New Jersey approved a group of harm reduction measures in 2022. These new measures allowed state and local providers to initiate programs specifically to reduce harm caused by opioid addiction.

Here’s how New Jersey Governor Phil Murphy described the legislation:

“Harm reduction is a cornerstone of our strategy, and through this legislation, we are paving the way for long-overdue expansion of…critical services to help people with substance use disorders stay healthy, stay alive, and thrive. These bills…will strengthen our ability to save lives and further our commitment to ending the opioid crisis in New Jersey.”

New Jersey passed this legislation based on a continuously growing body of evidence that shows the following benefits of MAT with suboxone. Treatment for heroin or fentanyl addiction with Suboxone can:

Improve treatment adherence:

• Suboxone treatment helps people stay in treatment longer.

Reduce drug use:

• People in treatment with Suboxone take opioids less frequently.

Reduce illegal activity:

• Suboxone treatment is associated with a decrease in criminal behavior.

Help with work:

• Patients in programs at Suboxone clinics have a greater capacity to find and keep a job.

Help with relationships:

• Suboxone treatment allows people to engage in healthy family and peer interactions.

Reduce overdose rates:

• People in suboxone treatment are at reduced risk of overdose.

Save lives:

• People with opioid use disorder (OUD) in MAT programs live longer than people with OUD who do not engage in MAT.

Pinnacle Treatment Centers: Comprehensive Heroin Addiction Treatment

When a patient engages in treatment at Somerdale Treatment Services, they don ‘t just receive medication. Pinnacle clinicians design a treatment plan around what will work best for each patient. In addition to medication, treatment plans at our Suboxone Clinic in Somerdale NJ may include:

• Full clinical evaluation
• Educational workshops
• Individual counseling
• Group counseling
• Family counseling
• Relapse prevention
• Medication management

The specific components of each treatment plan depend on the individual, their treatment history, the outcome of their clinical evaluation, and treatment goals. At Somerdale Treatment Services, we also offer special services for pregnant patients.

Finding Heroin or Fentanyl Addiction Treatment in Somerdale NJ

If you’re seeking treatment at a Suboxone Clinic in Somerdale, NJ, please email of call our providers at  Somerdale Treatment Services.

Additional resources for opioid addiction are available here:

• Addiction Treatment Providers -Treatment Directory Application (rutgers.edu)
• If you don’t have insurance: 1-844 ReachNJ.GOV at (844) 732-2465
• Call Rutgers University for emergency support or referrals to treatment services:
  • Call (844) 276-2777
  • Phones are staffed 24/7/365
• Nationwide Resource: SAMHSA treatment finder

Research over the past several decades tells us that the earlier an individual with opioid use disorder, heroin addiction, or fentanyl addiction receives evidence-based treatment with a gold-standard therapeutic approach like MAT, the better chance they have of achieving long-term, sustainable recovery.

The Opioid Crisis: Facts and Figures for the U.S. and Camden County, NJ

Since the beginning of the opioid overdose crisis in 1999, over a million people in the U.S. have died of fatal drug overdose. Almost ¾ of those fatalities involved opioids. Some fatalities involved illicit opioids like heroin, others involved misuse of prescription opioids, and still others involved synthetic opioids such as fentanyl.

Here’s the big-picture, nationwide data from the past 25 years:

Trends in Overdose Death, 2001-2022

• 2001: 19,394
• 2006: 34,415
• 2011: 41,340
• 2016: 63,632
• 2021: 106,699
• 2022: 108,388

That’s an overall increase of 458 percent, and overdose fatalities from opioids continue to increase. That’s why we remain committed to providing gold-standard, life-changing treatment for OUD at our Suboxone Clinics in Somerdale NJ: MAT with Suboxone.

Now let’s narrow the focus to the past five years. Here’s the latest data on overdose fatalities in the U.S., published by the Centers for Disease Control (CDC).

Overdose Deaths in the United States 2018-2022

• 2018: 67,850
• 2019: 71,130
• 2020: 92,478
• 2021: 106,699
• 2022: 108,388

That’s an increase of 60 percent over five years, which means we still have work to do. The data for Somerdale, where we operate Somerdale Treatment Services, is available online on the New Jersey Opioid Dashboard and /or the NJ Cares Opioid-Related Data website.

Here’s the most recent data, up to May 7^th, 2024:

Need for Suboxone Clinics in Somerdale NJ: Overdose in Camden County 2018-2024

• 2018: 327
• 2019: 340
• 2020: 288
• 2021: 335
• 2022: 354
• 2023: 326
• 2024: 84

This final set of data shows we’re beginning to make progress. We need to qualify that, however. By progress, we mean we’re almost back to where we were pre-pandemic, which is progress, but it’s not enough. One overdose fatality is one too many. At our Suboxone Clinic in Somerdale NJ, we’ll continue to offer MAT with Suboxone, alongside therapy, counseling, peer support, and a range of services designed to promote long-term, sustainable recovery.

The post How Do I Find a Suboxone Clinic in Somerdale NJ? appeared first on Pinnacle Treatment Centers.

That’s why knowing about the latest treatments – and how to find them – is critical for individuals and families who want to move past the harmful cycles of addiction.

What is a Suboxone Clinic?

A Suboxone clinic is an addiction treatment facility that’s fully licensed and approved by the Drug Enforcement Agency (DEA) and the Food and Drug Administration (FDA) to offer treatment for OUD with Suboxone, which is a combination of two medications: buprenorphine and naltrexone. Buprenorphine is a partial opioid agonist. It occupies opioid receptors in the brain without the euphoria associated with opioid use. Naltrexone, on the other hand, is a full opioid antagonist. It prevents any opioid from occupying opioid receptors in the brain, thereby preventing any opioid-related euphoria.

Treatment with Suboxone is part of an approach to heroin treatment and opioid addiction called harm reduction. Harm reduction was fully endorsed by the State Government of New Jersey with legislation passed in 2022.

The Director of Harm Reduction Services for the New Jersey Harm Reduction Coalition, Caitlin O’Neill, offers her opinion on harm reduction efforts in New Jersey:

“Many lives will be saved with the expansion of harm reduction centers…in New Jersey, and many peoples’ inherent value and humanity will be reinforced. This is a vital step towards New Jersey ending the overdose crisis…and finally building the systems of care that will keep all of us alive and safer — no matter where we lay our heads.”

The benefits of treatment with Suboxone include:

• Stopping/preventing the action of opioids on the brain
• Resetting the neurotransmitter system in the brain
• Blocking the euphoria associated with opioid use
• Reducing the severity of cravings for opioids
• Mitigating the most intense symptoms of opioid withdrawal

Suboxone treatment programs also helps:

• Increase the length of time people stay in treatment
• Reduce the use of opioids
• Reduce criminal behavior associated with drug use
• The ability to look for and find a job
• The ability to engage fully in family life
• School and work performance
• Reduce risk of fatal overdose
• Reduce risk of premature mortality (early death)

Evidence-based treatment with Suboxone is accessible in Tom’s River, NJ.

However, if you don’t know what to look for, how do you determine if you, a friend, or a loved one needs treatment?

Warning Signs: Opioid or Heroin Addiction

When a person has a substance use disorder, it’s important to get help sooner than later. Chronic, long-term addiction can create serious physical, psychological, and emotional problems.

If you or a loved one needs MAT treatment at a Suboxone clinic in Tom’s River, NJ, please remember: the earlier a person who needs treatment receives treatment, the better the outcome.

To determine whether someone might have an opioid/heroin addiction, watch for these warning signs:

Opioid Use Disorder: Physical Warning Signs

• Frequent accidents with no explanation
• Tremors/shaking hands
• Reduced attention/care about personal appearance
• Rapid change in weight
• Incoherent speech
• Clammy palms
• Bloodshot eyes
• Wide pupils
• Decreased coordination
• Strange smells: clothes, hair, breath
• Evidence of intravenous injections

Opioid Use Disorder: Behavioral Warning Signs

• Mood swings
• Drastic changes in personality
• Impaired performance at work or school
• Irritability
• Anger
• Problems concentrating
• Inability to fulfill obligations/responsibilities
• Reduced interest in favorite activities
• Lying about drug use
• Stealing to support drug use
• Furtive behavior
• Attempting to hide drug use

When these warning signs appear in someone you love, or you recognize them in yourself, the best first step is a professional evaluation for substance use disorder performed by a mental health professional.  After a full evaluation, a physician, psychiatrist, or therapist can arrive at an accurate diagnosis and provide a referral treatment at a Suboxone Clinic in Tom’s River, NJ.

Pinnacle Treatment Centers: MAT Treatment Follows National Guidelines

The support and care we offer at our Suboxone clinics in Tom’s River, NJ is not just about taking Suboxone every day. Our treatment approach follows guidelines established by the Substance Abuse and Mental Health Services Administration (SAMHSA). After a full biopsychosocial evaluation, our providers at Ocean Medical Services and Suboxone Services of Tom’s River develop a treatment plan with a variety of effective, evidence-based components.

MAT Programs at Pinnacle Suboxone Clinics in Tom’s River, NJ

• Individual counseling and therapy
• Group counseling and therapy
• Medication for opioid use disorder (MOUD): Suboxone
• Changes in daily habits: Healthy food, daily activity, stress management, sleep hygiene
• Enrichment: group classes on the science of addiction and recovery
• Auxiliary approaches: Yoga, Meditation, Mindfulness
• 12-step programs: Alcoholics Anonymous (AA), Narcotics Anonymous (NA) SMART Recovery
• Case management services: help after discharge with accessing social services, accessing recovery housing, and relapse prevention

While therapy, changes in daily habits, and education on addiction and recovery promotes a successful recovery, the inability to participate in these components of treatment does not prevent a person from receiving Suboxone. A core tenet of harm reduction is meeting people where they are, and offering the treatment they’ll accept in the manner they’ll accept it. If medication is where a person needs to start, then that’s where we start.

Finding Addiction Treatment at a Suboxone Clinic in Tom’s River, NJ

To find treatment at a Suboxone Clinic in Tom’s River, NJ, please call us at Ocean Medical Services or Suboxone Services of Tom’s River.

To find evidence-based treatment for addiction, you can also use these online resources:

• Addiction Treatment Providers -Treatment Directory Application (rutgers.edu)
• 1-844 ReachNJ.GOV at (844) 732-2465 (for people without insurance)
• Call (844) 276-2777 for 24/7/365 for referral and emergency support from Rutgers University
• SAMHSA treatment finder

The earlier a person who needs treatment gets the treatment they need, the better the outcome.

The Opioid Crisis in the U.S. and New Jersey: Facts and Figures

Since 1999, a staggering number of people have died of drug overdose in the U.S. Data from the Centers for Disease Control indicate that number exceeds 1,000,000 – and it’s growing every year. The data shows around 75 percent of those overdose deaths involved opioids.

Let’s look at the fatal overdose data from the past several years. These figures are available on the Centers for Disease Control (CDC) website.

Overdose Fatalities, 2018-2023: United States

• 2018: 67,850
• 2019: 71,130
• 2020: 92,478
• 2021: 106,699
• 2022: 108,388

That’s a 60% increase over those seven years – and the national numbers are still rising. To narrow our focus to Tom’s River, where we operate Ocean Medical Services and Suboxone Services of Tom’s River, we’ll look at the data for Ocean County, NJ, where Tom’s River is located. To explore the publicly available data further, please visit the New Jersey Opioid Dashboard and the NJ Cares Opioid-Related Data resource page.

Overdose Fatalities, Opioids, Ocean County 2018-2023

• 2018: 219
• 2019: 204
• 2020: 245
• 2021: 242
• 2022: 186
• 2023: 168

Let’s be clear: one overdose fatality is one too many.

This data shows us that, although the past two years show a downward trend, the residents of Tom’s River need access to treatment for opioid use disorder (OUD), which also includes heroin treatment and treatment for prescription opioid addiction. Experts call MAT with Suboxone the gold-standard treatment for opioid use disorder (OUD). Treatment for OUD with Suboxone is available at our Suboxone Clinics in Tom’s River, NJ.

The post How to Find a Suboxone Clinic in Toms River, NJ appeared first on Pinnacle Treatment Centers.

Harm Reduction in California Part I: The SOS Workgroup

Harm Reduction in California Part II: The California Harm Reduction Initiative (CHRI)

This article will focus on an important piece of California’s response to the nationwide opioid and overdose crisis, which has claimed over a million lives in the U.S. since 1999. California is at the forefront of harm reduction efforts in the country. They formed their SOS workgroup in 2014, and the California Harm Reduction Initiative in 2019. These responses anticipated the response of other states in adopting harm reduction legislation, such as New Jersey in 2022, and predated the inclusion of harm reduction programs in our new National Drug Control Strategy, also implemented in 2022.

Medication-Assisted Treatment in Prisons and Jails in California: The Integrated Substance Use Disorder Treatment Program (ISUDT)

In 2019, the California Department of Corrections and Rehabilitation (CDCR) and the California Correctional Health Care Services (CCHCS) created a program called Integrated Substance Use Disorder Treatment (ISUDT) to offer substance use disorder treatment – including medication-assisted treatment (MAT) – to incarcerated individuals in California.

The initial goals of ISUDT in the CDCR were to “reduce SUD-related morbidity and mortality, and recidivism.” With implementation of the program, however, the goals expanded and became more specific. These are the current goals of the program, as of 2024:

• Reduce SUD-related mortality and morbidity, and associated health care costs.
• Create a rehabilitative environment in state prisons, improving safety for residents and staff.
• Successfully reintegrate individuals into their community at time of release
• Improve public safety and promote healthy families and communities
• Reduce recidivism and associated criminal justice costs

Upon implementation of the program in 2020, the ISUDT identified five core program components:

1. Substance Use Disorder (SUD) Screening and Assessment
2. Medication Assisted Treatment (MAT)
3. Cognitive Behavioral Interventions (CBI)
4. Supportive Housing
5. Enhanced Pre-Release Planning and Transition Services

We’ll describe each of these core components below.

ISUDT in California: Harm Reduction and MAT in Prisons and Jails

Here’s a brief explanation of each ISUDT program component.

SUD Screening and Assessment

This component of ISUDT involves evaluating all individuals for addiction upon intake to the CDCR.

• Upon intake, CCHCS staff screen patient for SUD – which includes screening of alcohol use disorder (AUD), opioid use disorder (OUD), and other addiction disorders – using standard assessment tools created by the National Institute on Drug Abuse (NIDA) and the American Society for Addiction Medicine (ASAM).
• If a screening indicates SUD, CCHCS clinicians determine the severity of the disorder and the appropriate level of care for individual needs.
• CCHCS clinicians prioritize three groups for treatment:
  • Patients scheduled for release within 15-24 months
  • Patients at highest risk for overdose
  • Patients on MAT prior to intake

Medication Assisted Treatment (MAT)

This component of ISUDT involves treating patients diagnosed with AUD or OUD with medication-assisted treatment (MAT) with FDA-approved medications.

• For AUD, CCHCS physicians can prescribe Acamprosate and Naltrexone.
• For OUD, CCHCS physicians can prescribe Naltrexone, Buprenorphine, Methadone, and Naloxone.

MAT programs prevent symptoms of withdrawal and allow patients individuals to participate in treatment and rehabilitation programs.

• CDCR and CCHCS built an internal primary care provider (PCP) workforce to deliver MAT services.
• CCHCS PCPs prescribe medication to ISUDT patients, which distributes the workload over a large group of PCPs rather than a small group of addiction specialists.
• Between 2020 and 2022, all 500 CCHCS PCPs received specialized training to support patients with SUD
• Between 2020 and 2022, all 500 CCHCS PCPs obtained Drug Enforcement Agency (DEA) X-waivers, which allows them to prescribe buprenorphine, one of three medications for opioid use disorder (MOUD).

The CCHCS program prepares their PCPs to manage patients is currently one of the largest programs in the country designed to incorporate primary care providers in SUD treatment.

Cognitive Behavioral Interventions (CBI)

Evidence indicates that SUD programs and MAT programs that include therapy and counseling – i.e. cognitive behavioral interventions (CBIs) – improve outcomes, compared to SUD and MAT programs that don’t include CBIs.

• The cognitive behavioral interventions used by CCHCS are based on cognitive behavioral therapy (CBT)
• CBT based CBI helps patients understand the connection between thoughts, emotions, and behavior.
• CBI helps patients:
  • Identify and process self-destructive thoughts, beliefs, and/or attitudes
  • Change unwanted behavior
  • Develop emotional regulation skills, general coping skills, stress management skills, and techniques to tolerate adversity and distress
• Participants can choose from three CBI pathways, managed by their alcohol/drug counselors:
  • Life Skills
  • Outpatient Treatment
  • Intensive Outpatient Treatment

Supportive Housing

This component of ISUDT was meant to involve housing participants in SUD treatment in rehabilitative housing units separate from the rest of the incarcerated population. Research shows that, compared to patients with SUD who don’t live in separate supportive housing units, patients with SUD who live in separate supportive housing have:

• Lower rates of relapse
• Lower rates of recidivism

While each CDCR location identified appropriate supportive housing space for ISUDT program participants, the COVID-19 pandemic delayed implementation of the program until Summer 2022. As of April 2023, a total of 14,976 ISUDT participants lived in supportive housing units.

Enhanced Pre-Release Planning and Transition Services

Leading up to discharge, ISUDT staff work to lay the groundwork for a successful transition to the community after incarceration. In this component of the ISUDT, select CDCR staff work to:

• Assessing the participant’s current needs
• Collaborate to develop a comprehensive pre-release plan
• Facilitate connections with the community resources, which include:
  • MAT appointments
  • SUD counseling appointments
  • Mental health appointment
  • Health insurance resources
  • Housing resources
  • Vocational resources
  • Educational resources

Since implementing ISUDT in January 2020, CDCR staff have connected over 2,000 program participants with community SUD providers. These connections have the potential to reduce overdose rates, relapse rates, rates of premature mortality, and rates of recidivism. In addition, they help create a soft landing for patients upon release, and minimize the stress and challenges associated with rebuilding a life after incarceration.

Evidence-Based Outcomes: Impact of the ISUDT on Prisons and Jails in California

One requirement for all opioid response programs established as a result of the California SOS Workgroup and the California Harm Reduction Initiative (CHRI) is complete data transparency. This includes timely and accurate reporting of outcomes for all new overdose/addiction mitigation programs and harm reduction programs in the state. Public-facing data resources include:

• Califiornia Substance and Addiction Branch Home Page
• California Overdose Surveillance Dashboard
• California Harm Reduction Initiative Home Page
• The ISDUT Data Dashboard

Here’s a summary of the data reported on the ISDUT Data Dashboard as of February 28^th, 2024, with additional data collected from two reports: “Impacts of The Integrated Substance Use Disorder Treatment Program April 2022,” and “Impacts of the Integrated Substance Use Disorder Treatment (ISUDT) Program on Morbidity and Mortality April 2023.”

Overall Data: ISUDT 2020-2024

• 92,985 patients screened for SUD
• 39,661 assessed for SUD treatment needs
• 27,033 evaluated for MAT
• 17,127 prescribed MAT
• 10,156 patients receiving CBI
• 24,048 received SUD treatment

Based on this information, the ISUDT program in the CDCR is largest provider of MAT among jails and prisons in the country.

Now let’s review the data on overdose in California prisons and jails.

Overdose Data: ISUDT 2018-2021

• Overdose rate, all drugs:
  • 2018-2019 (Before ISUDT): 49.3 deaths per 100,000
  • 2020-2021 (After ISUDT): 22.8 deaths per 100,000

That’s a 54% decrease.

• Overdose rate, opioids:
  • 2018-2019 (Before ISUDT): 39.8 deaths per 100,000
  • 2020-2021 (After ISUDT): 20.4 deaths per 100,000

That’s a 50% decrease.

• Patients with OUD not on MAT:
  • 5 deaths per 1,000
• Patients with OUD on MAT:
  • 8 deaths per 1,000

A difference of 29%.

Next, the general health outcomes for patients participating in the ISUDT.

Hospitalization/Disease Data: ISUDT

• 18% decrease in hospitalization rates for overdose
• 21% decrease in skin/soft tissue infections
• 29% lower reinfection rate for hepatitis C virus (HCV) for patients with OUD on MAT compared to patients with OUD not on MAT

Finally, let’s look at the outcomes of the pre-release and release programs established by the ISUDT:

Pre-Release and Release Initiatives: ISUDT

• 95% of patients submitted Medi-Cal application (health insurance through state program)
• 75% of Veterans connected to VA services
• 86% offered state ID card
• 93% on MAT received medication upon release
• 84% of MAT patients had a post-release MAT appointment scheduled
• 97% of patients on MAT received naloxone training and kits upon release

Another insight included in the ISUDT report caught our attention. Program participants, CDCR, and CCHCS staff report the ISUDT program is life-changing for patients who adhere to treatment. Also, before the implementation of the ISUDT, state officials projected that 50 percent of patients offered MAT would accept and initiate treatment. However, upon implementation, their projections fell far short of reality: almost 90 percent of patients offered MAT accepted and initiated MAT.

Harm Reduction and MAT in Prisons and Jails in California

In the final article on our series on harm reduction in California, we’ll report on the role Pinnacle Treatment Centers and Aegis Treatment Centers take to support MAT programs in California prisons and jails. Our Director of Government Relations (California), Javier Moreno, coordinates this ongoing effort. Javier collaborates with the CDC and the CCHCS to provide MAT with methadone to patients opioid use disorder (OUD). Javier is also instrumental in working to provide continuing MAT services, counseling, and therapy to ISUDT patients upon their return to the community.

Look for Part IV of our Harm Reduction in California Series, coming soon.

The post Harm Reduction in California Part III: MAT in Prisons and Jails appeared first on Pinnacle Treatment Centers.

What is a Methadone Clinic?

A methadone clinic is a treatment center – also known as an Opioid Treatment Program (OTP) – that has met all the federal requirements to treat people with a medication called methadone. Methadone is a full opioid agonist, which means it completely occupies opioid receptors in the brain without causing the euphoria and elevated mood associated with opioid intoxication. Because it fully occupies opioid receptors, it also prevents other types of opioids – including illicit opioids like heroin or prescription opioids like oxycontin – from acting on the brain.

Methadone is one of three medications called medications for opioid use disorder (MOUD) approved by the Food and Drug Administration (FDA) for the treatment of opioid addiction, heroin addiction, and addiction to other opioids, such as prescription pain relievers and illicit fentanyl. Together, MOUDs are the primary component in medication-assisted treatment, which experts consider the most effective treatment available for opioid addiction.

Medication-assisted treatment is part of an approach to opioid addiction/heroin treatment called harm reduction, endorsed and funded by the State Government of New Jersey with the passage of an important legislative package in 2022.

Here’s how New Jersey Governor Phil Murphy describes harm reduction:

“Over the last four years, my Administration has prioritized a comprehensive, data-driven approach to ending New Jersey’s opioid epidemic. Harm reduction is a cornerstone of our strategy. We are paving the way for critical services to help people with substance use disorders stay healthy, stay alive, and thrive.”

For people in treatment at a methadone clinic for heroin addiction or opioid addiction, medications such as methadone can:

• Block the effect of opioids on the brain and body
• Normalize brain chemistry
• Stop the euphoric and pleasurable effects of opioids
• Decrease frequency and intensity of opioid cravings
• Reduce the symptoms of withdrawal from opioids

In addition, addiction treatment with methadone is associated with:

• Increased time-in-treatment
• Decreased opioid use
• Decreased criminal behavior/involvement with justice system
• Increased ability to find and maintain employment
• Increased ability to participate in family or school life
• Decreased overdose risk
• Decreased overall opioid-related mortality (death)

Addiction treatment is available – but how do you know if you or a loved one needs it?

Opioid Addiction, Heroin Addiction, Prescription Opioid Addiction: Warning Signs

Families seeking a Methadone clinic in Pennsauken, NJ should understand that the sooner a person who needs heroin treatment or opioid treatment gets the treatment they need, the better the outcome. If you think you or someone you love has opioid use disorder (OUD), you can look for two types of warning signs: physical signs and behavioral signs.

Physical Signs of Opioid Addiction:

• Unexplained accidents or injuries
• Shaking hands or other physical tremors
• Neglect of appearance and hygiene
• Sudden weight loss or gain
• Slurred or agitated speech
• Clammy palms
• Red, watery eyes
• Tiny pupils
• Poor physical coordination
• Unusual odors on breath, body, or clothes
• Needle marks on arms, legs, or feet
• Shaking hands or other physical tremors

Behavioral Signs of Opioid Addiction:

• Emotional instability
• Significant personality changes
• Decline in work or academic performance
• Increased anger, resentment, and sensitivity
• Decreased ability to focus
• Failure to keep commitments
• Apathy
• Stealing
• Lying
• Loss of interest in lifelong hobbies or passions
• Secretive activity/hiding things

If you see these warning signs in yourself or a loved one, we recommend seeking a professional assessment with an addiction treatment professional.  After a comprehensive assessment, an experienced treatment professional can make a referral or recommendation for treatment at a methadone clinic in Pennsauken, NJ.

Treatment for Addiction at Pinnacle Treatment Centers

Medication-assisted treatment at a methadone clinic is about more than the medication. In fact, the best methadone clinics follow the integrated treatment model, which is a holistic, all-of-the-above approach to addiction treatment. After a full biological, psychological, and social assessment, the treatment experts at Delaware Valley Medical create plan that includes a custom-tailored combination of cutting-edge therapeutic techniques, including:

Components of Integrated Treatment in Pennsauken, NJ

• Psychotherapy/Counseling: Individual, group, and family.
• Medication (if needed): methadone, Suboxone, naltrexone
• Lifestyle changes: Diet, Exercise, Stress management, Sleep hygiene
• Education: Classes/ workshops on the science of addiction and recovery
• Complementary supports: Yoga, Meditation, Mindfulness
• Community/Peer support: Alcoholics Anonymous (AA), Narcotics Anonymous (NA), SMART Recovery
• Aftercare/Case Management/Ongoing Support: Relapse prevention, connections to medical services, connections to social services

Families or individuals seeking addiction treatment should ensure that the facility offers more than just medication, but should also understand that the inability to access the additional services should not prevent them from engaging in treatment. A foundational principle of harm reduction is to meet people where they are and offer treatment in a manner they can accept.

Treatment Locators for Pennsauken, NJ

We encourage people in need of a methadone clinic in Pennsauken, NJ to contact us at Delaware Valley Medical. However, doing your due diligence is important. If treatment at a Pinnacle Facility doesn’t meet immediate needs, please use the following resources:

• New Jersey Treatment locator: Addiction Treatment Providers -Treatment Directory Application (rutgers.edu)
• Adults without insurance: 1-844 ReachNJ.GOV at (844) 732-2465
• IME Addiction Access Center: call (844) 276-2777 for 24/7/365 referral support
• The Substance Abuse and Mental Health Services Agency (SAMHSA) online treatment locator

The Opioid Crisis: Facts and Figures for the U.S. and Camden County, NJ

Since 1999, over a million people have died of drug overdose in the U.S., and about ¾ of those fatalities involved opioids. Here’s a quick look at overdose deaths between 2001 and 2022 nationwide. These figures are available on the Centers for Disease Control (CDC) website.

Overdose Fatalities, 2001-2022: United States

• 2001: 19,394
• 2006: 34,415
• 2011: 41,340
• 2016: 63,632
• 2021: 106,699
• 2022: 108,388

That’s a staggering 458% increase over the past 21 years. Now let’s look at the specific data for Camden County for the past six years, where we operate Delaware Valley Medical, a methadone clinic in Pennsauken, NJ. These figures are available to the public at both the New Jersey Opioid Dashboard and the NJ Cares Opioid-Related Data resource page.

Overdose Fatalities, Opioids, Camden County 2018-2023

• 2018: 327
• 2019: 340
• 2020: 288
• 2021: 335
• 2022: 354
• 2023: 326

These overdose numbers demonstrate a clear need for methadone clinic services in Pennsauken, NJ, which includes heroin treatment and opioid addiction treatment. Individuals or families seeking addiction treatment should understand that methadone treatment is one part of medication-assisted treatment (MAT) with medications of opioid use disorder (MOUD), and that MAT with MOUD is considered the gold-standard treatment for opioid use disorder (OUD), including heroin addiction and prescription opioid addiction.

Remember: the sooner a person who needs treatment gets the treatment they need, the better the outcome.

The post Finding a Methadone Clinic in Pennsauken, NJ appeared first on Pinnacle Treatment Centers.

What is a Suboxone Clinic?

A suboxone clinic is a treatment center that has met all the federal requirements to treat people with a medication called buprenorphine. Buprenorphine is a partial opioid agonist, which means it partially prevents opioids from acting on the brain. In a suboxone clinic, buprenorphine is often administered in a formulation that includes an additional medication called naltrexone. Naltrexone is an opioid antagonist, meaning it completely block all opioids from acting on the brain. When naltrexone and buprenorphine are combined, the medication is called Suboxone. The naltrexone component of Suboxone is an abuse deterrent, because it prevents any euphoric effect from any opioid, and also prevents misuse of Suboxone.

Medication-assisted treatment is part of an approach to opioid addiction/heroin treatment endorsed and funded by the State Government of New Jersey with the passage of an important legislative package in 2022.

Here’s how New Jersey Governor Phil Murphy describes harm reduction:

“Over the last four years, my Administration has prioritized a comprehensive, data-driven approach to ending New Jersey’s opioid epidemic. Harm reduction is a cornerstone of our strategy. We are paving the way for critical services to help people with substance use disorders stay healthy, stay alive, and thrive.”

For people in treatment at a Suboxone clinic for heroin addiction/opioid addiction, medications such as Suboxone can:

• Block the effect of opioids on the brain and body
• Normalize brain chemistry
• Stop the euphoric and pleasurable effects of opioids
• Decrease frequency and intensity of opioid cravings
• Reduce the symptoms of withdrawal from opioids

In addition, addiction treatment with Suboxone is associated with:

• Increased time-in-treatment
• Decreased opioid use
• Decreased criminal behavior/involvement with justice system
• Increased ability to find and maintain employment
• Increased ability to participate in family or school life
• Decreased overdose risk
• Decreased overall opioid-related mortality (death)

Addiction treatment is available – but how do you know if you or a loved one needs it?

Opioid Addiction, Heroin Addiction, Prescription Opioid Addiction: Warning Signs

Families seeking a Suboxone clinic in Pennsauken, NJ should understand that the sooner a person who needs heroin treatment or opioid treatment gets the treatment they need, the better the outcome. If you think you or someone you love has opioid use disorder (OUD), you can look for two types of warning signs: physical signs and behavioral signs.

Physical Signs of Opioid Addiction:

• Unexplained accidents or injuries
• Shaking hands or other physical tremors
• Neglect of appearance and hygiene
• Sudden weight loss or gain
• Slurred or agitated speech
• Clammy palms
• Red, watery eyes
• Tiny pupils
• Poor physical coordination
• Unusual odors on breath, body, or clothes
• Needle marks on arms, legs, or feet
• Shaking hands or other physical tremors

Behavioral Signs of Opioid Addiction:

• Emotional instability
• Significant personality changes
• Decline in work or academic performance
• Increased anger, resentment, and sensitivity
• Decreased ability to focus
• Failure to keep commitments
• Apathy
• Stealing
• Lying
• Loss of interest in lifelong hobbies or passions
• Secretive activity/hiding things

If you see these warning signs in yourself or a loved one, we recommend seeking a professional assessment with an addiction treatment professional.  After a comprehensive assessment, an experienced treatment professional can make a referral or recommendation for treatment at a suboxone clinic in Pennsauken, NJ.

Treatment for Addiction at Pinnacle Treatment Centers

Medication-assisted treatment at a Suboxone clinic is about more than the medication. In fact, the best Suboxone clinics follow the integrated treatment model, which is a holistic, all-of-the-above approach to addiction treatment. After a full biological, psychological, and social assessment, the treatment experts at Delaware Valley Medical create plan that includes a custom-tailored combination of cutting-edge therapeutic techniques, including:

Components of Integrated Treatment in Pennsauken, NJ

• Psychotherapy/Counseling: Individual, group, and family.
• Medication (if needed): Suboxone, methadone, naltrexone
• Lifestyle changes: Diet, Exercise, Stress management, Sleep hygiene
• Education: Classes/ workshops on the science of addiction and recovery
• Complementary supports: Yoga, Meditation, Mindfulness
• Community/Peer support: Alcoholics Anonymous (AA), Narcotics Anonymous (NA), SMART Recovery
• Aftercare/Case Management/Ongoing Support: Relapse prevention, connections to medical services, connections to social services

Families or individuals seeking addiction treatment should ensure that the facility offers more than just medication, but should also understand that the inability to access the additional services should not prevent them from engaging in treatment. A foundational principle of harm reduction is to meet people where they are and offer treatment in a manner they can accept.

Treatment Locators for Pennsauken, NJ

We encourage people in need of a Suboxone Clinic in Pennsauken, NJ to contact us at Delaware Valley Medical. However, doing your due diligence is important. If   treatment at a Pinnacle Facility doesn’t meet immediate needs, please use the following resources:

• New Jersey Treatment locator: Addiction Treatment Providers -Treatment Directory Application (rutgers.edu)
• Adults without insurance: 1-844 ReachNJ.GOV at (844) 732-2465
• IME Addiction Access Center: call (844) 276-2777 for 24/7/365 referral support
• The Substance Abuse and Mental Health Services Agency (SAMHSA) online treatment locator

The Opioid Crisis: Facts and Figures for the U.S. and Camden County, NJ

Since 1999, over a million people have died of drug overdose in the U.S., and about ¾ of those fatalities involved opioids. Here’s a quick look at overdose deaths between 2001 and 2022 nationwide. These figures are available on the Centers for Disease Control (CDC) website.

Overdose Fatalities, 2001-2022: United States

• 2001: 19,394
• 2006: 34,415
• 2011: 41,340
• 2016: 63,632
• 2021: 106,699
• 2022: 108,388

That’s a staggering 458% increase over the past 21 years. Now let’s look at the specific data for Camden County for the past six years, where we operate Delaware Valley Medical, a suboxone clinic in Pennsauken, NJ. These figures are available to the public at both the New Jersey Opioid Dashboard and the NJ Cares Opioid-Related Data resource page.

Overdose Fatalities, Opioids, Camden County 2018-2023

• 2018: 327
• 2019: 340
• 2020: 288
• 2021: 335
• 2022: 354
• 2023: 326

These overdose numbers demonstrate a clear need for suboxone clinic services in Pennsauken, NJ, which includes heroin treatment and opioid addiction treatment. Individuals or families seeking addiction treatment should understand that suboxone treatment is one part of medication-assisted treatment (MAT) with medications of opioid use disorder (MOUD), and that MAT with MOUD is considered the gold-standard treatment for opioid use disorder (OUD), including heroin addiction and prescription opioid addiction.

Remember: the sooner a person who needs treatment gets the treatment they need, the better the outcome.

The post How to Find a Suboxone Clinic in Pennsauken, NJ appeared first on Pinnacle Treatment Centers.

The article – Clinicians Lack Sufficient Awareness of Novel Synthetic Opioid 10 Times More Potent Than Fentanyl – suggests the majority of substance use disorder (SUD) treatment centers around the country are not ready to handle to increased risk of addiction and overdose presented by nitazenes.

According to Dr. Brown:

“This class of opioids has the potential to become a rising tide of multiple different analogs of similar substances that have greater potency.”

Nitazenes are ten times more powerful than fentanyl, which is itself about 100 times more potent than morphine, which means nitazenes are up to 1,000 times more potent than morphine.

That increase in potency means an increased risk of addiction and fatal overdose. The risk increased significantly because of how drug traffickers use nitazenes. They use them to “cut” or increase the volume/weight of drugs like heroin and fentanyl, and also use them in counterfeit versions of prescription medications like Dilaudid and oxycodone.

We’ve published two articles on this topic recently. One, by our Chief Clinical Officer, Lori Ryland:

Nitazenes: A New Factor in the Opioid Crisis

And one article with the basic facts about nitazenes, which are also known as “ISO”:

What is ISO? Illicit Drugs and Opioid Overdose

The Next Wave of The Opioid Crisis

Experts from the Centers for Disease Control (CDC) discuss three waves associated with the opioid crisis. The first was the result of overprescribing of opioids, the second was the result of the prescription to addiction pathway, and the third was the result of fentanyl and fentanyl analogs. We may now be in the beginning of a fourth wave, characterized by a mix of opioid and methamphetamine use, co-occurring mental health disorders, and the presence of new substances like nitazenes in the illicit drug supply.

The warnings about a fourth wave are supported by data. In 2021, the CDC reported a total of 106,699 overdose fatalities. For 2022, preliminary data indicates a total of 109,360 overdose fatalities. Treatment specialists like Dr. Brown and Dr. Ryland understand the role nitazenes are playing in the opioid crisis now. They also understand the role they may play over the next several years.

The Addiction Treatment Business article tells us that nationwide, “clinicians lack sufficient awareness” about nitazenes. However, we can confirm that our clinical and medical directors, including Dr. Brown and Dr. Ryland, share important information with all our clinicians about new developments in the opioid crisis – such as nitazenes – and clinicians at all our facilities understand the new risks, and how to face them as we move forward.

The post Pinnacle Treatment Centers Weighs in on the Danger of Nitazenes appeared first on Pinnacle Treatment Centers.

The HEAL initiative provided 36 million dollars for harm reduction research. This money funds pilot programs related to eight areas key essential to bringing harm reduction services to people in need:

1. Education
2. Overdose prevention/reversal
3. Medication-assisted treatment (MAT)
4. Needle & syringe programs
5. Drug consumptions rooms
6. Drug checking programs
7. Housing support
8. Legal services

We’ll discuss each of the program areas below. We’ll describe how they can help meet the objective that drives all harm reduction programs in the U.S. That objective? Reverse the ongoing, upward trend in drug addiction and overdose called the opioid crisis. Since 1999, the crisis has claimed over a million lives and caused significant harm to millions of others.

Harm Reduction Policies and Programs

We describe the fundamental principles and theoretical foundation for harm reduction in addiction treatment part one of this article. Now we’ll share how we – meaning treatment providers alongside local, state, and federal government entities – plan to apply these principles in public policies and programs with the help of funding provided initiative like HEAL.

These eight program areas – while not the sum total of harm reduction efforts nationwide – represent the priorities for effective harm reduction as established by the non-profit advocacy group Harm Reduction International (HRI), endorsed by the Office of National Drug Control Policy (ONDCP) and prioritized in our revised National Drug Control Strategy, developed in 2022.

1. Education and Awareness

Education programs provide people the real information about drugs, drug use, and addiction treatment. In the context of harm reduction in addiction treatment, education classes include specific information on opioid use and opioid use disorder (OUD), including the harms associated with OUD and how to address them. In addition, harm reduction education programs include offering workshops and classes about how to access social services, including vocational programs, housing support, adult education, general health care, and addiction treatment.

Another component of education and awareness around harm reduction is sharing basic information about harm reduction to people with no direct connection to drug use or the opioid crisis. We understand that at first blush, some parts of harm reduction – needle and syringe programs and drug consumption rooms, for instance – may seem unusual, counterproductive, or too progressive. Educating the public about why their tax dollars should go to these programs is important in maintaining support for ongoing funding and commitment to harm reduction.

2. Overdose Prevention and Reversal Programs

Education about drug use and the risks of opioid use and opioid overdose is the best tool we have to prevent overdose, because effective education can prevent the behavior that leads to illicit drug use before it happens.

Harm reduction programs spend significant time and energy on advocating a medication called Narcan, which contains the medication naloxone. When administered correctly and in time, Narcan can reverse an opioid overdose and dramatically reduce the likelihood of death. It’s a lifesaving drug, which, thanks to federal funding and the new national drug control policy, is now readily available nationwide from both pharmacies and public/community health clinics.

Making Narcan easily available to people who use opioids – or their friends or loved ones – means they have access to the same medication emergency medical personnel like paramedics use when they respond to an overdose call. When the Food and Drug Administration (FDA) approved Narcan for over-the-counter sale on March 2023, it was an important step that harm reduction experts have been recommending for years.

Let’s make that clear for anyone reading this who uses opioids or has friends or loved ones who use opioids: you can now get Narcan from a pharmacy without a prescription. Having Narcan on hand can save a life. Therefore, we recommend considering finding Narcan and keeping it close: it saves lives.

3. Medication-Assisted Treatment (MAT) Programs

Medication-assisted treatment (MAT) for opioid use disorder (OUD), also known as opioid agonist therapy, involves the use of three medications for opioid use disorder (MOUD): buprenorphine (Suboxone), Methadone, and Naltrexone.

While Naltrexone completely blocks the action of opioids in the brain and prevents both the analgesic and euphoric properties of opioids, buprenorphine and methadone act in a slightly different manner. They occupy opioid receptors, which reduces cravings, decreases the severity of withdrawal symptoms, and helps people with opioid use disorder (OUD) reach a physical, emotional, and psychological space where they can engage in treatment and start on the road to recovery.

The Substance Abuse and Mental Health Service Administration (SAMHSA) and the World Health Organization (WHO) consider MAT the gold standard treatment for people with opioid use disorder.

For more informant about MAT for OUD, please read these articles on our website:

Medication-Assisted Treatment

Methadone Treatment for Opioid Use Disorder

Suboxone Treatment for Opioid Use Disorder

In addition, there’s an increase in the number of programs that offer MAT to people incarcerated in prisons and jails. To learn more, please read this article by our Medical Director, Dr. Chris Johnston:

The Case for Medication-Assisted (MAT) Treatment in Jails and Prisons

4. Clean Needle/Syringe Programs

These programs can cause significant controversy and often lead to robust resistance from people who haven’t researched how or why they work. Needle and syringe programs provide clean needles/syringes for people who use illicit, intravenous drugs such as heroin. Opponents assert they promote and condone illicit intravenous drug use. However, evidence shows these programs are effective for the following reasons:

• Safe/clean needle/syringe programs prevent the spread of infectious diseases, including hepatitis C and HIV, by offering sterile needles/syringes to people at risk of reusing or sharing share needles/syringes.
• These programs get people who inject drugs off the street and out of unsanitary shooting galleries common to illicit IV drug use. They provide a safe atmosphere where people who use illicit IV drugs can talk about drug use – and the desire to enter treatment – in an atmosphere characterized by openness and understanding.
• Clean needle/syringe sites are most often managed by harm reduction advocates who help connect IV drug users to essential support, such as treatment for OUD, and lifesaving medication like Narcan.

5. Drug Consumption Rooms

This component of harm reduction also receives stiff resistance in the U.S. However, like clean needle/syringe programs, experts on treatment – including the  American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) – fully support their use. A drug consumption room is a safe, clean place where a person can access and utilize safe supplies under direct supervision. Staff in these rooms can help connect IV drug users to treatment programs, offer emergency medical assistance if needed.

Research indicates drug consumption rooms decrease transmission of infectious disease, decrease drug-related criminal activity, crime associated with drug use, and decrease rates of fatal overdose. Data collected at the only two drug consumption sites in the U.S. – both in New York City – report the following data, after two years of operation:

• 4,486 total participants
• 117,559 visits to safe injection rooms
• 1,339 overdose reversals
• Over 2 million units of drug waste (used needles, etc.) collected

6. Fentanyl Testing/Checking Services

Drug testing services are now an integral component of harm reduction services. Over the past several years, the DEA reports an escalating presence of dangerous substances in illicit drugs. These include fentanyl and xylazine, which have been detected in heroin, methamphetamine, cocaine, and others. Drug testing/checking programs individuals to test a substance for the presence of dangerous substances like fentanyl.

7. Housing

Evidence shows that access to safe and stable housing can reduce drug use, drug addiction, and fatal drug overdose. In some cases, housing support for people with substance use disorder (SUD) requires abstinence, but others do not. Research indicates shows that programs like Housing First – a program that has no sobriety or abstinence requirements for access – can help decrease drug consumption and promote overall wellbeing for people in recovery who experience housing instability.

8. Legal Services

In the context of harm reduction, legal services are necessary on at least two levels: the personal and the public. On the individual level, attorneys or legal aid groups support people in the criminal justice system with various needs. They can help them with charges related to drug use, and advocate for access to evidence-based treatment. In the public sphere, attorneys and legal aid groups have work to do. They can help overturn laws, policies, or programs that stigmatize people with substance use disorder. They can also help facilitate the transition from a punitive system to a supportive, reform-based system. A reform-based system is one that provides access to a comprehensive array of harm reduction programs and services.

Reducing Harm: Essential to Our National Drug Control Strategy

The Substance Abuse and Mental Health Services Administration (SAMHSA) is currently in the process of writing a Harm Reduction Framework. The framework will establish a set of best practices to guide harm reduction in addiction treatment around the country. This is a crucial step. It will help implement the harm reduction priorities identified in the National Drug Control Strategy published in 2022 by the Office of National Drug Control Policy.

Harm reduction works. At Pinnacle Treatment Centers, we advocate comprehensive harm reduction services for everyone in need. Keep an eye on our blog for more information, and the next article in our Harm Reduction Series. We’ll discuss the latest harm reduction efforts in California, where we own and operate Aegis Treatment Centers/A Pinnacle Treatment Center Network. Our California locations offer a wide range of SUD treatment services, including medication-assisted treatment (MAT), a core component of the harm reduction approach to opioid addiction.

The post Harm Reduction in Addiction Treatment: What You Need to Know, Part Two appeared first on Pinnacle Treatment Centers.

In this article, we’ll talk about a new drug involved in opioid overdose deaths – ISO – and address the problem of polysubstance misuse. We’ll also talk about how a new generation of designer drugs complicates the efforts of policymakers, treatment providers, and community advocates to help people with substance use disorder (SUD).

What is ISO?

ISO is short for “Isotonitazene,” which is a synthetic opioid recently identified by the Drug Enforcement Agency (DEA) as an emerging threat in the United States. Isotonitazene is one of a class of powerful opioid drugs developed in the 1950s called nitazenes. Here’s how the DEA describes nitazenes:

“Nitazenes are dangerous synthetic opioids that can be as powerful, or even more powerful, than fentanyl. They have no legitimate use.”

To learn more about nitazenes, please navigate to the blog section of our website and read this article:

Nitazenes: A New Factor in the Opioid Crisis

Experts indicate that nitazenes can be up to 10 times as potent as fentanyl, which itself is 50 times more powerful than heroin. That’s why ISO is so dangerous, and that’s why representatives from the DEA warn that ISO may exacerbate the overdose crisis in the U.S.

Designer Molecules Like ISO and Drug Overdose

People familiar with the phrase designer drugs often think of party drugs such as MDMA (ecstasy) popularized during the 1980s and 1990s, associated with all-night dance clubs, alternative lifestyles, the rave culture. What many people don’t know is that the culture of all-night partying and dance parties – with the assistance of various illicit drugs – never went away. In the 80s and 90s – and now – it’s common to mix opioids, stimulants, amphetamines, and alcohol in an ad hoc cocktail designed to reduce inhibitions, increase feelings of connectedness (I love everyone!), induce euphoria, and give people the energy to stay up all night.

That’s a somewhat romantic – and unrealistic – view of designer drugs. It’s particularly off base when we consider the new generation of designer drugs such as fentanyl, carfentanil, xylazine, and nitazenes. There’s nothing fun or party-like about these drugs or their consequences. They do two primary things:

1. Increase profits for drug traffickers
2. Increase risk of overdose and death for people who take them

When we talk about the opioid crisis, we logically focus on opioids. However, since the mid-teens – around 2015 – the opioid crisis has grown complicated, and although opioids are the main driver of the opioid crisis, fatal overdose involving other drugs is part of why the crisis persists.

This is where it gets more complicated. The other drugs contributing to the overdose crisis, such as methamphetamine, amphetamine, and cocaine, are now likely to contain drugs such as fentanyl, carfentanil, xylazine, and nitazenes.

ISO, Fentanyl, and Overdose

Why do drug traffickers put fentanyl and nitazenes in drugs like methamphetamine and others?

First, it’s currently easy for cartels – such as the Sinaloa Cartel and the Jalisco cartel – to buy the chemical precursors to fentanyl from overseas suppliers. It’s also not hard or too complicated to manufacture fentanyl or nitazenes in illicit laboratories. After manufacture, traffickers mix these chemicals – which they create themselves, and are easier to source than the opium or coca necessary to manufacture heroin or cocaine – with their supply of illicit drugs, which increases volume, thereby increasing their profit, as we mention above.

That’s good for drug traffickers, but a literal recipe for disaster for people who use drugs, especially people who use illicit opioids, illicit/fake prescription medications, methamphetamine, stimulants, or tranquilizers like benzodiazepines.

Here’s the problem, or part of it: a person who uses opioids often understands the warning signs of opioid overdose – and they often also have Narcan on hand in case of an accidental overdose. However, a person who takes an illicit stimulant, like cocaine, or an amphetamine, like methamphetamine, might not be on the lookout for the signs of opioid overdose, since stimulants/amphetamines generally have the opposite effect of opioids.

In other words, they may not know to watch for the warning signs of opioid overdose.

Why?

Because they had no idea they ingested and opioid or opioid-derived medication like fentanyl or a nitazenes like ISO.

Highest Danger: Illicit Opioids, Methamphetamine, Fake Prescription Drugs

Drugs like fentanyl, xylazine, and ISO – a.k.a. nitazenes – make purchasing illicit drugs akin to playing Russian Roulette. Here’s how DEA intelligence analyst Maura Gaffney describes the problem:

“People have to keep in mind, with all the synthetic drugs out there, and the way they’re being mixed together, you never know what you’re actually buying.”

In 2021, over 108,000 people died of drug overdose, with 75 percent of those fatalities involving a synthetic opioid. And, as we mentioned above, in many cases, overdose victims never knew they ingested an opioid.

According to the DEA, synthetic opioids – the new, deadlier designer drugs – are now detected in a variety of illicit and fake prescription drugs:

• Amphetamine
• Methamphetamine
• Cocaine
• Heroin
• Benzodiazepines
• Prescription opioids

Warning signs of a fentanyl or designer opioid overdose include:

• Person is unresponsive
• Irregular breathing
• Gray, pale, bluish skin/lips
• Tiny, pinpoint pupils

If you see these signs in someone, take the following steps:

1. Call 911
2. Administer Narcan, if it’s on hand
3. Administer CPR, if you know it
4. If nothing changes, administer a second dose of Narcan
5. Stay with overdose victim until help arrives

At the moment, there is no way for a regular person to test for or detect ISO in an opioid or another drug. However, fentanyl test strips are readily available and easy to use. To learn more about fentanyl test strips, check the Centers for Disease Control Fentanyl Test Strip Page. Buying fentanyl test strips is easy: simply search ‘fentanyl test strip’ on Amazon. To find free fentanyl test strips in your area, please visit the National Harm Reduction Coalition Fentanyl Page.

The post What is ISO? Illicit Drugs and Opioid Overdose appeared first on Pinnacle Treatment Centers.

By Lori Ryland, Ph.D., LP, CAADC, CCS, BCBA-D, Chief Clinical Officer,

Nitazenes are a class of opioid drug invented in the 1950s so strong scientists determined they had a high potential for misuse/abuse and no real practical medical use or application, but now, close to 75 years later, drug cartels mix nitazenes – known by the street name “iso” – with opioids and other illicit drugs, increasing risk of addiction and driving up the number of fatalities associated with the decades-old, nationwide opioid crisis.

Nitazenes are a stark reminder that the opioid crisis in the U.S. is not going away.

They join fentanyl as the latest complicating factor in the opioid crisis, which is also known as the overdose crisis, partially because illicit opioids like fentanyl are now present in non-opioid drugs, which increases risk of addiction and fatal overdose.

If you’re not familiar with the opioid crisis, please navigate to the blog section of our website and read about the current nationwide efforts underway to mitigate harm, reduce overdose deaths, and offer treatment and support to communities and families impacted by the crisis:

The Opioid Crisis: A New National Strategy

To learn about the impact of opioid derivatives on the opioid crisis, please read this article:

Emerging National Security Threat: Xylazine Laced With Fentanyl Exacerbates Opioid Crisis

If you’re not familiar with the impact of fentanyl on the opioid crisis, or you’ve never heard of fentanyl, please read this article:

Opioid Crisis Report: Need for Fentanyl Detox Increases

Before we discuss nitazenes and their impact on the opioid crisis, we’ll share the final, confirmed statistics on opioid use disorder and opioid fatalities in the U.S., published in the 2022 National Survey on Drug Use and Health (2022 NSDUH) and the Centers for Disease Control (CDC):

Opioid Use Disorder (OUD) and Opioid Overdose Fatalities, 2022

• Opioid use disorder (OUD):
  • Age 12+: 6.1 million
  • 12-17: 265,000
  • 18-25: 424,000
  • 26+: 5.4 million
• Total overdose fatalities:
  • All drugs: 110,757 (DEA)
  • Opioids: 79,770
  • Synthetic opioids (e.g. fentanyl, nitazenes, others): 75,125

That’s the data – and it clearly demonstrates the increasing problems and complications caused by the presence of illicit, synthetic opioids in the illicit drug supply. Let’s take a closer look at the latest drug that threatens the health and well-being of communities and families across the U.S.: nitazenes.

Nitazenes and the Opioid Crisis: What Are Nitazenes?

In a press conference held in October 2023, DEA administrator Anne Milgram made the following comments about the presence of nitazenes in the illicit drug supply in the U.S. She talks about nitazenes and how the joint DEA/Department of Justice (DOJ) taskforce is working to address the problem.

“Nitazenes are dangerous synthetic opioids that can be as powerful, or even more powerful, than fentanyl. They have no legitimate use. Today, we announce 8 indictments, charging 8 companies and 12 individuals, for importing into the United States fentanyl precursors [e.g., nitazenes], xylazine, and other man-made or synthetic chemicals.”

Law enforcement and laboratory analysts report at least ten types of nitazenes found in the drug supply in the U.S. The three most common include:

• Isotonitazene
• Metonitazene
• Etonitazene

To reiterate, these chemicals have no legitimate medical use. Currently, they exist only to increase profits for drug cartels and distributors to maximize profit from the sale of illicit drugs. Several types of illicitly produced drugs may include nitazenes:

• Opioids/opiates:
  • Fake prescription medications such as oxycodone, oxycontin, Vicodin, Percocet, and others
  • Fentanyl and derivatives
  • Heroin
  • Morphine
  • Dilaudid
• Methamphetamine
• Amphetamine
• MDMA, a.k.a. ecstasy
• Cocaine
• Benzodiazepines
• Ketamine
• Synthetic cannabinoids

Nitazenes appear in different forms:

• White, yellow, or brown powder
• White, yellow, or brown crystalline solid
• Liquid form

Ingesting nitazenes causes the following:

• Pain relief
• Euphoria
• Fever
• Sweats
• Nausea/vomiting
• Respiratory depression (slow breathing)

These symptoms/consequences/effects are one reason nitazenes are a real threat. They’re similar to the effects of opioids and other drugs. However, person who takes one of the illicit drugs containing nitazenes may have no idea they ingested nitazenes or a nitazene derivative. It’s similar to the problem posed by fentanyl, carfentanil, and other chemicals drug traffickers use to increase both the volume and potency of their products.

Think of it this way. If a person takes methamphetamine, or something different, like benzodiazepine, they won’t be on the lookout for signs of an opioid overdose. And when they realize what’s happening, it may be too late to administer Narcan. It may also be too late to get to an emergency room for lifesaving medical care.

So what can we do about nitazenes?

Nitazenes, the Opioid Crisis, Law Enforcement, and Evidence-Based Treatment

Here’s what we know, so far, about nitazenes, as reported by the DEA in the press conference we link to above:

• Drug manufacturers in China produce drugs such as xylazine and nitazenes, and sell them to drug traffickers in Mexico and Central America
• The DEA identifies the Sinaloa and Jalisco cartels as primary manufacturers and distributors of the nitazenes that reach the U.S.
• In October 2023, the DEA announced 8 indictments that charged 8 companies and 12 individuals responsible for importing nitazenes, xylazine, and other chemicals related to illicit drug manufacturing into the U.S.
• Chemicals like nitazenes are inexpensive
• It’s relatively easy for chemists working for drug cartels to turn fentanyl precursors into fentanyl. It’s also easy for them to use nitazenes to increase the potency of fentanyl

The first step in mitigating the harm caused by these drugs is awareness. DEA Special Agent Jarod Forget confirms this approach:

“We want to get this info out and warn people. If we can educate and inform our communities about the dangers of taking counterfeit prescription pills or other drugs, we stem the proliferation of these deadly opioids, stop all of these senseless deaths, and help keep our neighbors and loved ones safe.”

Although nitazenes are not yet as prevalent as fentanyl, they present a danger that we need to understand before their prevalence increases, and drives rates of fatal overdose even higher than they are now. It’s also important to understand two more things:

1. Evidence-based treatment for opioid addiction, methamphetamine addiction, cocaine addiction, and tranquilizer addiction – all drugs that may contain illicit nitazenes – is effective. Treatment can decrease risk of overdose and death.
2. Narcan can reverse a nitazenes overdose, but effective reversal may take more than one dose. Scientists currently don’t know enough about nitazenes to offer specific guidance on reversion nitazenes overdose, but they do know that Narcan can reverse a nitazene-related overdose.

We’ll keep any eye on any developments on nitazenes, and report the news on nitazene-related overdose prevention and the opioid crisis here as soon as it appears.

The post Nitazenes: A New Factor in the Opioid Crisis appeared first on Pinnacle Treatment Centers.

The survey is important for a variety of reasons, including but not limited to:

1. Large sample size – over 70,000 respondents each year – allows scientists to make population-level generalizations about drug use and health. That means, based on the data in the NSDUH, researchers can say things like “In 2021, 16.5% of adults over age 18 had a substance use disorder.”
2. The generalizations allowed by the data enable providers, policy makers, and people in the general public to understand the current state of drug use and health in the U.S.
3. Annual publication allows everyone – laypeople, providers, and policymakers alike – to identify trends in drug use and health. For instance, we can learn whether rates of addiction or overdose increased or decreased, compared to previous years.

We use data from the NSDUH to inform our treatment practices and create evidence-based, factual articles and blog posts like this one. We share the latest data so patients and families have access to the most recent, reliable, verified facts and figures about topics that are important to them.

In this article, we’ll share new data from the 2022 National Survey on Drug Use and Health, published in November, 2023. While it may be frustrating to arrive at 2024 and only recently have access to verified data for 2022, taking time is essential: researchers compile, study, restudy, revise, and review the data before publication.

Why?

They have to get it right.

They have to get it right because policymakers use this data to allocate funding, assign priorities, and write rules, guidelines, and laws related to substance use and substance use treatment. In addition, they have to get it right because people’s lives – and billions of dollars every year – are at stake.

With that said, let’s take a look at the top-line data on addiction from the 2022 NSDUH.

The 2022 NSDUH: Prevalence of Alcohol and Substance Use Disorder

There’s another thing to mention about the 2022 NSDUH before we proceed. This year, they used the updated criteria from the Diagnostic and Statistical Manual of Mental Disorders, Volume 5 (DSM-5) for substance use disorder diagnosis, rather than a combination of criteria from the DSM-IV and DSM-V.

Here’s the new, standardized criteria for diagnosing substance use disorder.

DSM-V: How to Identify SUD

1. The substance is often taken in larger amounts or over a longer period than intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
4. There is a craving, or a strong desire or urge, to use the substance.
5. There is recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
6. There is continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance.
7. Important social, occupational, or recreational activities are given up or reduced because of substance use.
8. There is recurrent substance use in situations in which it is physically hazardous.
9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. There is a need for markedly increased amounts of the substance to achieve intoxication or the desired effect, or markedly diminished effect with continued use of the same amount of the substance (i.e., tolerance).
11. For substances other than hallucinogens and inhalants that have a withdrawal criterion, there are two components of withdrawal symptoms, either of which meet the overall criterion for withdrawal symptoms:
    • There is a required number of withdrawal symptoms that occur when substance use is cut back or stopped following a period of prolonged use.
    • The substance or a related substance is used to get over or avoid withdrawal symptoms

Interpreting the answers:

Survey respondents who answered “yes” to two or more of the 11 questions above met criteria for substance use disorder (SUD) and were therefore included in the total prevalence estimates for 2022.

Let’s get to the data.

Substance Use Disorder and Alcohol Use Disorder in 2022

Here’s what the new data shows.

Alcohol and Substance Use Disorder, by Substance, Adults 18+

Any SUD:

• 2021: 44.3 million
• 2022: 46.4 million

Drug Use Disorder, excluding alcohol:

• 2021: 15.6 million
• 2022: 17.7 million

Alcohol Use Disorder, excluding drugs:

• 2021: 21.8 million
• 2022: 21 million

Marijuana:

• 2021: 15.3 million
• 2022: 17.6 million

Cocaine:

• 2021: 1.4 million
• 2022: 1.4 million

Heroin:

• 2021: 989,000
• 2022: 898,000

Methamphetamine:

• 2021: 1.6 million
• 2022: 1.8 million

Opioids:

• 2021: 5.3 million
• 2022: 5.8 million

Pain Relievers (Prescription):

• 2021: 4.7 million
• 2022: 5.3 million

Stimulants (Prescription):

• 2021: 1.2 million
• 2022: 1.5 million

Tranquilizers/Sedatives (Prescription):

• 2021: 1.6 million
• 2022: 1.7 million

In places we see increases, we understand we need to increase our efforts to support people with those diagnoses.

We also ask ourselves why.

In the data above, we can see we need to increase our efforts with regards to methamphetamine addiction (increased), opioid addiction (increased), prescription pain medication addiction (increased), and prescription stimulant addiction (increased). Drug use disorder overall increased, which means, overall, we have to redouble our efforts to help those in need.

We also see that marijuana use disorder increased, which is logical, given the recent nationwide movement toward legalization: that may be the why behind that increase.

With regards to the why behind increased opioid, methamphetamine, and pain reliever addiction, they why is not as clear as with marijuana. However, stress associated with the pandemic, which persisted through 2020 and 2021 – remember, most of us didn’t get a vaccine before May 2021 – may explain these increases, alongside the increased risk of addiction related to the presence of fentanyl in substances of misuse, including amphetamines and illicitly produced sedatives and tranquilizers.

Moving Forward: Our Work in 2024

Based on this data, we’re ready to increase our efforts supporting people with opioid use disorder and stimulant use disorder – including methamphetamine – with our full array of SUD treatment options. We’ll focus on offering traditional treatment and support, robust harm reduction efforts, and an ongoing commitment to offering medication-assisted treatment (MAT) with medications for opioid use disorder (MOUD) to people with opioid use disorder (OUD).

That’s our New Year’s Resolution: to continue offering the latest and best evidence-based addiction treatment available.

The post Research Report: New Data on Alcohol and Substance Use Disorder (AUD/SUD) appeared first on Pinnacle Treatment Centers.

The opioid crisis began in the late 1990s, and – except for a small dip in overdose fatalities around 2017 – has gotten steadily worse, year on year, since we became aware of the growing number of opioid overdose fatalities.

Public health officials began changing policies to address the crisis in the early 2010s, with changes in prescription policies for opioid drugs, new advisories from the CDC on prescribing opioids for pain, monitoring programs to identify doctors or pharmacies that over-prescribed of over-distributed opioid medications, and various law enforcement efforts to address the crisis by preventing illegal drugs from reaching people on the streets.

However, none of those efforts stopped the opioid crisis or reduced the yearly increase in opioid-related overdose deaths. When nothing else worked, we turned to harm reduction, following the example of several European countries, where evidence showed policies based in harm reduction are safe and effective. Harm reduction is a new approach in the U.S., and part of a new national strategy developed by the White House to mitigate the harm caused by the opioid crisis.

To learn more about our new strategy, please navigate to the blog section of our website and read this article:

The Opioid Crisis: A New National Strategy

In this article, we’ll answer the question posed in the title: do overdose prevention centers – a core component of a harm reduction approach – increase crime in the communities where they’re located?

Let’s take a look.

What is Harm Reduction?

Here’s a comprehensive definition of harm reduction, as published by the non-profit harm reduction advocacy group Harm Reduction International (HRI):

“Harm reduction refers to policies, programs and practices that aim to minimize the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.”

The underlying concept behind harm reduction is in the name: harm reduction advocates seek to reduce the widespread pain and suffering associated with drug use, drug addiction, and drug overdose.

The three primary goals of harm reduction policies are to (1) save lives, (2) reduce unintended negative consequences of drug policy, and (3) create treatment alternatives and options for people who want to stop using drugs. Policymakers pursue these goals through eight types of evidence-based programs:

1. Educational Programs
2. Overdose Prevention/Reversal
3. Treatment with medications for opioid use disorder (OUD) in medication-assisted treatment (MAT) programs
4. Needle/Syringe Programs
5. Safe Consumption Sites/Overdose Prevention Centers
6. Drug Checking (for presence of dangerous/fatal additives like fentanyl
7. Housing Support
8. Legal Support

In this article, we’ll focus on three of these programs that overlap: overdose prevention/reversal, needle/syringe programs, and safe consumption sites. A paper published in November 2023 called “Overdose Prevention Centers, Crime, and Disorder in New York City” explores the community impact of two new overdose prevention centers that opened in New York City in November 2021.

The Study: The Impact of Overdose Prevention Centers on Community Crime

Researchers collected data in order to examine the community impact of harm reduction programs that offer overdose prevention centers/safe consumption sites, compared to other harm reduction facilities that do not offer safe consumption sites. Researchers assessed the following indicators with information gather between January 2019 and December 2022:

• Crime
• Requests for assistance for emergency
• Nuisance complaints
• Police enforcement in the vicinity of the safe consumption sites

The study is called a difference-in-differences study, wherein researchers look at two similar phenomena that involve quantifiable change, and identify the discrete variances in change between the two similar phenomena. In this case, the researchers looked at the difference-in-differences between changes in crime measured around two new overdose prevention centers in New York City, and compared them to the changes measured around harm reduction centers that did not operate overdose prevention centers.

What Are Overdose Prevention Centers?

The National Institute on Drug Abuse (NIDA) defines and explains the practical utility of OPCs as follows:

“OPCs are facilities where individuals consume illicit drugs under the observation of trained staff to mitigate risk of fatal overdose. By intervening with use of naloxone, oxygen, and other overdose mitigation techniques, OPCs prevent fatal opioid overdoses on their premises.”

While this isn’t stated officially anywhere, it’s clear the name/designation overdose prevention centers (OPCs) replaced the terms safe injection or safe consumption sites to address the automatic, knee-jerk resistance and stigma attached to safe injection/consumption sites in the U.S. OPCs have operated in Europe and other regions around the world for the past several decades. However, despite overwhelming evidence supporting their safety and effectiveness, before the opening of the two OPCs in New York City in 2021, no such sites existed in the U.S.

Overdose Prevention Centers: Benefits and a Brief History

Although the U.S. is in the midst of a decades-long opioid addiction and drug overdose crisis, officials have been reluctant to implement OPCs. Resistance to OPCs coalesces around fear associated with these issues:

• They sanction illegal activity
• People who use OPCs will increase crime in communities
• OPCs will drive up drug use in communities

However, around the world, there’s no indication these fears are justified – we’ll report the details on that in a moment. For now, we’ll continue with the basic facts about OPCs, then discuss the benefits of OPCs for individuals and communities, and finish with the results of the study on the two new OPCs in New York City.

First, the history.

The first OPC opened in Switzerland in 1986, with no negative impact on the surrounding community. Here’s the data on the prevalence of OPCs worldwide:

• Canada: 36 OPCs
• Netherlands: 31 OPCs
• Germany: 24 OPCs
• Spain: 13 OPCs
• Switzerland: 12
• Denmark: 5 OPCs
• Australia: 2 OPCs
• Norway: 2 OPCs
• France: 2 OPCs
• Luxembourg: 1
• Portugal: 1
• Ukraine: 1

By our count, that means there are over a hundred OPCs operating safely and successfully around the world. The two new centers in New York add to that number. If they’re successful, then ideally every major city with an overdose problem – meaning every major city in the U.S. – may adopt this approach and sanction the opening of OPCs to mitigate the harm caused by the opioid crisis.

Benefits of Overdose Prevention Centers

The Drug Policy Alliance (DPA), a U.S. based non-profit organization dedicated to increasing awareness about progressive drug policy and harm prevention services, describes the following benefits of OPCs for individuals:

• Reduction of fatal overdose
• Reduced sharing of syringes
• Decreased infectious disease transmission
• Increased linkage/access to treatment
• Increased social connection
• Reduced use of emergency medical services

In addition, the DPA identifies the benefits of OPCs for communities:

• Reduction of public drug use
• Reduced presence of drug paraphernalia and used syringes/syringe debris
• Decreased public cost for hospital emergency room visits
• Decreased public cost for emergency medical services related to overdose, e.g. reduced need for paramedics/EMTs/ambulance services

Additional facts provided by the DPA that support the benefits of DPCs include:

• A study in San Francisco that showed opening one (1) OPC could save the city 3.5 million dollars
• A similar study showed Baltimore could save 7.8 million dollars per year
• 64% percent of voters in the U.S. support the implementation of OPCs in areas of need nationwide

That’s compelling evidence for OPCs. And just as a reminder, let’s review the need for OPCs in the U.S.: the opioid and overdose crisis. Here are the latest numbers as reported by the Centers for Disease Control (CDC).

Overdose Deaths: 2020-2021

• 2020: 92,478 deaths
• 2021: 107,573
• 2022: 109,705

For the 12-month period ending June 2023, the CDC reports 106,842 deaths, which leads experts to the following estimate that in 2023, we’ll see over 111,000 overdose deaths.

What the data tells us – to reiterate – is that we need new ideas, including the use of OPCs. Let’s look at the results of the study we mention above about the impact of the only two OPCs in the U.S., after two full years of operation.

Overdose Prevention Centers and Crime: The Results

After the two OPCs opened, relative to comparison sites, which offered harm reduction services but no OPCs, data shows the following changes in criminal activity and neighborhood disturbances in the immediate vicinity of the OPCs:

• 911 calls for crime and other emergencies:
  • Decreased overall by 30.1%
  • Calls in comparison locations decreased by 3.1%
• 911 calls for medical emergencies:
  • Decreased around the OPCs by 50.1%
  • Calls in comparison locations decreased by 8.6%
• 911 calls for:
  • Crime: 31% decrease
  • Assault: 42% decrease
  • Trespass: 27% decrease
  • Medical reasons: 51% decrease
• 311 calls for nuisance/disturbance:
  • Drug-related: 160% increase
  • Unsanitary conditions: 16% decrease
  • Noise: 25% increase
  • Homelessness: 49% decrease
  • 311 calls around comparison sites rose 33.3%
• Arrests/Summons:
  • Weapons: 56.5% decrease
    • 70.2% decrease in the larger neighborhood around the OPCs
  • Drugs: 82.7% decrease
    • 74.5% decrease in the larger neighborhood around the OPCs
  • Criminal summons, any type: 87.9% decrease
    • 59.7% decrease in in the larger neighborhood around the OPCs

Based on these figures, the study authors concluded:

“More research is required to [assert] that the 2 OPCs in NYC will not be associated with localized increases in crime and disorder over a longer span of time. Objections to their implementation that rest on these concerns are not necessarily supported by our initial observations in this cohort study.”

That’s a realistic summary of their findings. The two centers in NYC have only been open for two years, so we’ll need long-term data to assess long-term effects. With that said, over the first two years, the data shows that while some drug activity in areas adjacent to OPCs increased, overall criminal activity decreased, in comparison to harm-reduction sites that did not offer OPC services. Therefore, the data are promising. Not only can OPCs reduce drug related harms to individuals who use drugs, but they can also reduce overall criminal activity in the neighborhoods in which they’re located.

That’s positive news for individuals, families, and communities, and confirmation that our current harm reduction approach to the opioid crisis is a step in the right direction.

The post Do Overdose Prevention Centers Increase Crime in Communities? appeared first on Pinnacle Treatment Centers.

It’s time to revisit that topic, because what looked merely speculative close to five years ago now looks quite possible. Based on new evidence published this year, a vaccine for heroin, fentanyl, and other opioids may be closer to fact than fiction.

An addiction vaccine could be a very good thing.

Why?

Let’s take a look at the benefits of an effective vaccine.

The Centers for Disease Control (CDC) published the following data on death rates for various diseases before and after the production of vaccines for those diseases. Given the breadth and variability of the sources for this data, it’s not perfect, but these are the best estimates possible, given the information that had access to at the time.

Benefits of Vaccines: Reduction in Yearly Fatalities

• Smallpox:
  • Before vaccine: 48,164
  • After vaccine: 0
• Diphtheria:
  • Before vaccine: 175,000+
  • After vaccine: 1
• Pertussis (Whooping Cough)
  • Before vaccine: 147,000
  • After vaccine: 6,279
• Tetanus:
  • Before vaccine: 1,314
  • After vaccine: 34
• Polio:
  • Before vaccine: 16,316
  • After vaccine: 0
• Measles:
  • Before vaccine: 503,202
  • After vaccine: 89

In the year 2000, health officials in the U.S. determined measles was eradicated in the country. Unfortunately, though, there were several small outbreaks of measles in the U.S. Health officials attribute this to the refusal of some families to give the measles vaccine to their children. To drive the point home about the value of vaccines, let’s look at the impact of a more recent vaccine: the COIVD-19 vaccine. We retrieved this data from the CDC COVID Data Tracker:

• COVID-19 deaths, Week of January 9^th, 2021, one month after vaccine approval, before widespread uptake: 25,845
• COVID-19 deaths, Week of September 23^rd, 2023: 1,254

These numbers don’t lie: vaccines work. They worked in the 20^th century when we eradicated diseases that had been killing children and adults for millennia, and they worked in 2021, when we faced a worldwide pandemic with a death toll in the millions.

How Do Vaccines Work?

To understand how a vaccine works, it’s important to understand they work because they use something that already exists in our body, and is very effective: our immune system. Here’s a quick rundown on how our immune system works:

1. A pathogen (disease-causing virus bacteria, or other molecule) enters our body.
2. Special cells in our body – our immune cells – recognize this pathogen as dangerous. In immunology, the dangerous invader is called an antigen.
3. In some cases, immune cells destroy the invading cell immediately, but some replicate too quickly to prevent disease.
4. In other cases, the immune system creates what we call antibodies, which are small proteins that recognize and attach to the known antigen, which marks it for destruction by other immune cells.
5. For a new invader, the body takes time to create antibodies that recognize the antigen. Vaccines help us skip this step. They prepare the body to counter disease by introducing a harmless version of the antigen, which stimulates the formation of antibodies specific to that antigen. Then, when the antigen appears in the body, the immune system is ready: antibodies tag the invader, and immune cells sequester/eliminate/destroy the pathogen, or simply cause the body remove the pathogen via the lymphatic system.

When we have plenty of antibodies specific to an antigen, we say we have immunity to that antigen, or that we’re immunized. Immunization is not perfect, and it’s rare for a vaccine to completely prevent infection one hundred percent of the time. However, the data above shows that with regards to reducing disease-related fatalities, vaccines are one of the greatest accomplishments in the history of medical science.

That’s no exaggeration. Look at the numbers above, and consider the lives saved with vaccines: that’s why scientists are eager to create an addiction vaccine.

Can An Addiction Vaccine for Heroin and Fentanyl Work?

Theoretically, yes.

In the article we published back in 2019, we identified three primary hurdles to overcome in order to create and implement an addiction vaccine for any drug, including heroin or fentanyl: human, scientific and financial.  We’ll talk about these hurdles, starting with the human component.

Addiction Vaccines: Challenges to Overcome

Challenge 1: People

The human component of the challenge involves choice. A vaccine can only work when a person wants to prevent or recover from addiction. Second, the human component involves stigma. Many people still believe that addiction is a moral failing or character flaw, and don’t understand the medical model of addiction, which defines addiction as a medical disease that responds well to evidence-based treatment.

In 2023, things have changed. The overdose death rate has increased every year, and millions of people now realize that in order to prevent further harm from addiction and opioid overdose fatalities, we need to move past stigma, and embrace any and all evidence-based prevention and treatment strategies. That includes accepting the medical model of addiction, and understanding that medical problems require medical solutions – like a vaccine.

Challenge Two: Science

The scientific challenges are significant. First, with regards to addiction in general, we’d need antibodies to every molecule that has the potential for addiction. From opiates to marijuana to alcohol to cocaine, scientists would have to create antibodies that recognize each of these antigens. That’s why the current research is narrow, with scientists focusing on creating vaccines for the drugs that present the most imminent danger of fatality, which are heroin and fentanyl.

Another scientific challenge is that opioids like fentanyl are an important part of relieving/preventing severe pain during surgeries. With regards to a vaccine for fentanyl, doctors expressed concern about what type of pain relievers to use during surgeries on people with fentanyl antibodies.

In 2023, we’ve come a long way. Initial studies on laboratory animals showed we can create antibodies specific to heroin and fentanyl that completely prevent those molecules from acting on the central nervous system. This is a big step forward. We’ll discuss the problem of pain relief during surgery below. For now, it’s important to understand that we’ve cleared the first part of this hurdle – creating successful antibodies in animals.

Challenge Three: Funding

In 2017, we prioritized funding in this order: reduce demand through prescription monitoring and education, disrupt the supply of illicit drugs through enhanced law enforcement funding/international coordination, and increase access to evidence-based treatment for people with addiction, specifically opioid use disorder (OUD).

One thing missing from this plan was allocating significant resources toward two things: harm reduction and research into new treatment approaches. In 2022 – when we realized the plan we created in 2017 needed revising – we took a new approach. Now our funding priorities are flipped: our first priority is funding for treatment, prevention, and harm reduction, our second priority is increasing access to evidence-based treatment, and our third – but clearly still important – priority is stopping the flow of illicit drugs through enhanced law enforcement funding.

In 2023, what this means is that the initial research into vaccines for heroin and fentanyl is now completely funded by the Helping to End Addiction Long-Term Initiative (HEAL). The HEAL Initiative sponsors projects in all 50 states, with 2.5 billion dollars of funding allocated for over 1,000 individual research projects and over 40 large scale research programs – including funding for vaccine studies, which we’ll discuss below.

Our point here is that, for all practical purposes, we’ve met and overcome these challenges. The challenge of stigma still exists, but we’ve done a good enough job educating people about addiction and treatment that most people now agree: it’s time to move forward, accept the medical model of addiction, and help reduce harm for as many people as possible staring as soon as possible.

The Status of Addiction Vaccine Research in 2023: Progress For Fentanyl and Heroin

To make sure we’re all on the same page on this topic, let’s remind ourselves why we need a vaccine for heroin and fentanyl. The reason: the opioid crisis. To learn more about the crisis, please navigate to the blog section of our website, and find the 67 articles (yes, 67) articles we’ve published on this topic by selecting this category from the blog drop-down menu:

The Opioid Crisis in America

You’ll find everything you need to know in those articles. The top-line information, though, is that overdose fatalities associated with opiates like heroin and fentanyl have increased over 725% since 2001:

• 2001:
  • Total fatal drug overdose: 19,934
  • Opioid-related: 9,486
• 2022:
  • Total fatal drug overdose: 109,360
  • Opioid-related: 82,797

We need vaccines for heroin and fentanyl to keep people from dying of heroin and fentanyl overdose. It’s that simple. We can’t estimate what would have happened if we hadn’t taken the steps we have until this point, but we have to face the fact that the steps we’ve taken up to this point have not stopped the yearly increase in overdose fatalities.

To stop that yearly increase, scientists have already conducted successful trials on heroin vaccines in non-human primates. Researchers conducted that study in 2017. In 2023, two additional studies – read about them here and here – showed success for fentanyl vaccines in laboratory rodents.

Now, according to an article called “Doctors Are Getting Ready To Give Patients A Vaccine That Blocks Fentanyl’s Effects: This Could Be Huge” scientists are ready to start human trials on vaccines for both fentanyl and heroin.

About These New Trials

These trials are completely funded by grants from the HEAL Initiative we mention above. To be clear, human trials mean the researchers plan to give the vaccine to humans, expose them to the target antigen, and record the results. Although the studies on fentanyl were published already and the studies on heroin are forthcoming, researchers on these trials plan to study heroin first. Here’s how Dr. Jay Evans of the University of Montana (UMT) – a lead researcher on the study – describes this next phase of research on a vaccine for heroin and fentanyl in an interview published by the UMT:

“We anticipate testing our vaccines in humans in early 2024. The first vaccine will target heroin, followed shortly thereafter with a fentanyl vaccine in Phase I clinical trials. Once we establish safety and early efficacy in these first clinical trials, we hope to advance a combined multivalent vaccine targeting both heroin and fentanyl.”

In the first stages of clinical trials for a vaccine, safety is paramount. Researcher most often start with an amount of the vaccine they think won’t work, or will have a weak effect. In this case, researchers expect their first dosages to create antibodies, but not in the amounts that would prevent a typical dose of heroin or fentanyl from reaching the brain. Then, when they’re sure the antibodies – and the vaccine – are safe, and don’t cause any unforeseen complications, they’ll gradually increase the dosage until they find a dosage that meets these criteria:

1. Vaccine produces correct antibodies
2. Antibodies attach to the correct molecules
3. Targeted molecules – i.e. fentanyl and/or heroin – do not cross the blood/brain barrier and cause the euphoria or high associated with fentanyl and/or heroin
4. The antibodies and tagged molecules don’t cause any harmful side effects

That last point is the most important. A vaccine does no good if it causes more problems than it solves. To prevent any potential harm, researchers on this project will spend a significant amount of time and energy on making sure item #2 is as perfect as can be.

Creating the Right Antibody

Why does the antibody need to be perfect – or as perfect as possible?

To avoid causing additional harm.

Other molecules that are similar to heroin and fentanyl have legitimate medical purposes. First, fentanyl is a powerful analgesic that’s commonly used in surgeries. To ensure someone who takes any potential fentanyl vaccine, and later need fentanyl in a surgery, the researchers plan to create antibodies that last for several years – long enough for someone to be stable in recovery – then fade. Those antibodies can be renewed with a booster vaccine, if necessary.

In addition, it’s critical that these vaccines don’t prevent the action of medications for opioid use disorder (MOUD) in use in medication-assisted treatment (MAT) programs nationwide. These medications work by occupying opioid receptors and blocking the action of opioids in the brain. But if the antibodies bind to these molecules, they’ll lose their therapeutic effect, which we don’t want to happen.

Medications that are similar in structure to heroin and fentanyl:

• Buprenorphine
• Methadone
• Naltrexone
• Naloxone

All these medications are critical in our current treatments for OUD, and it’s important that any vaccine skip these molecules and have affinity (high likelihood of binding to) only their target molecules. That way, a person can engage in MAT with MOUD and take a vaccine at the same time: that would be the best of both worlds, and is one of the primary goals of this stage of research.

Addiction Vaccines for Fentanyl and Heroin: One Piece of the Puzzle

When we talk about addiction vaccines, we need to be careful. Just like we know addiction itself is about more than the drug the person misuses, treatment is about more than one single medication, even if that medication is an effective vaccine.

We know the best treatment for substance use disorder (SUD) is a combination of therapy, counseling, medication, lifestyle changes, education, family support, and peer support. If we discover an effective addiction vaccine for heroin and/or fentanyl, we won’t throw out everything we already know helps reduce harm. We’ll put a vaccine in the medication category. Then, we’ll use it as part of an overall, holistic whole person approach to treatment.

Why?

Because we know that’s how we help people achieve more than remission of symptoms. It’s how we help people achieve long-term recovery in the context of total health.

The post Addiction Vaccine for Heroin and Fentanyl? appeared first on Pinnacle Treatment Centers.

MAT and Medicaid: Lifesaving Medication Underused 

1. 500,000 Medicaid recipients with opioid use disorder (OUD) did not receive the best available treatment for OUD, which is medication-assisted treatment (MAT) with medication for opioid use disorder (MOUD). MOUDs include methadone, buprenorphine, and naltrexone.
2. That makes up around 33% of people on Medicaid with OUD.
3. MAT participation varies by state, and by state Medicaid expansion status. For instance:
   • 90% of Medicaid recipients with OUD in Rhode Island received MAT
   • Under 40% of Medicaid recipients with OUD in Mississippi and Illinois received MAT
4. Over 80,000 people died of opioid overdose last year.

That last fact makes the NYT headline all the more disturbing: we have the capacity to address the problem, but we’re not getting the right treatment to the right people in the right places with the kind of consistency that can help reduce rates of overdose.

To read the full NYT article, click this link:

A Third of Medicaid Recipients With Opioid Use Disorder Aren’t Getting Medication to Treat It

To learn about MAT at Pinnacle Treatment Centers, please navigate to our treatment page:

Medication-Assisted Treatment

Finding Help: Pinnacle Treatment Centers

If you or someone you know need support for opioid use disorder, alcohol use disorder, or another addiction, please contact us as soon as possible. We offer a wide range of holistic, integrated treatment programs for SUD, AUD, and co-occurring disorders.

The post MAT and Medicaid: A Third of Medicaid Recipients With Opioid Use Disorder Aren’t Getting Medication to Treat It appeared first on Pinnacle Treatment Centers.

The crisis: the opioid overdose epidemic.

In recent years, media attention to the opioid crisis faded because of another public health crisis: the COVID-19 pandemic.

Now that we’ve discovered a new normal with regards to the COVID-19 pandemic, with boosters addressing new variants and an increasing understanding of long COVID, we can return our attention to the opioid crisis. It’s critical that we return our attention to this public health crisis, because during the pandemic, it didn’t go away.

It got worse.

In 2022, the Centers for Disease Control (CDC) reported an increase in overdose deaths over 2021. In fact, the last time drug overdose deaths decreased in the U.S. was between 2018 and 2019. Since then, despite our best efforts, rates have increased each year. That means we need to redouble our efforts to help people with opioid use disorder in all areas of our society, including among individuals incarcerated in prisons and jails. That population is particularly vulnerable, because data shows high rates of opioid use disorder (OUD), and limited access to the gold-standard treatment for OUD, in the form of medication-assisted treatment (MAT) with medications for opioid use disorder (MOUD).

Trends in Overdose Death, 2001-2022

2001-2006:

• 2001: 19,394
• 2006: 34,425 drug overdose deaths
• 5-year increase: 77%

2006-2011:

• 2006: 34,415
• 2011: 41,340
• 10-year increase: 113%

2011-2016:

• • 2011: 41,340
  • 2016: 63,632
  • 15-year increase: 228% increase

2016-2021:

• • 2016: 63,632
  • 2021: 106,699
  • 20-year increase: 450%

2022:

• • Overdose deaths: 108,388
  • Total increase, 2001-2022: 458%

That’s the big-picture situation in the U.S. right now. The crisis is real, it’s reached every corner of our society. Both the Trump and Biden presidential administrations allocated billions of dollars of federal funding to mitigate the harm caused by the opioid crisis. To learn about those efforts, please navigate to the blog section of our website and read these articles:

Trump Administration Response: The Politics of Addiction: How a Group of Cities and Counties Shaped the Federal Response to the Opioid Crisis

Biden Administration Response: The Opioid Crisis: A New National Strategy

Both aid packages included comprehensive, all-of-the-above, all-hands-on-deck approach to the opioid crisis, including provisions to enhance law enforcement prevention, increase access to treatment and support, monitor opioid prescriptions, reduce regulations around MAT with MOUD for OUD, and expand harm reduction programs nationwide.

In addition, both plans included funding for OUD treatment in prisons and jails. But in 2019, between the first and second responses, harm reduction advocates made arguments before the Supreme Court of the United States (SCOTUS) that changed the ways we approach SUD treatment – particularly OUD treatment – in prisons and jails.

MAT in Prisons and Jails: The Department of Justice Position

The advocates cited SCOTUS precedent in a simple and effective manner. In 1976, they argued, the Supreme Court of the United States (SCOTUS) issued a decision in a case called Estelle v. Gamble that addressed medical care for incarcerated individuals. The decision stated:

“Deliberate indifference by prison personnel to a prisoner’s serious illness or injury constitutes cruel and unusual punishment contravening the Eighth Amendment.”

They argued this decision implies, therefore, that adequate medical care – which, for people with OUD, includes MAT with MOUD – is a constitutionally protected right. Then, in 2022, the Department of Justice (DOJ) issued further guidance, indication incarcerated individuals have protections provided by the Americans with Disabilities Act (ADA).

Here’s the text of the DOJ guidance:

“People who have stopped illegally using drugs should not face discrimination when accessing evidence-based treatment or continuing on their path of recovery. The Justice Department is committed to using federal civil rights laws such as the ADA to safeguard people with opioid use disorder from facing discriminatory barriers as they move forward with their lives.”

– Assistant Attorney General Kristen Clarke, Civil Rights Division, U.S. DOJ

What that means is that people in recovery should not only have access to the gold-standard care for their medical condition, but that care is protected by law. This presents an immediate quandary in our prisons and jails, because the latest data indicates that a very small percentage of incarcerated individuals with OUD receive support in the form of MAT with MOUDs. With that in mind, let’s take a look at a recent study published by Johns Hopkins University called “How the Drug Enforcement Administration Can Improve Access to Methadone in Correctional Facilities and Save Lives.”

MAT and Methadone in Prisons and Jails

Before we go any further, we should encourage anyone unfamiliar with MAT or MOUD to learn the basic facts on our treatment pages:

Medication-Assisted Treatment

Office-Based Opioid Treatment

Also, please read this article by our Chief Medical Officer, Dr. Chris Johnston, published in the online magazine Medium in 2021:

The Case for Medication-Assisted Treatment (MAT) in Prisons and Jails

Now, back to the topic at hand, which is how to improve our support for incarcerated individuals with OUD. The Johns Hopkins publication lays out a blueprint for change in four areas:

1. Regulations regarding medications for opioid use disorder (OUD)
2. The threshold for initiating treatment for OUD
3. Collaboration between corrections officers and medical staff
4. How to support incarcerated individuals upon release

We’ll review their recommendations in all four of these areas below. First, however, we’ll provide information about the use of MAT in prisons and jails for people with OUD.

Facts to Know, Ideas to Understand: MAT in Prisons and Jails

Prison, Jail, and OUD

• It’s common for people with opioid use disorder (OUD) to experience incarceration.
• Over 40% of people who use heroin report recent contact with the criminal justice system
• Almost 20% of people with a prescription opioid use disorder (OUD) report recent contact with the criminal legal system.
• 20% of people in jails and prisons reported regular heroin or opioid use before incarceration
• Current data estimates show there are roughly 2 million people in prisons and jails at any given time in the U.S.
• Fewer than 1% of jails and prisons in the U.S. offer MAT with MOUD for OUD

The next to last figure means that at any given time, there’s an opportunity to help close to half a million people (400,000) initiate MAT with MOUD, and that last figure shows that we’re falling woefully short, with lifesaving treatment absent in 99% of prisons and jails in the U.S.

Increased Overdose Risk

• Evidence shows incarceration significantly increases risk of fatal overdose
• From 2013-2014, 40% of deaths among people released from incarceration were caused by overdose
• Within 2 weeks of release:
  • People with OUD are 40 times more likely to die of an overdose than people in the general population
• Within 3 months of release:
  • 75% of people with OUD relapsed
• Within 1 year of release:
  • 45% of people with OUD are arrested for a new offense

This data shows us that initiating MAT during incarceration could reduce relapse, save lives, and prevent new offenses.

Decreased Recidivism (Repeat Offending/Reoffending)

• Treating people for addiction in jails reduces recidivism.
• For example, a study in Rhode Island showed a 60% decrease in overdose deaths, upon release, after participating in MAT in jail
• Experts estimate that initiating MAT in prisons and jails could prevent 2,000 overdose deaths per year

This data shows that MAT in prisons and jails has a dual effect: it reduces repeat offenses and decrease overdose deaths upon release.

Comprehensive Access to MOUD Recommended

• Major stakeholders endorse all three medications for opioid use disorder (MOUD), including:
  • National Commission on Correctional Health Care
  • National Governors Association
  • American Society for Addiction Medicine
  • National Academy of Medicine
• Availability of methadone in prisons and jails is inadequate, compared to buprenorphine
• Naltrexone is the most common MOUD used in prisons and jails, but it’s the least favored among people with OUD, and associated with shorter duration of treatment adherence

This information shows us that important stakeholders support MAT in prisons and jails, including those typically cautious and averse to change, such as National Commission on Correctional Health Care.

Next, let’s look at the recommendations they make in each of these four areas.

How to Expand Access to MAT in Prisons and Jails

We’ll review these Johns Hopkins recommendations one item at a time, beginning with their position on current rules and regulations. The details on these recommendations appear in the publication “Medications for Opioid Use Disorder in Jails and Prisons: Moving Toward Universal Access.”

Toward Universal Access for MAT

Changing Rules and Regulations

• The problem(s):
  • Under current regulations, patients can only receive methadone through licensed opioid treatment programs (OTPs), and must visit their provider daily to receive medication. For an incarcerated person, this is impossible.
  • Before the pandemic, patients could only initiate buprenorphine treatment with a provider with an X-waiver. The X-waiver is no longer necessary, but rules prevent providers from dispensing buprenorphine to more than 30 patients, which creates problems for patients in prisons and jails.
• The possible solutions:
  • Reduce barriers to methadone access in prisons and jail by increasing allowable take-home doses
  • Expand regulations to allow mobile methadone units to support patients in prisons and jails
  • Expand regulations to allow medical personnel to prescribe buprenorphine to more than 30 patients per provider
  • Expand the existing 72-hour rule to allow prison and jail medical personnel to distribute MOUDs to patients past the existing 72 hour maximum
  • Lobby the Drug Enforcement Agency (DEA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Commission on Correctional Health Care (NCCHC) to publish a set of best practices for MAT in prisons and jails

Lower the Threshold for OUD Diagnosis and Treatment.

• The problem(s):
  • Jails and prisons have stringent criteria for diagnosis and treatment of OUD
  • They place arbitrary limits on dosage and treatment duration
  • They make participation in peer support groups mandatory for receiving medication
  • When incarcerated individuals break rules, consequences are punitive, and may include withholding medication
• The possible solutions:
  • Lower the threshold for diagnosis and treatment. The idea is that it should not be hard for a person to get an accurate diagnosis and appropriate medication for a well-known, well-established, well-defined medical condition
  • Facilitate “warm-handoff” programs for patients both entering and exiting incarceration
  • Allow patients access to medication, even when they don’t participate in peer support groups or counseling
  • Institute non-punitive practices for breaking program rules: denying lifesaving medication should never be a consequence
  • Create appropriate dosage regimens for methadone and buprenorphine for patients in prisons and jails

Collaboration Between Corrections Officers and Medical Staff

• The problem(s):
  • Stigma from prison and jail personnel prevent adequate access to evidence-based treatment with MOUD
  • Officers and medical staff may think they have conflicting goals: one the one hand, officers want to ensure safety and security, while on the other hand, medical staff want to provide evidence-based treatment
  • Officers are more accustomed to confiscating methadone and buprenorphine than assisting in distributing methadone and buprenorphine as medication
• The possible solutions:
  • Educate corrections officers on the science of addiction
  • Education corrections on the science of addiction treatment
  • Teach prison staff about the benefits of MAT with MOUD for people with OUD
  • Communicate with other facilities, in other locations – different counties or states – to learn about the benefits of MAT programs
  • Enlist an advocate in a position of leadership who understands the pressing need for MAT in prisons and jails

Supporting Patients Upon Release

• The problem(s):
  • Currently, federal law terminates Medicaid for incarcerated individuals
  • Infrastructure for reenrolling incarcerated individuals upon release is inconsistent and prevents many incarcerated individuals from accessing medical care upon release from incarceration
  • Rules vary state to state, county to county, jail to jail, and prison to prison, which creates confusion for everyone involved, and often results in treatment gaps for incarcerated individuals upon release
  • Significant barriers to accessing social support exist for formerly incarcerated individuals, including access to support for housing, food, employment, and medical care
• The solutions:
  • Expand Medicaid coverage for low-income adults upon release from prisons or jails
  • Create technology infrastructure for automatic enrollment in Medicaid upon release from incarceration
  • Create programs to establish continuity of care between incarceration and release
  • Distribute Naloxone to patients with OUD upon release
  • Invest in specific reentry clinics for patients with OUD upon release
  • Eliminate the Medicaid inmate exclusion policy
  • Pass the Medicaid Reentry Act, which allows Medicaid services for patients to begin 30 days before release

If we can implement those recommendations, then we’d make considerable progress in addressing the gap between the number of incarcerated people with OUD who need treatment with MAT and the number of incarcerated people with OUD who receive MAT.

MAT in Prisons and Jails: Underlying Priorities

The first priority is, of course, the health and safety of our population as a whole. It’s important for people out in the world to understand that helping people with OUD heal and grow not only helps them, it helps everyone. Individuals benefit, families benefit, and communities benefit. To learn more about MAT in prisons and jails, please refer to these resources, which explain both where we are and where we want to go:

Current Policies on MAT in Prisons and Jails

1. SAMHSA: Use of Medication-Assisted Treatment for Opioid Use Disorder (OUD) in Criminal Justice Settings
2. Model Access to Medication for Addiction Treatment in Correctional Settings Act
3. Expanding Access To Medications For Opioid Use Disorder In Corrections And Community Settings
4. Medication-Assisted Treatment for Opioid Use Disorder in Jails and Prisons: A Planning and Implementation Toolkit

We’ll end this article with a list of core values, as determined by the study team at Johns Hopkins University, for implementing future MAT programs in prisons and jails.

Core Values: Priorities for MAT in Incarcerated Populations

Patient-Driven Support

The foundation of effective treatment for substance use disorder is personal agency. This is as true for people in prisons and jails as it is for people in the general public. People should have the right to choose treatment, and have both voice and choice in what treatment they receive and how they receive it.

Racial Equality:

Rates of incarceration among Black, Latinx, and American Indian/Alaska Native/Native Hawaiian people are higher than for people in non-minority demographic groups. This impacts access to evidence-based treatment and support. It’s essential to create programs for OUD treatment that eliminate the potential for institutional racism, systemic bias, or discrimination of any sort.

Follow the Evidence

The evidence speaks: the gold-standard treatment for opioid use disorder is medication-assisted treatment (MAT) with medication for opioid use disorder (MOUD). That’s true wherever a person is: incarcerated or not incarcerated. Therefore, it’s time to recognize this fact, and scale up our MAT program in prisons and jails, in order to follow the evidence, and give everyone with OUD a chance at making a full recovery – whether they’re incarcerated or not.

Holistic, Integrated Treatment

Health is when a person thrives on all levels: physical, emotional, psychological, and relational. SUD treatment in prisons and jails needs to address the complete person in order to keep them healthy. Granted, the fact of incarceration creates challenges. However, we have a duty to provide incarcerated individuals with complete care that maximizes total health, and create systems that allow a person to engage in continuous, uninterrupted care before, during, and after incarceration.

Moving Forward: Treatment Improves Lives

When we implement these policies and practices in places where patients need them the most, we know we can improve lives. As a society, this is an achievable goal: we can help incarcerated people turn their lives around, and prepare them to live, thrive, and grow in recovery upon release. It’s not only achievable, it’s the right thing to do, and will help improve our world, one person at a time.

The post Methadone and MAT in Prisons and Jails appeared first on Pinnacle Treatment Centers.

This awareness day is organized by a non-profit health advocacy group based in Australia called the Pennington Institute. The overall goals of iOAD are to:

• Set aside a day for family and friends to mourn loved ones lost to overdose.
• Remind people who use drugs and people in recovery that we recognize their value and seek to support them in any way we can.
• Raise awareness worldwide about the risk of drug overdose.
• Supply helpful, practical, accurate information on the support services available to people in recovery, people who use drugs, and people at risk of overdose.
• Prevent and/or end harm associated with drug use and overdose by recognizing and supporting the value of evidence-based prevention and treatment practices.

The theme for IOAD2023 is “Recognizing Those People Who Go Unseen.” This theme allows us to bring attention to people directly affected by overdose, but for various reasons, may go unrecognized, be undervalued, or be otherwise overlooked when our attention is on supporting victims of both fatal and nonfatal overdose.

These unseen heroes include:

• Family and friends of lost loved ones
• Healthcare workers and support service workers who display strength, resiliency, and compassion every day
• First responders who save lives every day

The organizers of IOAD2023 and everyone at Pinnacle Treatment Centers has one message for these underappreciated and underrecognized people:

#weseeyou

We see your strength, we see your courage, and we see your commitment to helping other people. On international overdose awareness day, we want to amplify your voices and recognize everything you do behind the scenes. You should not bear this burden in silence: today, we loudly and proudly lift you up so the world can see the heroic deeds – large and small – you perform every day, not just on overdose awareness day.

Why Do We Need International Overdose Awareness Day?

If you follow the news, or read this blog regularly, you know we need an overdose awareness day in the United States because of the opioid overdose crisis. To read our library of over sixty articles on the opioid crisis, please navigate to the blog section of our website and browse our articles, or click this link:

The Opioid Crisis in America

The need for an overdose awareness day in the U.S. is further bolstered by recognition from our highest-ranking public officials. Here’s A White House Proclamation from last year that describes the importance of iOAD, and established the last week in August of every year as Overdose Awareness Week:

“Overdose Awareness Week is a time to remember those tragically lost to overdose and the pain of the families who are left behind.  But it is also an opportunity to recommit ourselves to working together to build safe, healthy, and resilient communities.  By adopting evidence-based approaches to reducing overdose risks and lowering barriers to treatment and support, we can save more American lives.

Now, therefore, I do hereby proclaim August 28 through September 3, 2022, as Overdose Awareness Week.”

In 2023, Overdose Awareness Week will occur from August 27^th to September 3^rd. We’ll publish articles on that week soon. For the moment, we’ll return to the topic of why we need an international overdose awareness day.

The answer is simple.

We need one for the same reason we need overdose awareness in the U.S.: the entire world is in the midst of a drug overdose crisis.

Let’s take a look at the data.

Drug Overdose Worldwide: Facts and Figures

It’s important to recognize that like in the United States, misuse of opioids drives the worldwide overdose crisis. At the end of 2022, the organizers of iOAD, Pennington Institute, released a study called “The Global Overdose Snapshot: 2022.” We’ll draw on data from that report throughout this section of this article.

Here’s the first salient fact from that report: the increase in opioid use around the world.

Global Number of Opioid Users

• 2010: 31 million
• 2020: 61.3 million

That’s an increase of 65 percent in ten years. That qualifies as a red flag and indicates the presence of a real public health crisis that puts millions of lives at risk every day. Next, we’ll look at the rates of fatal overdose around the world. We’ll report the data available in the Pennington Report: reports from some countries includes all drugs, while reports from others include opioids only.

Drug-Related Deaths: The Most Recent Worldwide Data

(For data on the 29 countries in the European Union, click here and scroll to “EU”)

Australia, All Drugs:

• 2010: 1,756
• 2020: 2,220

Canada, Opioids:

• 2010: 1,160
• 2020: 7,560

England and Wales:

• 2010: 2,747
• 2020: 4,561

New Zealand:

• 2014-2018, All Drugs: 46 per year, average
• 2019, Opioids: 307

Northern Ireland:

• 2010: 92
• 2020: 218

Scotland:

• 2013: 527
• 2020: 1,339

Serbia:

• 2018: 47
• 2019: 57

Ukraine:

• 2019, All Drugs: 421
• 2018: 335
• 2018, Opioids: 319

United States:

• 2010, All Drugs: 38,329
• 2010, Opioids: 21,089
• 2020, All Drugs: 91,799
• 2020, Opioids: 68,5630
• 2021, All Drugs: 107,622
• 2021, Opioids: 80,411

That information makes the case clear. There’s a worldwide drug overdose crisis. Within that drug overdose crisis, there’s an opioid overdose crisis driving the fatalities. That’s true in the United States, Canada, and throughout Europe. While access and accurate records are difficult to obtain for Africa, Asia, the Middle East, Central America, the Caribbean, and South America, here’s the information we do have:

Africa:

• The WHO reports a serious problem with the drug tramadol, and estimate drug use will increase by 40% by 2030 in Africa.

China:

• 2014:
  • Unofficial estimates indicate 49,000 drug related deaths
  • Chinese media reported 14 million drug users
• 2020:
  • The Office of China National Narcotics Control Commission reported “The situation of drug abuse continues to improve and that drug abuse in China has been curbed.”

South America and Latin America:

• Reliable, verifiable opioid use and overdose data is unavailable
• South America and Latin America report the highest rate of individuals in treatment for cocaine addiction
• In Mexico, hospital records indicate methamphetamine is the most common drug detected in overdose deaths
• Authorities report an increased presence of fentanyl in street and party drugs in Colombia, Argentina, Uruguay, and Chile

Clearly, we have a worldwide crisis on our hands. It revolves around the misuse of drugs, specifically opioids. Therefore, we’ll now share the signs of opioid overdose, so that anyone reading this article knows what to look for, and can share this information with anyone who needs it.

Opioid Overdose: What to Watch For

First, let’s define overdose:

Overdose occurs when a person’s body has a severely harmful reaction to taking too much of a drug or a combination of different drugs. Overdose can be fatal or non-fatal.

Next, it’s important to understand the risk factors associated with opioid overdose:

Opioid Overdose Risk Factors

• Diagnosis of opioid use disorder (OUD)
• Excessive opioid, regardless of OUD diagnosis
• Use of powerful opioids such as fentanyl or carfentanil
• Long-term opioid use
• Misuse of prescription opioids
• Mixing opioids with drugs such as benzodiazepines, alcohol, or any sedative
• Intravenous (IV) opioid use, a.k.a. injecting any opioid
• Relapse to opioid use after a period of abstinence
• Presence of chronic health conditions including obesity or sleep apnea

Those are the risk factors, which means the presence of one or more increase risk of opioid overdose. Now let’s discuss how to recognize an opioid overdose when it’s happening. The Centers for Disease Control (CDC) maintains International Overdose Awareness Day page filled with useful information on overdose awareness and prevention.

CDC: How to Recognize an Opioid Overdose

It’s not always easy to recognize an overdose. If there’s any uncertainty, it’s best to err on the side of caution, and call 911 immediately. If naloxone is available, administer it immediately – and do not leave the possible overdose victim alone.

Physical Signs of Opioid Overdose

• Small pupils, called pinpoint pupils
• Passing out/losing consciousness
• Slow, weak, or absence of breathing
• Unusual, uncharacteristic choking/gurgling sounds
• Any strange noises related to breathing
• Limp, unresponsive body
• Cold, clammy skin
• Discolored skin
• Discolored lips and/or fingernails

The best way to reverse and overdose is with the medication naloxone. Naloxone can reverse an overdose due to opioids such as heroin, fentanyl, and prescription opioids. It’s available in two forms:

• Injectable liquid in a pre-filled syringe
• Intra-nasal spray

Naloxone can be administered as follows:

• Injection into the muscles of upper arm (injectable form)
• Injection into the outer part of the thigh muscle (injectable form)
• Spray directly into the nose (nasal spray)

The CDC indicates you should carry naloxone if:

• You’re at risk increased risk of opioid overdose, as determined by the risk factors listed above
• A friend or family member is at risk of opioid overdose, as determined by the risk factors listed above
• You have an opioid use disorder (OUD) diagnosis
• A friend or family member has an opioid use disorder (OUD) diagnosis
• You take high-dose prescription opioids
• A friend or family member takes high-dose prescription opioids
• You have prescriptions for both opioid and benzodiazepine medication
• A friend or family member has prescriptions for both opioid and benzodiazepine medications prescriptions
• You use illicit substances like heroin or fentanyl
• A friend or family member uses illicit substances like heroin or fentanyl

If you meet any of the criteria above, we recommend gaining access to naloxone and either asking your doctor how to use it or find a local resource for naloxone training. You can find out where to acquire naloxone and receive naloxone training on this website:

Save a Life: Get Naloxone Now

You can also watch tutorials, read information flyers, and engage in virtual role-play scenarios involving naloxone administration here:

CDC: Naloxone Training

All of that information on naloxone is essential for people who use opioids either legally or illegally, and it’s equally essential for people with friends or family who use opioids either legally or illegally. In either case, the importance of having the means at hand to immediately reverse an opioid overdose is impossible to overstate.

Stated simply, having naloxone on hand can save your life, or the life of someone you love.

How We Can All Participate in International Overdose Awareness Day

Let’s remind ourselves of the theme for iOAD2023: The theme for iOAD2023:

“Recognizing Those People Who Go Unseen”

The unseen include family members of fatal overdose victims, addiction treatment providers, case managers, peer support workers, and social support experts that show up every day to help people with opioid use disorder (OUD) or any other type of addiction that increases risk of overdose. The theme is to recognize the unseen, and the message is this:

#weseeyou

That’s what we want our colleagues around the country and world to know: we see you, we see the work you do, we see the suffering you experience, we see the suffering you alleviate, we see the same harm you see every day, and we see your efforts to reduce that harm. We see ourselves in you and your work, and we thank you for doing it.

To reduce risk of overdose, providers at Pinnacle Treatment Centers and other treatment centers around the world engage in daily efforts to:

• Educate patients and families on factors that increase overdose risk
• Raise awareness about naloxone
• Encourage patients at risk of overdose to carry naloxone
• Teach patients and families how, why, and when to administer naloxone
• Stress the importance of the steps to take after an overdose

We’ll focus on that last point. Administering naloxone and stopping a potential overdose does not solve the problems that led to the opioid overdose: it’s a short-term, lifesaving solution to an acute medical emergency caused by opioids.

After an overdose, the most important thing to do is connect the overdose victim to professional support for opioid use disorder (OUD). An overdose can be the wake-up call a person needs to get into treatment – but if no one is around to answer that call, the moment can pass, and the person may lose the desire to seek treatment. Therefore, following up after the overdose is essential. Getting the overdose victim into the care of treatment professionals is the best way to prevent another overdose.

We’ll end this article on iOAD2023 with two messages. To our treatment colleagues in the U.S. and around the world, this is well worth saying again: #weseeyou.

And to everyone else, this message:

Addiction is treatable. Overdose is preventable. Together, we can end the harm caused by the overdose crisis, and work to save lives, one person at a time, one day at a time.

The post International Overdose Awareness Day: August 31st, 2023 appeared first on Pinnacle Treatment Centers.

Ibogaine is not new.

It’s derived from the root of a plant common in West Africa, used in spiritual rituals for centuries. Ibogaine was marketed in France as a stimulant before it was made illegal in the 1960s. Research into the mental health benefits of ibogaine began in the late 20^th century in the United States. This research was part of the psychedelic therapy movement. This movement recently gained traction with the approval and success of medications like Spravato and ketamine for treatment-resistant mental health disorders.

In 2023, ibogaine is in the news for three reasons:

1. The resurgent interest in psychotherapy supported by psychedelic medications
2. Preliminary evidence that ibogaine may be an effective addiction treatment
3. A potential 42-million-dollar research effort in Kentucky to study ibogaine as an addiction treatment that’s an alternative to the three current medications approved by the Food and Drug Administration (FDA) as medications for opioid use disorder (MOUD) in federally approved medication-assisted treatment (MAT) programs

In this article, we’ll briefly review the history of ibogaine treatment, the recent renewed interest in the therapeutic properties of ibogaine for addiction treatment and mental health treatment, the evidence supporting ibogaine for addiction treatment, and the risks associated with ibogaine. We’ll close this article with a report on the proposed clinical studies researchers may conduct in Kentucky in the next several years.

We should note that at Pinnacle Treatment Centers, we do not use psychedelics or psychedelic therapy. Our interest in ibogaine stems from its potential as an addition to the current medications for opioid use disorder.

History of Ibogaine and Ibogaine for Addiction Treatment

Ibogaine is an indole alkaloid found in the shrub Tabernanthe iboga, known as iboga, and the plant Voacanga africana. Practitioners of the indigenous Bwiti religion in West Central Africa use iboga in various traditional ceremonies. People who ingest iboga in this context report powerful visions and spiritual experiences. Evidence of this practice dates back to at least the 18^th century, but has likely been common for longer.

In the 20^th century, pharmaceutical companies in France sold ibogaine as a stimulant and antidepressant before authorities outlawed its sale in 1966. According to a story in Time Magazine, the first documented knowledge of the potential value of ibogaine for addiction treatment appeared around 1962 when a group of informal researchers – all addicted to heroin – led by Howard Lotsof, discovered that ibogaine eliminated withdrawal symptoms and completely reduced heroin cravings and desire to use heroin for at least six months. A detailed account of the Lotsof experiment appeared in Chapter 16 of the medical textbook “The Alkaloids: Chemistry and Biology” in 2001.

However, in 1970, the federal government classified ibogaine as a Class 1 controlled substance. This significantly curtailed the use of ibogaine in the United States. Nevertheless, use of ibogaine continued in various countries around the world. The National Institute on Drug Abuse (NIDA) initiated a series of studies on ibogaine in the animal model in 1991, but abandoned the effort in 1995 for various reasons, including concerns over safety.

Almost five years later, research into ibogaine for addiction treatment restarted, with the work of Dr. Kenneth Alper and a team of researchers in a study called “Ibogaine in Acute Opioid Withdrawal” that demonstrated benefits of ibogaine in mitigating opioid withdrawal symptoms. That work led us to where we are today: considering ibogaine’s potential for addiction treatment.

New Research on Ibogaine for Addiction Treatment

It’s important to recognize another part of the ibogaine story. Ibogaine is illegal in the U.S. and has been since the early 1970s. But around the world, other governments allowed the use of ibogaine for mental health and addiction treatment, and still do. Although it’s impossible to determine whether anecdotal evidence from U.S citizens traveling abroad for ibogaine addiction treatment and returning home with success stories impacted the resurgence of interest in ibogaine and FDA approval of clinical trials, it’s also impossible to completely dismiss this part of the ibogaine story.

In any case, around the year 2000, and with increasing frequency since 2014, research into ibogaine for addiction treatment began to garner renewed attention and interest. Ibogaine research is now in full swing in various studies and trials around the country. A team of scientists conducted a thorough review of this new research and published a paper called “A Systematic Literature Review of Clinical Trials and Therapeutic Applications of Ibogaine” in July 2022. This paper summarizes what we know about ibogaine for addiction treatment. It includes subjective experiences of ibogaine patients, clinical data from random controlled trials, and important information on the risks and adverse events associated with ibogaine treatment.

Let’s take a look at what they found.

Ibogaine: Impact on Opioid Withdrawal, Opioid Craving, Cocaine Craving, Depression Symptoms, Post-Traumatic Stress Disorder (PTSD) Symptoms

First, we’ll review the big-picture takeaways from this literature review. A synthesis of the available research shows:

• Ibogaine may be an effective new medication to treat substance use disorder (SUD). Disorders include opioid use disorder (OUD), cocaine use disorder (CUD), heroin use disorder (HUD), and alcohol use disorder (AUD)
• Ibogaine may be an effective medication for reducing symptoms associated with some mental health disorders. Disorders include major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and anxiety.
• Adverse events associated with cardiac (heart) issues, up to and including the documentation of two deaths during ibogaine treatment, indicate that a thorough medical screening process must precede any treatment with ibogaine, and treatment should be delivered in medical setting with rigorous safety standards and effective emergency protocols in place.
• Comprehensive screening and precautions can mitigate the risks mentioned in the previous bullet point. Researchers indicate that for appropriately screened and vetted patients, the benefits of ibogaine treatment outweigh the risks.

Now let’s drill down on the data and look at the specific benefits of ibogaine treatment.

Ibogaine: Impact on SUD and Mental Health Disorders

Opioid Use Disorder (OUD), Heroin Use Disorder (HUD)

Studies on patients with opioid use disorder showed significant reduction of opioid cravings and opioid withdrawal symptoms:

• A 2020 study showed:
  • 80% of participants reported a reduction in OWS
  • 50% reported decreased in cravings for one week
  • 25% reported decreased cravings for three months
• A random controlled trial assessed the safety or ibogaine – a slightly different variation of ibogaine – for patients on MAT with methadone:
  • Patients reported reduction in withdrawal symptoms
  • Patients reported improved mood
• Single dose ibogaine for people with heroin use led to reductions in heroin craving:
  • Reductions present post-treatment
  • Reductions persisted upon discharge
• A study compared single doses of ibogaine in people with OUD delivered pre- and post-treatment showed:
  • Both groups reported reductions in withdrawal symptoms measured by an objective clinical withdrawal scale
  • Both groups reported reductions in withdrawal symptoms as measured by the Opiate-Symptom Checklist, a self-reporting questionnaire for people with OUD

Cocaine Use Disorder (CUD)

Studies on patients with cocaine use disorder showed reductions in cravings:

• A large-scale trial showed significant reductions at discharge and one month follow up for cocaine cravings, as measured by the Minnesota Cocaine Craving Scale (MCCS)
• Single dose ibogaine led to a significant reduction in cocaine craving
• A double-blind placebo-controlled trial in Brazil showed:
  • Significant reduction in the MCCS at 72 hours and 24 weeks post-treatment
  • No change in MCCS in the placebo group did not change.
  • Fewer instances of relapses in the ibogaine groups

Depression, PTSD, and Anxiety

A small number of studies show ibogaine may be an effective treatment for some mental health disorders:

• A study used the Beck Depression Inventory (BDI) to measure depressive symptoms in people with MDD, and showed significant symptom reduction between intake and discharge
• A large-scale trial showed significant reductions in depressive symptoms using the following metrics:
  • Symptom Checklist-90-R Depression Subscale (SCL-90-R)
  • Beck Depression Inventory (BDI)
  • Profile Of Mood States (POMS)
• A study on U.S. veterans with mental health challenges showed significant reduction in:
  • Symptoms of post-traumatic stress disorder (PTSD)
  • Symptoms of depression
  • Anxiety related symptoms

Those results are persuasive, and explain the interest in ibogaine as an addiction treatment and a treatment for mental health disorders. However, questions concerning the safety of ibogaine treatment remain.

Is Ibogaine Safe for Addiction and Mental Health Treatment?

For most people, yes. For people with specific heart problems or cardiac issues, however, ibogaine may be unsafe, and contraindicated. In the 24 studies the research team reviewed, two fatalities occurred:

• In a study in 1995, a female patient died within 24 hours of receiving ibogaine. An autopsy was inconclusive, and researchers suspected unreported heroin use
• A participant in a study in New Zealand died after ibogaine treatment, and an official inquiry found “…the treatment provider as being in breach of their duty of care but did not offer a medical explanation for the death.”

In studies not reviewed in this publication, a total of 56 additional deaths occurred. Data shows the following:

• 35% of these deaths involved concomitant drug use (using another drug before/immediately after ibogaine treatment)
• 71% occurred in patients with OUD
• Adverse events were predominantly associated with cardiac arrhythmias, i.e., irregular heartbeat

In addition:

• One patient with schizophrenia reported increased psychotic symptoms
• Three patients reported symptoms of mania – with no previous diagnosis of bipolar disorder – after ibogaine treatment in unregulated overseas ibogaine clinics

There is currently no consensus in the medical community on what constitutes best-practices and safety around ibogaine treatment for addiction or mental health disorders. That’s the last piece of the puzzle for this medication. Data shows it can be effective, but for some patients, it can be dangerous. That’s one of the questions at issue in the state of Kentucky, which is currently considering funding an ibogaine research program to address the opioid crisis.

Ibogaine in Kentucky: Officials Debate Plans for Ibogaine Research

We recently published this article in the blog section of our website:

The Opioid Crisis in the United States: Update on Settlements with Opioid Manufacturers, Distributors, and Retailers

It’s about exactly what the title implies: the financial settlements reached between various states and the companies that manufactured and distributed the medications that caused the first phase of the opioid crisis in the United States.

The State of Kentucky will receive over $800 million dollars from the settlements we discuss in that article. Members of the Kentucky Opioid Abatement Advisory Commission (KOACC) plan to allocate $42 million dollars to a pilot program to study ibogaine for the treatment of opioid use disorder (OUD). Other state officials question the wisdom of allocating resources to a new medication when there are already FDA-approved medications for opioid use disorder (MOUD) that are considered the gold-standard in opioid addiction treatment.

Advocates of the ibogaine program indicate an all-of-the-above strategy is the best approach. They point to the research we cite in this article, as well as the first-person testimony of people like psychotherapist Juliana Mulligan, who is in recovery from a decades-long opioid use disorder. Mulligian says ibogaine saved her life. Interviewed in an article in a local Kentucky newspaper, she offered this insight:

“I remember suddenly feeling with total certainty that ibogaine is the future of opioid-disorder treatment…of course, ibogaine isn’t magic and it isn’t a cure, but it is hands-down the best door open to the path of healing that myself and many others could find.”

Dr. Kenneth Alper, a leading ibogaine researcher, who testified at a recent KOACC hearing, indicates that the deaths reported during early ibogaine studies were preventable. He believes that adequate screening and monitoring can make ibogaine treatment both safe and effective. Dr. Deborah Mash, founder of the company who may oversee the research initiative, describes the importance of this study:

“What we want to be able to demonstrate, working in a public-private partnership, is that this drug [will] help break the cycle of addiction. We need the best scientists, the best people who know how to do clinical trials, our academic colleagues together (with) public-private partnership, to accelerate the pace of this.”

The Kentucky Opioid Abatement Advisory Commission (KOACC) will vote on the funding for this research on November 13^th, 2023. We’ll keep an eye on the result of that vote. We’ll also keep any eye on the results of the studies that may follow – and report on them here as soon as they’re available.

The post What is Ibogaine? appeared first on Pinnacle Treatment Centers.

The Opioid Crisis in the United States

The opioid crisis in the U.S. continues to claim lives at an alarming rate.

In 2022, a total of 109,680 people died of drug overdose, with 74 percent – or 81,045 – of those death attributed to opioids. That’s 300 drug overdose deaths overall per day, and 222 opioid overdose deaths per day.

Each of those deaths – whether from opioids or another drug – leaves friends, families, and loved ones behind, in mourning, wondering they could’ve done to help. In many cases, loved ones did everything they could, but it wasn’t enough. They had to face the fact that only one person can create real change in the life of a person with a substance use disorder: the person with the disorder themselves.

The National Institute on Drug Abuse (NIDA) reports the following data about prescription opioids:

• 21% to 29% of people prescribed opioids misuse them
• 8% to 12% will develop an opioid use disorder (OUD)
• 4% to 6% will initiate illicit heroin use

These percentages translate into millions of people with a life-threatening medical condition, which we call opioid use disorder (OUD).

• Opioid misuse in the past year:
  • Total: 9.2 million
• Opioid prescription misuse:
  • Total: 8.7 million
• Opioid use disorder: 5.6 million
• Heroin use: 1.1 million
• Heroin use disorder: 1.0 million

That’s the data: millions of people need help, because the disordered use of opioids and/or heroin leads to severe, and sometimes life-threatening problems, such as overdose.

The Consequences of Opioid Addiction/Opioid Use Disorder (OUD)

For many people who experience chronic drug use and develop a substance use disorder, the future can feel bleak and even hopeless. In most cases, people with opioid or heroin use disorder spend their days preoccupied with seeking, finding, and using opioids or heroin. This can disrupt relationships, impair academic achievement, and degrade work performance. In extreme cases, opioid and heroin use can lead to unemployment and homelessness. But let’s be clear. Doctors, CEOs, and lawyers experience opioid and heroin use disorder as well. However, they may not end up unemployed or on the street, because they have a more substantial financial safety net than others.

In any case, people engaging in active, chronic opioid use often feel that their happiness, joy, and ability to participate in the healthy parts of life are all but gone.

Many people give up hope completely. And every single person with opioid use disorder faces the risk of fatal overdose, which has increased in recent years due the influx of dangerous additives in the illicit drug supply in the U.S., such as fentanyl and xylazine.

If you or someone you love is living with the disordered use of any substance, whether opioids, alcohol, or something else, there is hope – and it’s just a call away.

Treatment for Opioid Use Disorder: The Role of Methadone Clinics

There are millions of people who need help and support for opioid use disorder/opioid addiction. Thousands of those people seek that treatment and support every day – and among those, there are millions around the world in recovery. They’ve made a proactive decision to choose health and wellness and give themselves the opportunity to celebrate the joy of life every day.

At Pinnacle Treatment Center, we understand how difficult the recovery journey can be. Our knowledgeable, experienced, compassionate staff help people across the nation 24/7/365. Medical conditions like opioid use disorder don’t take days off – and neither do we.

As we mention in the introduction of this article, evidence shows the best available treatment for opioid use disorder is medication-assisted treatment (MAT) with one of the three medications for opioid use disorder (MOUD). In fact, experts call MAT the gold standard treatment for opioid use disorder (OUD). There are three medications approved by the FDA for OUD treatment: methadone, buprenorphine, and naltrexone.

Here’s the latest data on MAT treatment, published in the 2021 National Survey on Drug Use and Health (2021 NSDUH):

Medication-Assisted Treatment for OUD

Among the 5.6 million people diagnoses with OUD in 2021:

• 2 million people received treatment for OUD
• 533,000 people received MAT for OUD
• 1 million people received MAT for opioid use, with or without OUD diagnosis
• 887,000 who misused opioids, without OUD diagnosis, received MAT for OUD

This article will discuss the oldest of the MOUDs approved for MAT: methadone.

Methadone is considered a full opioid agonist. That means it completely occupies the same receptors in the brain as both prescription and illicit opioids. However, due to its slightly different chemical structure, methadone does not include the same euphoria associated with other opioids – but it’s similar enough that it can significantly reduce withdrawal symptoms associated with stopping opioids, and also significantly reduce cravings for opioids. These aspects of methadone have been studied extensively since the 1950s, when methadone was first used to treat heroin use, and since the 1970s, when the first methadone clinic in New York City.

Treatment professionals also use methadone for the misuse/disordered use of other opioids, including prescription opioids like oxycodone and illicit opioids like fentanyl.

Methadone is a medication that can only be prescribed by a licensed medical provider in an Opioid Treatment Program (OTP) that’s certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and registered with the Drug Enforcement Agency (DEA). Patients receive methadone in either a tablet or liquid form.

Many OTPS, such as those at Pinnacle Treatment Centers, administer an initial medical assessment, create an individualized treatment program, dispense the first dose, and provide daily dosing according to the treatment plan and federal guidelines. That’s a very basic idea of how methadone clinics – i.e. OTPSs – work for most patients.

Let’s take a closer look at treatment at a federally licensed Opioid Treatment Program (OTP) at Pinnacle Treatment Centers.

Understanding How Methadone Clinics Work

Methadone clinics exist for the purpose of dispensing medications used in medically assisted drug therapy treatments. In many cases, treatment locations called methadone clinics provide other medications for opioid use disorder (MOUDs) such as Suboxone and naltrexone.

As we mention above, the first step in engaging in MAT with methadone is a comprehensive assessment – called a biopsychosocial assessment – administered by a licensed and qualified healthcare professional. Once the assessment is complete, patient and provider collaborate on a treatment plan. This is when most patients learn something critical about MAT:

The medication is only part of the treatment.

Federal guidelines require methadone clinics to offer the following services:

Counseling/Therapy/Professional support.

• Rules require methadone clinics to offer addiction counseling provided by an experienced addiction treatment provider.

Educational Workshops/Classes:

Rules require methadone clinics OTPs to provide education about addiction, relapse prevention, and other topics that promote long-term recovery.

Community Support/Peer Self-Help Meetings:

Rules require methadone clinics to offer the support required to connect MAT patients to community resources, vocational assistance, and other social services that support and promote health, wellness, and recovery.

Treatment Plan:

Rules require clinicians at methadone clinics to create a treatment plan that includes:

• Relapse prevention
• Stress management
• Lifestyle changes, such as healthy eating, exercise, and recovery-friendly activities

Before the COVID-19 pandemic, rules required close monitoring for the first week to ten days of treatment, and required patients to visit the methadone clinic every day to receive their medication. Most patients were required to receive their medication in person on a daily basis for at least six months. Then, after the first six months – if a patient complied with the rules, regulations, and expectations of the clinic and their individual treatment plan –  they were allowed to take home a limited supply of medication.

However, during the COVID-19 pandemic, the federal government allowed states to ease these rules around take-home doses of methadone. These new rules were in effect until May 2023. Clinics were allowed to continue to operate under these new rules if they applied for exceptions by May 10^th, 2023:

• For stable patients in treatment for less than two weeks, new rules permitted providers to dispense up to 7 take-home doses
• For stable patients in treatment for 15-30 days, new rules permitted providers to dispense up to 14 take-home doses
• Finally, for patient in treatment for 31 or more , new rules permitted providers to dispense up to 28 take-home doses

Note: Patients should contact their potential provider/methadone clinic to learn whether they’ve applied for continued exceptions to take-home dose rules established during the COVID-19 public health crisis. If they haven’t, some version of the original guidelines apply. If they have, the new rules may apply. In any case, patients should contact their methadone clinic directly to find out about their current take-home dosage policies.

The Benefits of Treatment at Methadone Clinics

Here’s what we want anyone reading this article to take away: MAT with methadone can be lifesaving and lifesaving.

However, it’s not as simple as taking medication and calling oneself cured. As we mention above, the only person that can create real change in the life of a person with opioid use disorder is that person themselves.

They have to show up and do the hard work of recovery – otherwise they have very little chance of creating real change.

We’ll say it this way:

The medication is not magic.

Patients have to commit to recovery and follow their treatment plan closely.

It’s essential for patients engaging in MAT with methadone to stay on the prescribed amount of methadone consistently and adhere to all the protocols established by their methadone clinic. This is how methadone clinics work, and their successful track record reinforces the importance of the protocols. This is also how a patient can meet the criteria for stability that allows them to request take-home doses.

In the context of MAT treatment at a methadone clinic, a.k.a. a federally licensed OTP, a patient must meet the following criteria to be considered stable:

• No additional active substance use disorders
• No physical or behavioral health conditions that increase the risk of harm
• Regular attendance for medication distribution
• No serious behavioral problems that increase risk of harm to themselves or others
• No diversion of methadone for illicit purposes
• Ability to safely store and transport medication

In addition, patients must meet any further criteria their supervising physicians, clinicians, or providers deem essential for the safety of the patient and the safety of the patient’s family and community.

Research has shown that when a person adheres to a methadone treatment program, their lives can change for the better. Positive outcomes include:

• Decreased opioid-related mortality (death)
• Increased time-in-treatment, which increases likelihood of long-term recovery
• Decreased opioid use
• Decreased criminal behavior related to opioid use
• Reduced transmission of infectious disease
• Increased ability to seek and maintain employment
• Improved outcomes for pregnant women with OUD, for both mother and child

That’s why it’s important to follow the protocols in a treatment plan. When a patient adheres to a treatment plan with methadone, they can experience all those lifechanging, and in some cases, lifesaving benefits.

Treatment and Support is Available Now

If you or someone you love needs professional support for opioid use disorder (OUD), we want you to know help is available. There are kind, caring, compassionate providers who understand addiction: some of our providers are in recovery, themselves, and bring their wealth of experiential knowledge to the Pinnacle Treatment Centers experience. We understand that taking the first step – making that first phone call – can often be the hardest step in the entire treatment journey.

At Pinnacle, we promise to be there for you every step of the way – not just during your official treatment program, but for your entire recovery journey.

Methadone Treatment at Pinnacle Treatment Centers

In our medication-assisted treatment programs, we use every tool available to help as many people as possible achieve sustainable recovery. MAT helps patients build a full, vibrant, purpose-driven life, free from opioids and opioid use disorder.

The post What is a Methadone Clinic? appeared first on Pinnacle Treatment Centers.

Rates of overdose continue to increase, despite coordinated nationwide efforts over the past several years to halt the increase. Local, state, and federal authorities began addressing the opioid crisis as long ago as 2014. Various initiatives, programs, and approaches showed varying degrees of success. These programs represent our best efforts to mitigate the damage caused by the opioid crisis to individuals, families, and communities across the country.

But they haven’t been good enough – because rates of fatal overdose continue to increase. That’s why we needed a new national strategy. To learn more about that five-point strategy, please navigate to the blog section of our website and read this article:

The Opioid Crisis: A New National Strategy

The first priority in the five-point strategy is to enhance and fund nationwide harm reduction efforts. The funding will come from the Helping to End Addiction Long Term Initiative (HEAL) Initiative. The HEAL Initiative allocates 36 million dollars over the next five years to support harm reduction services. To learn about the HEAL initiative and the various programs in effect as we speak, please read this article:

National Harm Reduction Research Effort Could Reduce Overdose Deaths

That article offers basic information about harm reduction and its benefits. This article goes further. It offers an updated summary of the three primary goals of harm reduction and an in-depth discussion of the principles of harm reduction.

Harm Reduction: Three Goals

Here’s a comprehensive definition of harm reduction, as published by the non-profit harm reduction advocacy group Harm Reduction International (HRI):

“Harm reduction refers to policies, programs and practices that aim to minimize the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.”

The underlying concept behind harm reduction is in the name. Harm reduction advocates seek to reduce the widespread pain and suffering related to drug use. Here are the three goals of harm reduction, as defined by the experts at HRI:

The Three Goals of Harm Reduction

1. Save Lives

The first goal is to prevent drug-related deaths. Alongside that goal, harm reduction services are designed to help people who use drugs create positive change in their lives. Approaches are supportive instead of coercive. They seek to promote any positive change in the life of a person who uses drugs, whether large or small.

2. Reduce Unintended Harms Associated With Drug Laws and Policies

Harm reduction recognizes that the warlike/bellicose attitude toward drug users and drug use advocated during the 1980s did not work. In many cases, it was counterproductive and caused harm. Negative components of this approach include:

• Criminalization of people who use drugs
• Excessive/abusive policing of people who use drugs
• Denial of care/lifesaving support services
• Restrictions on sale of safe supplies
• Forced testing
• Incarceration or detention as opposed to treatment and rehabilitation
• Discrimination related to drug use, economic status, race, or gender

3. Creating Treatment Options/Alternatives

For people who use drugs, increasing access to evidence-based treatment is essential. However, not all people who use drugs want to seek treatment. Many do want to reduce the harms drug use causes in their lives, though. Therefore, one concept of harm reduction is not requiring abstinence to participate in support programs. The idea is that abstinence should be considered a personal choice. It should be neither a barrier to support nor a prerequisite for seeking support in mitigating the harms associated with drug use.

Those are the three fundamental goals of harm reduction. Next, we’ll examine the four principles of harm reduction.

Harm Reduction: Four Principles

These four principles are an update to the eight principles of harm reduction we discuss in the article we link to above, National Harm Reduction Research Effort Could Reduce Overdose Deaths, revised for 2023:

The Four Principles of Harm Reduction

1. Follow the Evidence

All harm reduction policies and practices are evidence-based. Decades of peer-reviewed research shows harm reduction interventions are safe, effective, practical, and cost effective. Harm reduction services are inexpensive and simple to implement. For their relatively low expense, harm reduction efforts have a disproportionately positive impact on individuals, families, and communities, in comparison to traditional approaches to reducing drug use and associated harms.

2. Respect First

In past years, approaches to curbing drug use and reducing drug-associated harm often dehumanized and devalued not only people who use drugs, but also the communities where drug use is common. Harm reduction prioritizes treating people who use drugs – and their families and communities – with dignity and respect. The idea is that people who use drugs have the same basic human rights we all have, which include:

• The right to life
• Access to affordable, effective health care
• Access to social services
• The right to privacy
• The right to freedom from unnecessary detention/incarceration
• Freedom from discrimination, prejudice, and degrading/dehumanizing treatment

These rights are common to all people. Harm reduction advocates see no reason to deprive any human of fundamental rights because they use drugs.

3. Social Justice and Collaboration

With regards to social justice, harm reduction advocates seek to ensure that no entity denies anyone access to healthcare or social services as a result of:

• Drug use
• Racial/ethnic identity
• Gender
• Gender identity
• Sexual orientation
• Vocation
• Economic circumstances

In addition, harm reduction advocates support the inclusion of people who use drugs in the “design, implementation, and evaluation” of programs and policies that have direct impact on their lives and communities.

4. Reduce Stigma

Reducing stigma happens on two levels: public and private. It involves changing the way we think and talk about people who use drugs on a person-to-person level. It involves how we talk about and think about public policies that impact people who use drugs. Harm reduction reduces barriers by meeting people where they are and offering services in a way they can accept them, and stresses using respectful, person-first language based on medical knowledge rather than social tradition. For instance, instead of junkie or heroin addict we say a person with opioid use disorder or a person with heroin use disorder. This makes a difference, and reduces barriers to support and care.

Those are the four principles that inform all harm reduction programs worldwide. Next, we’ll examine how we can apply these principles in order to help as many people as possible.

Harm Reduction in Action: Eight Policy and Program Approaches

We outline the conceptual framework for harm reduction above. The application of those ideas appears in public policies and publicly and privately funded programs to reduce harm for people who use drugs, and improve the lives of their families, and the communities where they live.

Here are the eight most common harm reduction programs currently active in the world today:

1. Education Programs

Education programs are exactly what they sound like, and more. At the most basic level, they’re programs designed to teach people the facts about drugs, drug use, and treatment for substance use disorder. Harm reduction education programs go further, and include classes or workshops on how to access social services, vocational support, relationship support, and a continuing education/basic education support.

2. Overdose Prevention and Reversal Programs

After education and prevention programs, which can stop drug use before it starts, the most effective way to prevent overdose fatalities/reverse an overdose is through targeted naloxone distribution programs. Naloxone – brand name Narcan – is a drug that carries no risk of abuse and can reverse and overdose and prevent fatality. Distributing Narcan to people who use drugs or people who know people who use drugs can save lives by getting the same medication paramedics use into the hands of people who are on the scene of an overdose when it happens. In fact, in a major step forward for harm reduction and overdose prevention, the Food and Drug Administration recently approved Narcan for over-the-counter sale without a prescription. Evidence shows access to over-the-counter naloxone can help reduce rates of fatal overdose.

3. Opioid Agonist Therapy (Medication-Assisted Treatment, or MAT) Programs

Opioid agonist therapy is a subset of medication-assisted treatment (MAT). This approach uses medications for opioid use disorder (MOUD) to reduce cravings, mitigate withdrawal symptoms, and help a person with opioid use disorder (OUD) transition from chronic drug use to recovery. Both the U.S. Substance Abuse and Mental Health Service Administration (SAMHSA) and the World Health Organization (WHO) consider MAT with MOUD as the most effective available treatment for people with opioid use disorder. Current MOUDs approved for use in the U.S. include methadone, buprenorphine, and Naltrexone. Of these three medications, methadone and buprenorphine are opioid agonists, while naltrexone is an opioid antagonist.

To learn more about medication-assisted treatment for opioid use disorder, please navigate to the treatment section of our website and read this page:

Medication-Assisted Treatment

To learn more about opioid agonist therapy with methadone or buprenorphine, please navigate to the blog section of our website and read these articles:

Methadone Treatment for Opioid Use Disorder

Suboxone Treatment for Opioid Use Disorder

4. Needle & Syringe Programs

These programs are also known as syringe service programs or needle exchange programs. These programs work for three primary reasons:

1. They prevent the transmission of infectious disease – hepatitis C, HIV, and others – by providing clean and sterile needles for people who otherwise might reuse needles, or share a needle despite carrying an infectious disease.
2. They provide a safe, non-judgmental environment for people who inject drugs to discuss drug use in an open and honest way. These conversation build support and trust, and often result in a person who injects drugs deciding to seek treatment and support.
3. The staff who manage needle service programs can connect people interested in seeking support with access to substance use treatment, naloxone, or other social services.

Needle and syringe programs face stiff opposition in the U.S., but evidence shows they reduce harm associated with opioid use, which is why they’re an integral component of our national strategy to reduce rates of opioid use and opioid overdose.

5. Drug Consumption Rooms

Like needle/syringe programs, drug consumption rooms face significant opposition in the U.S. Resistance is strong, despite the fact these programs are supported by both the American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA). Also called supervised injection facilities, a drug consumption room is a safe, clean place where a person who injects drugs can inject drugs with clean supplies under the supervision of staff prepared to offer emergency support, or connect individuals directly to substance use treatment programs. Evidence shows drug consumption rooms reduce the spread of infectious disease, reduce crime associated with drug use, and prevent overdose.

Here’s how the AMA describes the current state of research on drug consumption rooms:

“The data speaks for itself—supervised consumption sites effectively treat health emergencies and help prevent certain drug-related harm or death.”

The authors of a study published in July 2022 on the impact of drug consumption rooms in Denmark and France concluded:

“DCRs may be a suitable tool for fighting the dramatic opioid overdose crisis in North America.”

There are currently two official DCRs in the United States, both located in New York City. Data from one center shows 150 overdose reversals in over 9,500 visits during the first three months of operation.

6. Drug Checking

This is a service that allows people to submit a sample of a drug – illegal or prescription – to have it tested for the presence of dangerous additives or chemicals used by drug distributors to cut or expand the volume of the substance. Drug checking is an important part of the harm reduction effort in the U.S. due to the increased presence of fentanyl and xylazine in the illicit drug supply.

To learn more about the dangers of fentanyl and xylazine, please navigate to the blog section of our website and read these articles:

Opioid Crisis Report: Need for Fentanyl Detox Increases

Emerging National Security Threat: Xylazine Laced With Fentanyl Exacerbates Opioid Crisis

7. Housing

The housing component of harm reduction services involves programs to provide homeless people with substance use disorder or substance use problems with safe housing in a harm-reduction, recovery-oriented environment. Advocates stress the connection between chronic drug use and homelessness, and the fact that safe, stable housing is a protective factor against drug use and overdose. Some harm reduction housing services require abstinence, while others, like Housing First in Massachusetts, does not. Evidence shows that Housing First approaches are an effective way to reduce drug use. They can also improve health for people who use drugs who don’t have safe and stable housing.

8. Legal Services

Legal services related to harm reduction include both personal and public efforts to reduce the harm caused by drug use. On a personal level, volunteer lawyers and/or government sponsored legal aid programs can help people who use drugs navigate the criminal justice system. They can help patients access treatment and support, rather than experience punishment and incarceration. On a pubic level, legal services related to harm reduction involves challenging laws and policies that discriminate against people who use drugs. Lawyers can advocate for a transformation of drug-related laws from a wholly punitive approach to a holistic approach that includes treatment, support, and efforts to promote recovery. All of this takes the time and expertise of experienced, qualified legal experts.

Harm Reduction: A Summary

It’s important to understand that if traditional approaches – like the war on drugs, enhancing enforcement, and increasing punishment for drug offenses – were effective in reversing the dramatic increase in overdose deaths in the U.S., then there would be no need for a new national strategy, and we wouldn’t be considering – as a nation – adopting harm reduction strategies pioneered in Europe at the end of the 20^th century.

However, traditional approaches have not been effective. Therefore, we need a new approach. The most reliable evidence, verified over the past three decades by respected experts in addiction medicine, indicates that harm reduction offers us the best chance of addressing and resolving the opioid overdose crisis. While some elements of harm reduction meet significant resistance and pushback from our citizens and leaders alike, every component of our harm reduction strategy is evidence-based and data-driven.

That’s why we’re implementing harm reduction strategies nationwide. Regardless of our opinions, the evidence shows these strategies are our best hope of bringing help and relief to the individuals, families, and communities negatively impacted by the opioid crisis.

At Pinnacle Treatment Centers, we honor the principles and practices of harm reduction every day.  We begin with a foundation of respect and compassion for all our patients. Next, we apply our philosophy through the types of treatment we offer. Finally, we reduce harm with the ongoing aftercare support we provide for patients when they complete a treatment program.

We’re committed to reducing harm in any way we can. We hope our new national strategy, solidly grounded in evidence-based harm reduction principles, will turn the tide, and reverse the steady yearly increase in overdose deaths in the U.S.

The post The Opioid Crisis: What is Harm Reduction? appeared first on Pinnacle Treatment Centers.