Details

Published: 11 November 2024

Hits: 864

In recent years, the challenge of opioid use disorder (OUD) has prompted extensive research into effective treatment methods. Among the most widely studied are buprenorphine/naloxone and methadone. A recent comprehensive study sheds light on the comparative effectiveness of these treatments, providing valuable insights for those seeking to address this pressing health issue. According to a Cochrane review, “Buprenorphine is currently used and can reduce illicit opioid use compared with placebo, although it is less effective than methadone”. Meanwhile, the Recovery Answers article notes that “Methadone, which predates buprenorphine by almost three decades, may be more effective and have higher rates of patient retention than buprenorphine”.

Treatment Discontinuation: A Key Concern

One of the critical findings of the study is the difference in treatment discontinuation rates between the two medications. Methadone, it emerges, is associated with a significantly lower risk of treatment discontinuation compared to buprenorphine/naloxone. Within 24 months, 88.8% of individuals on buprenorphine/naloxone discontinued treatment, against 81.5% of those on methadone. This suggests that methadone may provide a more stable option for individuals committed to overcoming OUD.

Mortality Risks: A Comparative Perspective: When it comes to the risk of mortality, the study reveals similar outcomes for both treatments. Mortality rates remained low during treatment, with methadone at 0.13% and buprenorphine/naloxone at 0.08%. This parity in mortality risk underscores the potential safety of both treatment options when monitored and administered correctly.

Examining the Bigger Picture: While treatment effectiveness is paramount, understanding the broader implications of such studies is equally crucial. The findings highlight methadone’s potential in reducing treatment discontinuation, offering a more sustainable path for individuals seeking recovery. However, as we reflect on these results, it’s essential to consider the ultimate goal of eliminating drug dependence altogether.

Towards a Healthier Future: The journey to a drug-free life is one that requires dedication, support, and the right treatment pathway. This study provides evidence that can guide decision-making, prioritising methods that offer the best chance for sustained recovery. As we move forward, let us focus on solutions that not only treat but aim to eradicate the dependency on substances, paving the way for a healthier, substance-free future.

Supporting people with OUD means focusing on treatments that help them rebuild stable and healthier lives. With each step, we come closer to reliable solutions that can make a lasting difference. Source: Jama Network

Details

Published: 17 October 2024

Hits: 815

Alcohol Use Disorder isn’t just a personal struggle. It touches the lives of everyone around the individual, especially family members. The stress and worry they feel can lead to serious emotional challenges, making it vital to support not only those with AUD but also their loved ones. Understanding this ripple effect is crucial for creating effective support systems.

The Ripple Effect of AUD

Alcohol Use Disorder (AUD) extends its impact beyond the individual, deeply affecting family members who often endure significant emotional and psychological stress. This disruption within families is a critical issue that deserves attention, as it can lead to lasting emotional turmoil and strain on family dynamics.

Neurological Insights into Family Reactions

Recent research employing functional magnetic resonance imaging (fMRI) has uncovered compelling insights into how family members of individuals with AUD respond neurologically. The study highlights that these family members exhibit significant activation in brain areas associated with the reward network, specifically the left hippocampus and left amygdala. Such findings indicate that family members might experience a reward-based “approach” response, similar to those with AUD themselves. This underscores the need for comprehensive understanding and support for families navigating the challenges of AUD.

Implications for Societal Well-being

The broader societal implications of alcohol use are increasingly evident. The challenges faced by families dealing with AUD are mirrored in wider societal issues, such as the increase in drink-related incidents. This calls for a unified effort to address alcohol-related issues comprehensively, recognising the profound and far-reaching effects on both individuals and their loved ones.

By focusing on the underlying causes and advocating for robust preventative measures, we can work towards creating a healthier, more supportive environment for all affected by AUD.

(Source: Springer Link)

Details

Published: 01 August 2024

Hits: 810

An article from DB Recovery Resources provides an update on the relationship between abstinence programs and the criminal justice system. It highlights recent studies showing that incorporating abstinence-based recovery programs into criminal justice settings has led to significant reductions in recidivism rates. These programs focus on complete abstinence from alcohol and drugs, supported by counselling and peer support groups.

The article also discusses the challenges and criticisms of abstinence-based approaches, such as the need for more comprehensive support systems and the potential for relapse. Despite these challenges, the findings suggest that when effectively implemented, abstinence programs can play a crucial role in helping former offenders maintain sobriety and reintegrate into society successfully.

Source: DB Recovery Resources

Details

Published: 19 July 2024

Hits: 835

Nicotine, arguably the most difficult of substance use habits to ‘kick’, is highlighted in the following research, but one can apply this same ‘non-assisted’ exiting of drug use to other substances to. 

This of course is and has been done by millions of citizens who through abstinence based programs and processes, including therapeutic communities and 12 Step programs, has seen people break free from the tyranny of addiction. 

This exhortation, if you will, is not to denigrate medically assisted treatments that help an individual exit the drug using habits that are undermining their health and humanity – No, not at all!  It is, however, wanting to put back in a more prominent place on the ‘treatment table’ that has been cluttered with a growing number of drug use maintenance vehicles masquerading as treatment options, and empower people to become the drug free human units they were born to be. 

Also see ‘Drug Use, Stigma and Proactive Contagions to Reduce Both’

The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences

Summary Points

• Research shows that two-thirds to three-quarters of ex-smokers stop unaided. In contrast, the increasing medicalisation of smoking cessation implies that cessation need be pharmacologically or professionally mediated.
• Most published papers of smoking cessation interventions are studies or reviews of assisted cessation; very few describe the cessation impact of policies or campaigns in which cessation is not assisted at the individual level.
• Many assisted cessation studies, but few if any unassisted cessation studies, are funded by pharmaceutical companies manufacturing cessation products.
• Health authorities should emphasise the positive message that the most successful method used by most ex-smokers is unassisted cessation.

Introduction

As with problem drinking, gambling, and narcotics use [1]–[9] population studies show consistently that a large majority of smokers who permanently stop smoking do so without any form of assistance [10]–[15]. In 2003, some 20 years after the introduction of cessation pharmacotherapies, smokers trying to stop unaided in the past year were twice as numerous as those using pharmacotherapies and only 8.8% of US quit attempters used a behavioural treatment [16]. Moreover, despite the pharmaceutical industry's efforts to promote pharmacologically mediated cessation and numerous clinical trials demonstrating the efficacy of pharmacotherapy, the most common method used by most people who have successfully stopped smoking remains unassisted cessation (cold turkey or reducing before quitting [16],[17]). In 1986, the American Cancer Society reported that: “Over 90% of the estimated 37 million people who have stopped smoking in this country since the Surgeon General's first report linking smoking to cancer have done so unaided.” [18]. Today, unassisted cessation continues to lead the next most successful method (nicotine replacement therapy [NRT]) by a wide margin [15],[16].

Yet, paradoxically, the tobacco control community treats this information as if it was somehow irresponsible or subversive and ignores the potential policy implications of studying self-quitters. Unassisted cessation is seldom emphasised in advice to smokers [19]. We know of no campaigns that highlight the fact that most ex-smokers quit unaided even though hundreds of millions have done just that. Reviews typically give unassisted cessation cursory attention [20], framing it as a challenge to be eroded by persuading more smokers to use pharmacotherapies: “Unfortunately, most smokers …fail to use evidence-based treatments to support their quit attempts” [21]; “If there is a major failing in the UK approach, it is not that it has medicalised smoking, but that it has not done so enough.” [22]. Clinical guidelines also ignore unassisted cessation [8]. Finally, although the US National Centre for Health Statistics routinely included a question on “cold turkey” cessation in its surveys between 1983 and 2000, this question disappeared in 2005 [23].

Because of these prevalent attitudes, smoking cessation is becoming increasingly pathologised, a development that risks distortion of public awareness of how most smokers quit to the obvious benefit of pharmaceutical companies. Furthermore, the cessation research literature is preoccupied with the difficulty of stopping. Notably, however, in the rare literature that has bothered to ask [24], many ex-smokers recall stopping as less traumatic than anticipated. For example, in a large British study of ex-smokers in the 1980s, before the advent of pharmacotherapy, 53% of the ex-smokers said that it was “not at all difficult” to stop, 27% said it was “fairly difficult”, and the remainder found it very difficult

(For complete research go to PLOS Medicine)