Acknowledging International Overdose Awareness Day

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In 2021, only 22% of approximately 2.5 million individuals over 18 with opioid use disorder (OUD) received medications to treat it.¹ Of those who did receive medications for OUD, 59% were men, 62% were 35 or older, 58% were non-Hispanic white, and 58% lived in large metropolitan areas. Black adults, women, individuals who were unemployed, and those living in rural areas were amongst those less likely to receive treatment.

Psychiatric Times' Addiction & Substance Disorders Section Editor, Roueen Rafeyan, MD, DFAPA, FASAM, had this to say:

"Dear Colleagues,

In light of international Overdose Awareness Day, it is important for all of us to remind ourselves that opioid use disorder continues to remain a public health challenge. We are losing more lives every year, either to opioid use by itself or in combination with other drugs and medications. Hence, clinicians need to remain vigilant regarding any potential use and misuse. Data from the National Institute of Drug Abuse shows us steady increases in use, misuse, and death.

Rising overdose death rates has been fueled by synthetic fentanyl. More and more of synthetic fentanyl is found in various drug supplies, including cannabis and cocaine. Lately, we are also seeing increase in Xylazine. Up to 20% of street supplied drugs in Philadelphia had Xylazine in it which significantly contributes to overdose and lack of response to naloxone.

Let us take note that we are all responsible in prevention, education, and advocacy. We can reduce this burden and initiate effective treatment for the patients suffering from disease of addiction.

The best approach for a patient with a substance use disorder is compassion and understanding that addiction is a complex disease that involves genetics, epigenetics, environment, psychosocial and medical interlays, yet is treatable.

Let us extend a hand to those in need and provide them life saving treatments."

Today, on International Overdose Awareness Day, we at Psychiatric Times would like to focus on this critical issue. How can you, as a clinician, provide the best possible care? Check out our latest articles, videos, and more, full of clinical pearls.

Anti-Fentanyl Antibody: A Valuable New Weapon

A study found that an anti-fentanyl antibody reversed the signs of carfentanil overdose in rodents. Investigators developed the antibody in single-chain fragment variable format that binds with very high affinity to several variants of fentanyl, including the most dangerous variant, carfentanil. The antibody enters the bloodstream quickly via intramuscular injection and persists in the body to offer long-term protection. This new treatment option has the potential to be a more powerful and longer-lasting treatment for synthetic opioid overdose.

Fentanyl and the Adolescent Opioid Crisis

“J.T.” is a 16-year-old boy who just received life-saving naloxone after overdosing on fentanyl—for the third time. In this case-based Special Report article on child & adolescent psychiatry, we discuss the difficulty of achieving abstinence from illicit opioids for youth who misuse fentanyl. Future treatment might necessitate integrating medications for OUD with therapeutic interventions to address other motivators for substance use and increase treatment retention.

Your Patient Overdosed…

Death by suicide is known to greatly affect psychiatrists, but the impact of patients’ overdose deaths on clinicians is not well studied. Patients taking medication for OUD may die of accidental opioid overdoses from having misestimated their current opioid tolerance or overdosing on other substances such as sedatives/hypnotics and stimulants. Promotion of honesty about recurrence of substance use and finding a balance of boundaries can help prevent these situations.

$16.6M for Research on Investigational OUD Treatment

The National Institute on Drug Abuse has awarded a grant of up to $16.6 million for the investigation of cebranopadol as a treatment for OUD. Cebranopadol is an investigational, dual nociception/orphanin FQ peptide (NOP) receptor and an µ-opioid peptide (MOP) receptor agonist. Over 5 years, Tris Pharma Inc, the developer of cebranopadol, will receive funds to complete preclinical through phase 2 studies. These will assess cebranopadol’s addictive potential and explore the dosages that are needed to block withdrawal and subjective effects of dependence on opioids.

Are you interested in writing about opioid use disorder or substance use? Let us know at PTEditor@MMHGroup.com!

Reference

1. Only 1 in 5 U.S. adults with opioid use disorder received medications to treat it in 2021. News release. National Institutes of Health. August 7, 2023. Accessed August 31, 2023. https://www.nih.gov/news-events/news-releases/only-1-5-us-adults-opioid-use-disorder-received-medications-treat-it-2021