Innovations In Clinical Neuroscience

Hot Topics in Pain Management October 2017

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Hot Topics in Pain Management [October 2017] 16 Journal Watch Highlights of noteworthy, peer-reviewed, evidence-based articles on pain management OPIOID EPIDEMIC "A PUBLIC EMERGENCY," DECLARES THE PRESIDENT, but lack of funding might create substantial barrier to effective drug treatment programs by Laura G. Alexander, PhD Dr. Alexander is with Arizona Western College in Yuma, Arizona On Thursday, October 26, 2017, President Trump declared the United States opioid epidemic a public health emergency, initiating a 90-day period in which the administration can draw upon the Public Health Emergency Fund to finance related programs. Unfortunately, that fund is largely depleted. 1,2 This poses a substantial barrier to response on this issue since the primary need in the fight against opioid addiction appears to be funding for in-patient detox and treatment. 3,4 Written prescriptions for opioids have increased rapidly in the last decade, a rise that is not correlated with incidence of pain-causing health conditions such as cancer. 5 The impact of this trend is more pronounced in certain states, in Louisiana for example, where deaths due to opioid use have doubled since 2012. 4 According to the Secretary of Health for the State of Louisiana, Dr. Rebekah Gee, in order to combat opioid addiction in her budget- challenged state, she needs better access to in-patient treatment programs for Medicaid recipients, lower prices for the overdose drug naloxone (e.g., Narcan), and money...hundreds of millions of dollars. 4 The Trump administration's plan for dealing with opioid addiction as revealed in his October 26, 2017, press conference is based on interim recommendations from a report 6 published online almost three months ago by the White House Commission on Combating Drug Addiction and the Opioid Crisis. 2,7 The full report was available October 30, 2017. 1 In the meantime, the interim report recommended, among other things, waiving the prohibition against Medicaid payment for in-patient residential treatment of mental health and substance use disorders, an action that could go a long way to boosting addiction treatment in cash-strapped states. However, this waiver might only apply to the 32 states that expanded Medicaid under the Affordable Care Act, 4 potentially excluding individuals who rely on Medicaid in the remaining states. Whether that is the case is not yet clear, but it is clear that if the opioid epidemic is to be wiped out, states will need substantial financial support from the Federal government for in-patient detox and treatment for all individuals, regardless of insurance status. 2,4 Keeping the current drive to reduce opioid misuse and addiction, i n this month's Journal Watch, we focus on develpments in abuse-deterrent opioids, a relatively new class of drugs designed to be more difficult to manipulate for misuse. REFERENCES 1. Allen G and Kelly A. 2017. Trump administration declares opioid crisis a public health emergency. Morning Edition, National Public Radio. Published online 26 October 2017. Accessed online 27 October 2017. [http://www.npr. org/2017/10/26/560083795/president- trump-may-declare-opioid-epidemic- national-emergency]. 2. Keith T. 2017. In opioid crisis, public health emergency vs. national emergency. Morning Edition, National Public Radio. Published online 26 October 2017. Accessed online 27 October 2017. [http:// www.npr.org/2017/10/26/560229103/ in-opioid-crisis-public-health-emergency- vs-national-emergency]. 3. Allen G. 2017. Doctors react to Trump's opioid emergency declaration. Morning Edition, National Public Radio. Published online 27 October 2017. Accessed online 27 October 2017. [http://www.npr. org/2017/10/27/560346475/doctors- react-to-trumps-opioid-emergency- declaration]. 4. Martin R. 2017. State health officials met with Trump before opioid crisis announcement. Morning Edition, National Public Radio. Published online 27 October 2017. Accessed online 27 October 2017. [http://www.npr. org/2017/10/27/560361685/state-health- Click * at the end of each summary to access the full news item online.

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