Treatment News

Moderate physical exercise can help control cravings in people with substance use disorder

This study tested the ability of two types of physical exercise (aerobic and whole body strengthening) for controlling impulses and craving in people with substance use disorder. Each exercise type led to improvements in craving and control.

Higher stress, trauma and drug cravings are related to multi-drug use in women

Higher stress, traumatic events and stronger cravings are each associated with multiple substance use days and amounts in women who use cocaine, opioids, marijuana, alcohol, benzodiazepines and/or nicotine. Pain, anxiety and depressive symptoms are not. Treatments that focus on these three specific patterns could help reduce multidrug use in women.

Ongoing depression can make treating opioid pain medicine addiction harder

In people taking a combination of buprenorphine/naloxone or methadone to treat prescription opioid pain medication addiction, moderate depression led to greater opioid use. Severe depression symptoms lead to stopping treatment more often. Other treatments can be used to help reduce depression.

Addiction is not just an individual problem. The environment in which a person lives (housing, jobs, healthcare and more) can either support or hinder recovery

Individual approaches to recovery are too narrowly focused. Looking at behavior patterns as they change over time as well as contexts in which they occur such as community, neighborhoods and social factors tells us more about how addiction starts, develops and resolves. This is vital to understanding recovery and developing multi-layered approaches to help people change.

Physical activity during substance use treatment can give a boost to your recovery

Physical activity during substance use treatment helps you develop a healthy lifestyle and protects against relapse. It can be a tool to learn how to take better care of yourself and stay in treatment. Recovery programs may benefit from adding physical activity to their treatment.

Project BLUE, a brief alcohol intervention, may help young adults avoid problems with alcohol

Prevention programs are needed to help young adults who are not in college and who may be at high risk for alcohol addiction. This study looks at a single session discussion format to explore a person’s risks and beliefs about drinking – and talk about general wellness, life goals, and doing more activities not involving alcohol. A very short relaxation training teaches stress reduction skills.

Smoking cannabis daily may be a risk factor for heart attack and stroke

In adults who had never smoked cigarettes, the association was even stronger. These findings suggest cannabis may be a risk factor for heart disease and stroke, whether you smoke cigarettes or not. The more days you smoke it per month, the greater the risk.

Older adults with opioid use disorder are facing problems in opioid treatment programs

Older adults with opioid use disorder feel disconnected from others in treatment programs, are in worse health and feel shame and discrimination. Health care for this group needs to combine age-friendly care with substance use disorder treatment and address the stigma older adults experience in healthcare settings.

Buprenorphine treatment for opioid use disorder at a primary care clinic helped people start and stay in treatment

Prescribing medication for opioid use disorder (MOUD) in a primary care setting rather than a recovery setting helps more people start treatment and stay in treatment. On average, patients were on buprenorphine treatment for 2 ¼ years. Even if they had gaps in treatment, if they returned to care within 90 days, 64% still received buprenorphine at 6 months and 70% at 9 years.

Abstinence in people with alcohol use disorder led to significant healthy changes in the brain within months

The brain is able to recover physically with continued abstinence, as seen by increased thickness in certain brain regions after 7 months of not drinking.

Thus, the effects of long-term heavy alcohol use may be at least partially reversible when abstinence is maintained. This leads to improvements in brain structure that help the ability to make decisions, regulate emotions and exercise self-control.

Making art shows promise in residential treatment setting for substance abuse disorder

Making art may help support self-control and the ability to delay gratification. In the context of substance use, people with substance use disorders are less likely to see future rewards as important as immediate rewards.

In this study making art supported learning to delay gratification, and this may eventually support improved substance-use treatment outcomes.

The goal is to develop other methods for intervention including the visual arts, music, dance and more.

Cannabis use linked to anxiety diagnoses and worsening anxiety disorders

Using cannabis use may increase the risk of developing a new anxiety disorder or worsen existing anxiety, a large Ontario study suggests.

The study looked at health data of 12 million people and found that 27.5% of people who visited an emergency room for cannabis use had developed an anxiety disorder. Researchers also found that 12.3% of cannabis users who already had an anxiety disorder were admitted to hospital because their anxiety symptoms worsened.

The risk was particularly great for young males up to 24 years old.

Access to Methadone and Buprenorphine treatment are made easier

Updates to 20-year-old rules allow take-home methadone and treatment initiation via telehealth. The aim is to simplify and expand access to addiction treatment in order to save more lives.

As of April 2, eligible patients with an opioid use disorder (OUD) can receive take-home methadone doses which have been shown to help people stay in treatment and reduce their risk of illicit opioid use. For treatment with methadone, audio-visual telehealth is allowed, and for treatment with buprenorphine, audio technologies are permitted.

This will be particularly helpful for those in rural areas or with low income for whom reliable transportation can be a challenge.

MORE (Mindfulness-Oriented Recovery Enhancement) led to less severe pain, less pain interference in daily life, and reduced opioid use

In this study, the MORE program was more effective than supportive group therapy in reducing the life effects of long-term pain, pain severity, and opioid use. A recent large review study found positive effects of MORE on addictive behaviors, craving, opioid dose reduction, chronic pain, and mental health symptoms.

This study has important implications for the use of MORE in veterans with chronic pain who may be trying to reduce their use of medication without increasing their level of pain. In this study, 34% of the enrolled veterans who received long-term opioid therapy for chronic pain were diagnosed with an opioid use disorder.

Recovery support focused on self-managing cravings, stress, and anxiety can empower those in recovery

Research has shown that slow-paced breathing may be effective in managing drug cravings by affecting heart rate. This study offers resonance frequency breathing training for managing cravings through a smartphone App. When feeling stress, anxiety, or cravings, participants will use the app to practice breathing exercises.

Birth defects are lower in pregnant women who take buprenorphine vs. methadone to treat heroin use disorder in the first 3 months of pregnancy

Use of buprenorphine or methadone to treat opioid use disorder is recommended in pregnancy. In this study buprenorphine reduced the risk of cardiac, oral cleft and clubfoot deformities in infants. It also lowered the risk of central nervous system, urinary and limb malformations.

Alcohol and drugs change how your genes work – but the changes are not permanent

Alcohol and drugs effect how genes change cells in the brain related to memory and reward - two areas strongly related to addiction. But these changes can be altered by medications and healthy lifestyle choices, creating new approaches to treatment.

Medications, exercise, diet, and meditation may have profound effects on your brain.

Reducing alcohol and drug use and starting healthy lifestyle practices like these can bring long-term benefits for your physical and mental health.

Using e-cigs or nicotine replacement products to stop smoking in the last trimester of pregnancy appears safe

The regular use of nicotine-replacement products during pregnancy has not been found to harm mothers or babies. While the main damaging effect of smoking during pregnancy is low infant birth weight, the use of nicotine products in later pregnancy do not effect an infant’s weight.

Substance use disorder is higher in certain cancer survivors

Substance use disorders (SUD) occur more often in people recovering from head and neck cancer, throat cancer, stomach cancer, cervical cancer and melanoma skin cancer. Alcohol use disorder was the most common SUD overall followed by cannabis. This knowledge can help identify cancer survivors who may benefit from combined cancer care and substance use disorder care.

A new way to treat alcohol use disorder in young adults

A new treatment called “Contingency Management plus Problem Solving Therapy” (CM-PST) was developed by The University of Illinois. It focuses on reducing alcohol use and increasing feelings of well-being. The treatment combines incentives that motivate healthy changes and teaching practical problem-solving techniques to help deal with everyday life challenges.

Adding a computer-based version of cognitive behavioral therapy (called CBT4CBT) to residential treatment helped women who used opioids cope with anxiety, depression and high stress after discharge

This study compared standard treatment alone vs the addition of a computer CBT training (two sessions per week) during residential treatment for women with opioid use disorder (OUD). The women who did not get medication for OUD but took the CBT4CBT training doubled their number of coping strategies compared to treatment as usual.

More than 75% of people with opioid use disorder have sleep problems which affect stress, mood, craving, and pain

The NIH HEAL Initiative® has a dedicated research program investigating the role of sleep in opioid use disorder and recovery. They are studying how sleep and circadian rhythms affect opioid addiction, withdrawal, relapse, and response to medication treatment and how drug use impacts sleep health.

Techniques that act directly on your nervous system may help reset areas of the brain changed by addiction

Neurostimulation therapies are a newer field of addiction treatment. They stimulate parts of the nervous system to reset brain circuits involved in addiction – changing the way your nerves carry information to and from the brain.

The most common types of devices are:

•  repetitive transcranial magnetic stimulation (rTMS)
•  transcranial direct current stimulation (tDCS)
•  deep brain stimulation (DBS)

A review 94 studies looked at their effects on craving, use, and relapse in people using alcohol, tobacco, cannabis, stimulants, and opioids. It found that rTMS reduced substance use and craving, with the best results after multiple sessions targeting a specific area of the brain. tDCS also reduced drug use and craving, though less strongly than rTMS.

Adding a Mindfulness Program focused on recovery (called MORE) to methadone treatment helps people stay in treatment longer and reduces depression and chronic pain

The MORE program helps change a person’s reward system from valuing drug rewards to valuing and savoring natural rewards.

In this study of 154 opioid users with chronic pain, adding 8 weeks of the MORE program to standard methadone treatment lowered the risk of relapsing or dropping out of treatment. After 4 months, 83.6 % of people in standard methadone treatment continued to take methadone while 95.5% of participants receiving MORE plus methadone stayed in treatment and had less depression and pain.

Semaglutide, a drug used for diabetes (Ozempic) and weight loss (Wegovy), has strong potential for treating alcohol use disorder

In the first small study in humans, it reduced cravings and alcohol consumption. Two large studies at Oklahoma State University and the National Institute on Drug Abuse (NIDA) will now test the safety and effectiveness of semaglutide in reducing alcohol use.

Oral naltrexone and acamprosate are effective for treating Alcohol Use Disorder

A systematic review of 118 clinical studies found that acamprosate and oral naltrexone (50 mg a day) were effective for alcohol use disorder (AUD).

Quickly starting extended-release buprenorphine (BUP‐XR) injections in people using fentanyl rapidly reduced opioid withdrawal symptoms and overdose

Giving a long-acting injection of buprenorphine on the first day of treatment assures high enough levels of the medication for a month - and is a promising development for the treatment of opioid use disorder.

Fentanyl and other synthetic opioids are the leading cause of overdose deaths in the U.S. Rapidly giving a BUP‐XR injection is an important potential treatment for people using these opioids who are significantly at-risk for overdose.

An 8-week program of mindfulness training in middle aged adults with substance use disorders increased self-awareness and decision-making

Mindfulness-Based Relapse Prevention (MBRP) was tested in people between 40 and 60 years of age who had a variety of substance use disorders, over 8 weeks. It made some positive changes but did not improve control of one’s thoughts, feelings or impulsive actions. This may need a longer period of training and daily practice.

Chatbot or dialogue systems can deliver highly tailored smoking cessation programs using artificial intelligence

These computer programs provide two-way communications through writing or speaking – and can provide highly personalized advice to those who want to stop smoking. Other health uses of this technology include cognitive behavioral therapy for mental health conditions and substance use disorders, support for people with dementia, and screening for health conditions.

Higher doses of buprenorphine reduce craving and withdrawal in people who use fentanyl – and they stay in treatment longer

Buprenorphine works well in treating opioid use disorder, decreasing the risk of mortality by 50%. The recommended dose for people using heroin is between 16 mg (target dose) and 24 mg.

This dosing guideline may need to be updated for fentanyl. In a study of 6499 people, those starting buprenorphine treatment on a 24 mg dose stayed in treatment longer than those on a 16 mg dose. The 16 mg daily target dose did not control withdrawal and cravings, suggesting a higher daily dose may be needed.

A medical visit by video or telephone (telemedicine) helps people start and stay in treatment for opioid use disorder

Research from the NIH on addiction treatment showed that starting buprenorphine for opioid use disorder through telehealth visits increased access to treatment and the likelihood of people staying in treatment longer. It has been shown to be safe and helpful and should be made available to those who need it.

A new model of treatment for cannabis use disorder (CUD) in TEENS

To improve CUD treatment in teens, specific approaches are needed that address cannabis use, mood and mental health, and factors such as peers and family. By paying attention to all these factors, better treatment results are likely.

Proposed treatments include:
1. MET (Motivational Enhancement Therapy) as a first-choice treatment to help teens choose to start treatment.
2. (Acceptance and Commitment Therapy) psychotherapy to help teens cope better with their feelings and reduce use.

MET and ACT can be used separately or together, along with slowly reducing cannabis use. Family therapy and stress coping tools may help too.

New breastfeeding guidelines for women during substance use disorder treatment and for those using opioids, stimulants, sedative-hypnotics, alcohol, nicotine, or cannabis

Breastfeeding is recommended for mothers who stop non-prescribed substance use by the time of delivery. They should continue to receive ongoing care after delivery, including breastfeeding support and substance use disorder treatment.

Recovery checkups during primary care visits helps people start addiction treatment and supports their recovery

Seeing substance use disorders as chronic health conditions and adding a Recovery Management Checkup at regular healthcare visits can improve treatment and recovery rates.

This approach provides regular check-ins over a longer period of time (such as every 3 months for a year), early intervention in cases of relapse, and guidance and feedback from providers on how to stay sober or reduce use.

Older adults (over 60) have a better quality of life after being treated for alcohol use disorder

Both men and women showed improvements in their physical health, psychological well-being, and social relationships. These improvements in their quality of life were found to be reachable and continued over time.

Treating anxiety and substance use disorder together is shown to help

Substance use disorders (SUD) and anxiety disorders very often occur together and complicate recovery. Research shows that dealing with these problems together rather than separately leads to better results than SUD treatment alone when both anxiety and SUD occur together.

Patients with substance use disorder (SUD) want to be involved in making decisions about their treatment, but not too much

Most people with SUD want to help decide on their treatment – and this leads to better treatment results, more self-control and less substance use.

But it is not clear how much patients want to take an active role in choosing treatment or sharing the decision-making with their health practitioner. Some studies show that people are comfortable with more information than responsibility when deciding.

More testing and better ways to treat xylazine use are needed

Xylazine (or tranq) is a drug often added to opioids like fentanyl so that the high is stronger and lasts longer. But because xylazine is a tranquilizer not an opioid, medications such as naloxone that block opioids do not work.

Standard urine analysis tests for xylazine are needed. And even though Narcan does not work to reverse a xylazine overdose, it should still be used in emergencies because xylazine is almost always mixed with fentanyl or other opiates.

Ten days of treatment with Lofexidine reduced withdrawal symptoms in 50% of people addicted to opioids so they could then start treatment with injectable naltrexone

Injectable naltrexone (ER-NTX) works well in treating opioid use disorder, BUT a person must be free from opioid use for a certain period of time before it can be started. This is a barrier to treatment, especially in the outpatient setting.

In this study the medication Lofexidine, often used to treat high blood pressure or anxiety, was used to reduce opioid withdrawal symptoms until ER-NTX could be started.

Higher doses of buprenorphine help people stay in treatment longer

In this NIH-funded study, patients prescribed a 24 mg dose of buprenorphine stayed in treatment longer than those prescribed the usual dose of 16 mg.

Because fentanyl is so widely available, people have higher levels of tolerance and dependence on opioids. Findings show that a higher buprenorphine dose – up to 24 mg – is safe with few side effects in people with opioid use disorder. It helps decrease cravings and ease withdrawal symptoms.

People who use both tobacco and cannabis report the highest level of depression and anxiety

Because of this it would be helpful for tobacco and marijuana cessation programs to also provide mental health support for depression and anxiety.

988 Suicide & Crisis Lifeline Adds American Sign Language Services for Deaf and Hard of Hearing Callers

New U.S. plan to target xylazine-laced fentanyl

Xylazine (known as Tranq dope) can be life-threatening and is especially dangerous when combined with opioids like fentanyl. How to deal with this? - quickly raise awareness about xylazine in the drug supply, provide active referral to treatment and recovery support services, and improve care for xylazine complications (especially wounds) and substance use.

Over-the-counter Narcan nasal spray is now available at drug stores, grocery stores and online

This opioid overdose reversing medication is sold nationwide without a prescription. It can reverse the effects of an opioid overdose within minutes.

It will cost approximately $45 at retail stores. Free Narcan may be available from state or local public health departments, community health centers, harm reduction organizations and even some libraries.

SAMHSA focuses on Recovery

Recovery is based on the belief that the challenges can be overcome - people can improve their health and wellness and live the life they want to live. “Today, when individuals with mental and/or substance use disorders seek help, they are met with the knowledge and belief that anyone can recover and/or manage their conditions successfully”.

Mindfulness-based relapse prevention (MBRP) helps inpatients with substance use disorder manage their anger

Mindfulness has been shown to help manage cravings and prevent relapse in people with substance use disorders (SUD). This study showed it is also effective in managing anger in people with SUD.

FDA Approves Second Over-The-Counter Naloxone Spray for Opioid Overdose

RiVive is a 3 milligram (mg) naloxone nasal spray to treat emergency opioid overdose. This gives people another way to get naloxone without needing a prescription. It is safe, effective and easy to use.

New Medicare Coverage for Addiction Treatment beginning in 2024

In 2024, Medicare will be covering intensive outpatient services (IOP) for addiction treatment at Community Mental Health Centers, Federally-Qualified Health Centers, Rural Health Centers, and Opioid Treatment Programs (OTPs).

Science is learning more about long-term effects of chemicals in vaping

Vaping creates chemical reactions in the mouth that can destroy good bacteria and cause gum disease, cavities and changes that can lead to cancer. One way it does this is by interfering with the signaling that turns the immune system on.

FDA Approves New Buprenorphine Treatment Option for Opioid Use Disorder

The FDA approved Brixadi (buprenorphine) extended-release injection for moderate to severe opioid use disorder. It is available in two forms: a weekly injection and a monthly version for patients already being treated with buprenorphine. It will be available in September 2023.

Being physically active helps people stop or decrease substance use

Forty-three studies were included in this review: 75% of the studies showed people stopped or decreased substance use after exercising 3 times a week for 13 weeks. Fourteen studies on aerobic activity showed a 71% improvement. Twelve studies reported decreased symptoms of depression.

Varenicline (Chantix) helped smokers with major depression stop smoking

In this study of 300 people, varenicline helped people give up smoking in the short and long term and was shown to be safe. It worked for people who were being treated for major depression and those who were not.

Masimo Opioid Halo™ – an FDA-approved alert system to help prevent opioid overdose

Halo™ monitors and detects slowed or stopped breathing from opioids to prevent overdose. It alerts the person and sends texts to family, friends and caregivers to let them know help may be needed. The cost is $249.99. It is available over the counter without a prescription for people 15 years and older or by prescription.

When it comes to alcohol less is better – and no amount protects your health

In this review of 107 studies, low to moderate drinking (between 1 drink per week to 2 drinks per day) does not improve your health. And 3 or more drinks a day increases the risk of early death – especially in women.

A daily text messaging program lowers stress, depression, anxiety and cravings

In this study people who received supportive text messages reported less desire to use drugs. The program helped them cope better with addiction-related stress, anxiety, and depression. They felt hopeful and had a greater sense of well-being.

Starting buprenorphine after an opioid overdose reduces the risk of future overdose deaths

Buprenorphine treatment reduced the risk of overdose deaths by 62% in this study. This highlights the need for it to be prescribed in medical office visits, ERs and telehealth visits.

A Barrier to Medication Treatment for Opioid Addiction Is Removed

It is now easier for people with an opioid use disorder to get treatment with buprenorphine from a qualified health practitioner. Buprenorphine was the first approved narcotic drug for addiction that could be prescribed by doctors in their offices. It reduces cravings and may only needed to be taken every other day.

Mental health issues are often linked to addiction

People often use substances to help them deal with other mental health issues such as depression or anxiety. Both need to be treated.

A Sleep Medication During Opioid Withdrawal Cuts Cravings

Trouble sleeping during withdrawal can lead to re-starting drug use. New research on the sleep medication suvorexant shows it eases withdrawal symptoms, reduces cravings and helps people sleep better during the withdrawal period.

When trying to stop smoking, exercise helps cut cravings

Negative and sad emotions increase cravings - but these can be eased by exercise.