In episode 50 we discuss 3 articles about kratom. We are again joined by our friend Dr. Casey Grover from the Addiction Medicine Made Easy Podcast. Smith KE, Dunn KE, Rogers JM, Grundmann O, McCurdy CR, Garcia-Romeu A, Schriefer D, Swogger MT, Epstein DH. Kratom use as more than a "self-treatment". Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694.…

In episode 49 we discuss the 12-week follow-up data from the ADAPT-2 trial about using ER injectable naltrexone and bupropion for methamphetamine use disorder. Li MJ, Chau B, Belin T, Carmody T, Jha MK, Marino EN, Trivedi M, Shoptaw SJ. Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial.…

In this episode we discuss kratom with our friend Dr. Casey Grover of the Addiction Medicine Made Easy podcast. Stay tuned for part 2 coming next, Kratom Journal Club. Tampa Bay Times: Deadly Dose Annals of Internal Medicine Kratom: An Emerging Issue for Research and Physician Education --- This episode is not eligible for CME, but other episodes o…

In episode 48 we discuss the association between semaglutide and alcohol use disorder. Wang, W., Volkow, N.D., Berger, N.A. et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun 15, 4548 (2024). The Journal of Addiction Medicine: The Efficacy of GLP-1 Agonists in Treating Subst…

In episode 47 we discuss the effectiveness of sublingual and injectable buprenorphine for patients with OUD, with and without fentanyl. Nunes EV, Comer SD, Lofwall MR, Walsh SL, Peterson S, Tiberg F, Hjelmstrom P, Budilovsky-Kelley NR. Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fentanyl Use: A Post Hoc Analy…

In episode 46 we discuss using high doses of varenicline and nicotine for smoking cessation. Cinciripini PM, Green CE, Shete S, Minnix JA, Robinson JD, Cui Y, Kim S, Kypriotakis G, Beneventi D, Blalock JA, Versace F, Karam-Hage M. Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial…

45. Urine Drug Screens and Treatment Retention In episode 45 we discuss urine drug screens and treatment retention. Michener PS, Knee A, Wilson D, Boama-Nyarko E, Friedmann PD. Association of random and observed urine drug screening with long-term retention in opioid treatment programs. Drug Alcohol Depend. 2024 Feb 1;255:111067. We also discuss st…

44. Cannabis and CV Outcomes In episode 44 we discuss the association between cannabis use and cardiovascular outcomes. Jeffers AM, Glantz S, Byers AL, Keyhani S. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024 Mar 5;13(5):e030178. doi: 10.1161/JAHA.123.030178. Epub 2024 Feb 28. We also discuss the D…

In episode 43 we discuss prescribing medication for alcohol use disorder at hospital discharge. Bernstein EY, Et al. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge. JAMA Netw Open. 2024 Mar 4;7(3):e243387. We also discuss grandparents raising grandchildren who’ve lost a parent to drug overdose, and how nativ…

In episode 42 we discuss how buprenorphine protects against fentanyl overdose. Zheng Dai, et al. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures. Journal of Substance Use and Addiction Treatment, Volume 158, 2024. 209252, ISSN 2949-8759. We also discuss semaglutide for alcohol use disorder…

In episode 41 we discuss vaping for smoking cessation. Auer R, et al. Electronic Nicotine-Delivery Systems for Smoking Cessation. N Engl J Med. 2024 Feb 15;390(7):601-610. We also discuss the NarxCare addiction risk score and the recent increase in alcohol-related deaths. New York Times: Addiction Risk Scores Won’t Solve the Opioid Crisis CDC: Deat…

Quick summaries of Episodes 31-40. 31. Injection Drug Use Frequency Before and After Take-Home Naloxone Training 32. Trazodone for sleep disturbance in opioid dependent patients maintained on buprenorphine: A double blind, placebo-controlled trial 33. Non-fatal overdose risk associated with prescribing opioid agonists concurrently with other medica…

In this episode we discuss drug overdose after benzodiazepine prescriptions for anxiety and depression. Bushnell GA, et al. Drug overdose risk with benzodiazepine treatment in young adults: Comparative analysis in privately and publicly insured individuals. Addiction. 2023. We also talk about the war on recovery treatments and patients leaving the …

In this episode we discuss improvements in cognitive function with opioid abstinence. Kaur, G. Et Al. Effects of Abstinence From Opioid on Neuropsychological Performance in Men With Opioid Use Disorder: A Longitudinal Study. Journal of Addiction Medicine 17(5): p 557-562, 9/10 2023. We also talk about paramedics giving buprenorphine along with nalo…

In this episode we discuss 5 more articles that changed our addiction medicine practice. Chambers LC, et al. Buprenorphine Dose and Time to Discontinuation Among Patients With Opioid Use Disorder in the Era of Fentanyl. JAMA Netw Open. 2023; 6(9):e2334540. September 2023. (Episode 34) Caponnetto, P., et al. Varenicline and counseling for vaping ces…

In this episode we discuss 5 articles that changed our addiction medicine practice. Mahdi Sheikh, et al. Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality: A Prospective Cohort Study. Ann Intern Med.2021;174:1232-1239. [Epub 27 July 2021]. (Episode 4) Santos GM, et al. Targeted Oral Naltrexone for Mild to Mo…

In episode 38 we discuss an article comparing different treatments (and no treatment) for opioid use disorder. Robert Heimer, Anne C. Black, Hsiuju Lin, Lauretta E. Grau, David A. Fiellin, Benjamin A. Howell, Kathryn Hawk, Gail D’Onofrio, William C. Becker. Receipt of Opioid Use Disorder Treatments Prior to Fatal Overdoses and Comparison to No Trea…

37. Injectable Vs. Sublingual Buprenorphine In episode 37 we discuss an article comparing injectable and sublingual buprenorphine. Superiority and cost-effectiveness of monthly extended-release buprenorphine versus daily standard of care medication: a pragmatic, parallel-group, open-label, multicentre, randomised, controlled, phase 3 trial. Marsden…

In episode 36 we discuss an article about the mediators of problematic smartphone use. Christiane Arrivillaga, Caleb J. Hallauer, Christian Montag, Jon D. Elhai. Emotion dysregulation factors associated with problematic smartphone use severity: The mediating role of fear of missing out. Addictive Behaviors. Volume 143. 2023. https://doi.org/10.1016…

In episode 35 we discuss whether eliminating prior auths leads to more buprenorphine prescribing. Christine PJ, Larochelle MR, Lin L, McBride J, Tipirneni R. Removal of Medicaid Prior Authorization Requirements and Buprenorphine Treatment for Opioid Use Disorder. JAMA Health Forum. 2023;4(10):e233549. We also discuss buprenorphine diversion, and th…

In episode 24 we discuss prescribing 24 mg of buprenorphine daily. Chambers LC, Hallowell BD, Zullo AR, et al. Buprenorphine Dose and Time to Discontinuation Among Patients With Opioid Use Disorder in the Era of Fentanyl. JAMA Netw Open. 2023;6(9):e2334540. September 2023. We also discuss why Rite Aid filed for bankruptcy, and the FDA ban on mentho…

In episode 33 we discuss overdose risk and polypharmacy: opioids, benzodiazepines, antipsychotics, and gabapentinoids. Domzaridou E, Carr MJ, Millar T, Webb RT, Ashcroft DM. Non-fatal overdose risk associated with prescribing opioid agonists concurrently with other medication: Cohort study conducted using linked primary care, secondary care and mor…

In episode 32 we discuss an article about trazodone for sleep in people with opioid use disorder on buprenorphine. Piyush Goyal, Dheeraj Kattula, Ravindra Rao, Roshan Bhad, Ashwani Kumar Mishra, Anju Dhawan. Trazodone for sleep disturbance in opioid dependent patients maintained on buprenorphine: A double blind, placebo-controlled trial. Drug and A…

31: We discuss an article about how naloxone training impacts IV drug use. Colledge-Frisby S, Rathnayake K, Nielsen S, et al. Injection Drug Use Frequency Before and After Take-Home Naloxone Training. JAMA Netw Open. 2023;6(8):e2327319. We also discuss gambling self-exclusion and which professions use the most drugs. From the Pennsylvania Gaming Co…

Quick summaries of Episodes 21-30. 21. SOAT for OUD: Short-Acting Opioid Agonists for Opioid Use Disorder: Safety and preliminary outcomes of short-acting opioid agonist treatment (sOAT) for hospitalized patients with opioid use disorder 22. Contingency Management for Coronary Artery Disease: High-risk Coronary Plaque Regression in Cash-based Conti…

In episode 30 we discuss an article about racial differences in the receipt of medications for opioid use disorder. Barnett ML, Meara E, Lewinson T, Hardy B, Chyn D, Onsando M, Huskamp HA, Mehrotra A, Morden NE. Racial Inequality in Receipt of Medications for Opioid Use Disorder. N Engl J Med. 2023 May 11;388(19):1779-1789. We also talk about opioi…

In episode 29 we discuss an article about using varenicline and counseling for vaping cessation.. Caponnetto, P., Campagna, D., Ahluwalia, J.S. et al. Varenicline and counseling for vaping cessation: a double-blind, randomized, parallel-group, placebo-controlled trial. BMC Med 21, 220 (2023). In other vaping-related news: From NYSCSH: Vape pens tha…

In episode 28 we discuss an article about pain and addiction recovery. Ajay Manhapra, Elina A. Stefanovics, Taeho Greg Rhee, Robert A. Rosenheck, Persistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery, Drug and Alcohol Dependence, Volume 232, 2022, 109339…

In episode 27 we discuss an article about the risk of developing opioid use disorder after the first opioid prescription. Kendler, K., Lönn, S., Ektor-Andersen, J., Sundquist, J., & Sundquist, K. (2022). Risk factors for the development of opioid use disorder after first opioid prescription: A Swedish national study. Psychological Medicine, 1-9. Fr…

26. We discuss a new conceptual model of addiction recovery. Pytell, J.D., Chander, G., Thakrar, A.P. et al. Pytell, J.D., Chander, G., Thakrar, A.P. et al. Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment. J GEN INTERN MED 38, 1638–1646 (2023). We also talk about c…

25. We discuss an article about high-dose buprenorphine induction. Herring AA, Vosooghi AA, Luftig J, et al. High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder. JAMA Netw Open. 2021;4(7):e2117128. From NPR: Drugmaker Mallinckrodt may renege on $1.7 billion opioid settlement ---------- This podcast off…

24. We discuss updated data on the harms of smoking and the benefits of quitting. Thomson B, Emberson J, Lacey B, et al. Association Between Smoking, Smoking Cessation, and Mortality by Race, Ethnicity, and Sex Among US Adults. JAMA Netw Open. 2022;5(10):e2231480. We also discuss the drug supply shift from heroin to fentanyl, and how California wan…

23. We discuss an article about the Eat-Sleep-Console approach to treat neonatal opioid withdrawal syndrome. Young LW, Ounpraseuth ST, et. al. ACT NOW Collaborative. Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal. N Engl J Med. 2023 Apr 30. doi: 10.1056/NEJMoa2214470. Epub ahead of print. PMID: 37125831. We also share how…

22. Contingency Management for Coronary Artery Disease 22: We discuss an article about contingency management and the regression of coronary plaques in HIV+ cocaine users. Lai, Hong PhD; Bluemke, David A. MD; Fishman, Elliot K. MD; Gerstenblith, Gary MD; Celentano, David D. ScD; Treisman, Glenn MD; Foster, Parker MS; Mandler, Raul MD; Khalsa, Jag M…

21: We discuss an article about using short-acting opioids to treat opioid use disorder in the hospital. Thakrar, A.P., Uritsky, T.J., Christopher, C. et al. Safety and preliminary outcomes of short-acting opioid agonist treatment (sOAT) for hospitalized patients with opioid use disorder. Addict Sci Clin Pract 18, 13 (2023). We also discuss compuls…

What We Learned at ASAM2023 In this episode, we share what we learned at the 2023 American Society of Addiction Medicine Conference. Some links from the conference that you might like: Curbsiders Addiction Medicine Podcast ToxIC: Toxicology Investigators Consortium DrugsData from the Erowid Center CESAR: Center for Substance Use, Addiction, and Hea…

11-20 Round-up Super busy? Here are quick summaries of the last 10 articles. Article list: 11. Impact of wine bottle and glass sizes on wine consumption at home: a within- and between- households randomized controlled trial 12. Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities 13. Prescription opioids and lon…

20. Targeted Naltrexone for Binge Drinking In episode 20 we discuss an article about taking naltrexone as needed to reduce binge drinking among sexual and gender minority men. Santos GM, Ikeda J, Coffin P, Walker J, Matheson T, Ali A, McLaughlin M, Jain J, Arenander J, Vittinghoff E, Batki S. Targeted Oral Naltrexone for Mild to Moderate Alcohol Us…

19. Patients’ Goals in Treatment In episode 19 we discuss an article about what is most important to patients in treatment for opioid use disorder. Reed, M.K., Smith, K.R., Ciocco, F. et al. Sorting through life: evaluating patient-important measures of success in a medication for opioid use disorder (MOUD) treatment program. Subst Abuse Treat Prev…

In episode 18 we discuss the Hepatitis C Real Option (HERO) Study about two different models of HCV treatment in people who inject drugs. Litwin AH, Lum PJ, Taylor LE, Mehta SH, Tsui JI, Feinberg J, Kim AY, Norton BL, Heo M, Arnsten J, Meissner P, Karasz A, Mckee MD, Ward JW, Johnson N, Pericot-Valverde I, Agyemang L, Stein ES, Thomas A, Borsuk C, …

In episode 17 we discuss buprenorphine-naloxone vs. buprenorphine alone in pregnancy. Perry, Briana N. MD; Vais, Simone MD; Boateng, Jeffery O. MBchB, MPH; Jain, Mayuri MPH; Wachman, Elisha M. MD; Saia, Kelley A. MD. Buprenorphine-naloxone Versus Buprenorphine for Treatment of Opioid Use Disorder in Pregnancy. Journal of Addiction Medicine 16(6):p …

16. Treating Opioid Use Disorder in Jail In episode 16 we discuss an article about in-jail medication for opioid use disorder and recidivism. Elizabeth A. Evans, Donna Wilson, Peter D. Friedmann. Recidivism and mortality after in-jail buprenorphine treatment for opioid use disorder. Drug and Alcohol Dependence, Volume 231, 2022, 109254, ISSN 0376-8…

In episode 15 we discuss buprenorphine vs. methadone in pregnancy. E.A. Suarez, K.F. Huybrechts, L. Straub, S. Hernández‑Díaz, H.E. Jones, H.S. Connery, J.M. Davis, K.J. Gray, B. Lester, M. Terplan, H. Mogun, and B.T. Bateman. Buprenorphine versus Methadone for Opioid Use Disorder in Pregnancy. N Engl J Med 2022; 387:2033-2044. Bruzelius E, Martins…

In episode 14 we discuss the connection between early life trauma, depression, anxiety, stress, and opioid use disorder. Effects of Early Life Trauma on Risks for Adult Opioid Use Disorder Are Mediated by Stress and Occur Independent of Depression and Anxiety. Dunn, Kelly E. PhD, MBA; Turner, Gavin M. BS; Oswald, Lynn M. PhD. Journal of Addiction M…

In episode 13 we discuss opioids and cognitive changes in older adults. Warner, NS, Hanson, AC, Schulte, PJ, Habermann, EB, Warner, DO, Mielke, MM. Prescription opioids and longitudinal changes in cognitive function in older adults: A population-based observational study. J Am Geriatr Soc. 2022; 1- 12. doi:10.1111/jgs.18030 https://agsjournals.onli…

In episode 12 we discuss overdoses related to methamphetamine and opioid use in rural areas. Korthuis PT, Cook RR, Foot CA, et al. Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities. JAMA Netw Open. 2022;5(8):e2226544. doi:10.1001/jamanetworkopen.2022.26544 August 2022 Rural Opioid Initiative ---------- We als…

In episode 11 we discuss an article about the impact of wine bottle and glass size on consumption. Mantzari, E, Ventsel, M, Ferrar, J, Pilling, MA, Hollands, GJ, Marteau, TM. Impact of wine bottle and glass sizes on wine consumption at home: a within- and between- households randomized controlled trial. Addiction. 2022. ---------- We discuss non-ab…

Short on time? In this episode we give you quick summaries of articles 1-10. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease Analysis of Stimulant Prescriptions and Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment for Opioid Use Disorder Association of Dose Tapering With Overdose or Mental Healt…

In episode 10 we discuss an article about buprenorphine tapering. Bozinoff N, Men S, Kurdyak P, Selby P, Gomes T. Prescribing Characteristics Associated With Opioid Overdose Following Buprenorphine Taper. JAMA Netw Open. 2022;5(9):e2234168. ---------- Take a look at Riggs, KR, DeRussy, AJ, Leisch, L, et al. Sensitivity of health records for self-re…

In episode 9 we discuss psilocybin for treating alcohol use disorder. Bogenschutz MP, Ross S, Bhatt S, et al. Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2022;79(10):953–962. ---------- We talk abo…