PodMed TT –Addiction Treatment Following an Opioid Overdose

When someone survives an opioid overdose with administration of naloxone, how often are they offered medicines to help them overcome addiction, and which work best? A critically important study in Annals of Internal Medicine we discuss on PodMed TT this week illustrates the need to streamline referrals, and Rick and I agree.

Turns out that only about a third of patients were even offered naltrexone, methadone or buprenorphine—drugs that help patients overcome addiction—following reversal of opioid overdose. Among those in whom medicines were used, buprenorphine resulted in a 40 percent reduction in opioid-related and all-cause mortality over 12 months of follow-up, while methadone achieved a 60 percent reduction. Naltrexone was not associated with a reduction but was used much less frequently than the other two medicines.

Rick and I agree that barriers to providing such medicines as part of a comprehensive strategy to overcome addiction must be discerned, and addiction management initiated in the ED. Another disturbing finding in this study is the fact that many survivors were able to obtain another prescription for opioids following their overdose.

Also discussed this week is a look at a single blood test to predict diabetes risk and the emotional toll of gun violence for survivors in Annals; and who really needs to be screened for abdominal aortic aneurysm in The Lancet.

Until next week, y’all listen up and make healthy choices.