Breaking News
August 16, 2018 - Promoting HPV Vaccine Doesn’t Prompt Risky Sex by Teens: Study
August 16, 2018 - Treating Rheumatoid Arthritis: Search for a Cure
August 16, 2018 - Research shows in the long run, charcoal toothpaste likely won’t whiten teeth
August 16, 2018 - Seattle Children’s opens new clinic to provide convenient access to pediatric specialty care services
August 16, 2018 - Curious case of the lost contact lens
August 16, 2018 - GN Hearing unveils world’s first Premium-Plus hearing aid
August 16, 2018 - Parental life span linked with increased longevity and health in daughters
August 16, 2018 - Health leaders reveal ten most important medicines in NHS history
August 16, 2018 - Mobile health devices diagnose hidden heart condition in at-risk populations
August 16, 2018 - When it comes to shedding pounds, it pays to think big
August 16, 2018 - Liva Healthcare announces appointment of Thomas Cooke as clinical services manager in the UK
August 16, 2018 - New digital pharmacy aims to help people living with chronic care conditions
August 16, 2018 - Preventing ACL injuries in high school athletes
August 16, 2018 - Experts provide insight into novel concepts and approaches for stroke rehabilitation
August 16, 2018 - Scientists reverse congenital blindness in mouse model
August 16, 2018 - Study shows link between use of benzodiazepines and increased risk of Alzheimer’s disease
August 16, 2018 - Trial shows PARP inhibitor as novel treatment option for patients with advanced breast cancers
August 16, 2018 - Prenatal exposure to violence increases toddlers’ aggressive behavior to their mothers
August 16, 2018 - Can manipulating gut microbes improve cardiac function in patients with heart failure?
August 16, 2018 - Hearts of newborn piglets can completely heal after heart attacks
August 16, 2018 - Ablating the mutant p53 gene in mice with colorectal cancer inhibits tumor growth
August 16, 2018 - Higher BMI in people with prediabetes related to evening preference and lack of sufficient sleep
August 16, 2018 - Using peripheral nerve blocks to treat facial pain may produce long-term pain relief
August 16, 2018 - Neural stem cells are the key to tail regeneration
August 16, 2018 - Study compares genetic and neural contributions to ADHD in children with or without TBI
August 16, 2018 - Adding energy drinks to alcohol may exacerbate negative effects of binge drinking
August 16, 2018 - Eye Examination Can Help Detect Abuse in Children
August 16, 2018 - Know the Difference: Rheumatoid Arthritis or Osteoarthritis?
August 16, 2018 - From ‘sea of mutations,’ two possible cancer links rise to the surface
August 16, 2018 - Does medical school take too long?
August 16, 2018 - Brown University researchers reveal key physical properties of ‘giant’ cancer cells
August 16, 2018 - Regular resistance training improves exercise motivation
August 16, 2018 - Feds urge states to encourage cheaper plans off the exchanges
August 16, 2018 - Seven activities that prevent you from getting quality sleep during summer
August 16, 2018 - Five ways to tell if your baby is getting enough milk from breastfeeding
August 16, 2018 - From Pigs to Peacocks, What’s Up With Those ‘Emotional-Support Animals’?
August 16, 2018 - Breast cancers enlist the help of normal cells to help them spread and survive
August 16, 2018 - Engaging with “high-need” patients outside the clinic
August 16, 2018 - Research illuminates how online forum may offer suicide prevention support for males
August 16, 2018 - Researchers identify way to grow immune cells at large scale for preventing cancer reoccurrence
August 15, 2018 - Keck Medicine of USC’s hospitals ranked among nation’s best for the 10th consecutive year
August 15, 2018 - Researchers compare existing approaches for automating diagnostic procedures of skin lesions
August 15, 2018 - Autism risk determined by health of mom’s gut, research reveals
August 15, 2018 - WELL for Life challenges you to explore the great outdoors
August 15, 2018 - ‘Zombie’ gene protects elephants from cancer, study finds
August 15, 2018 - Ebola outbreak in Congo spreads to active combat zone
August 15, 2018 - Study highlights pollution exposure of babies in prams
August 15, 2018 - Study provides insight into link between sleep apnea and lipid metabolism
August 15, 2018 - New study focuses on promise of gene therapy for Amish nemaline myopathy
August 15, 2018 - Researchers discover new approach to alleviate chronic itch
August 15, 2018 - Uncovering the Mysteries of MS: Medical Imaging Helps NIH Researchers Understand the Tricky Disease
August 15, 2018 - Autistic people at greater risk of becoming homeless – new research
August 15, 2018 - New imaging technique can spot tuberculosis infection in an hour
August 15, 2018 - Scientists study effects of eating breakfast versus fasting overnight before exercise
August 15, 2018 - Talking with children about suicide could save lives
August 15, 2018 - Grip strength of children predicts future cardiometabolic health
August 15, 2018 - New polyclonal immunotherapy successfully neutralizes Ebola virus
August 15, 2018 - Innovative oncofertility program launched by RMA of New York and Mount Sinai Health System
August 15, 2018 - Study shows efficacy, safety of AAV5-based gene therapy to treat sheep model of achromatopsia
August 15, 2018 - Simple score helps predict which hospitalized heart attack patients are at high risk of readmissions
August 15, 2018 - New discoveries show how protein droplets do more than keep cells’ interiors tidy
August 15, 2018 - Study shows impact of optimizing airport flight patterns on human health
August 15, 2018 - Life experiences of feeling unwanted or unplanned associated with attachment insecurity
August 15, 2018 - ACS Briefing Discusses Use of Lessons From Combat Care
August 15, 2018 - Study identifies distinct origin of ADHD in children with history of brain injury
August 15, 2018 - IgG3 antibody stops B cells from fighting pathogens in HIV patients
August 15, 2018 - Scientists discover key vulnerability of mixed lineage leukemia
August 15, 2018 - College students may experience pressures from secondary exposure to opioid abuse
August 15, 2018 - Powerful new microscope reveals inner workings of human cells with unprecedented clarity
August 15, 2018 - Married people who fight nastily more likely to suffer from leaky guts, study suggests
August 15, 2018 - Working Out After Baby – MedNews
August 15, 2018 - Rheumatoid Factor (RF) Test: MedlinePlus Lab Test Information
August 15, 2018 - ADHD linked to an increased risk of injury in children, study finds
August 15, 2018 - UIC researchers receive NIH funding to develop a better way to regenerate bone or tissues
August 15, 2018 - Study reveals how immune cells in the brain influence sexual behavior
August 15, 2018 - Researchers move closer to finding potential soft spot in drug-resistant tuberculosis
August 15, 2018 - Real-time dynamic monitoring of cell’s nucleus for effective cancer screening
August 15, 2018 - Lower rates of Medicare preventive care visits found in racial, ethnic minority older adults
August 15, 2018 - Scientists identify stress hormone as key factor in failure of immune system to inhibit leukemia
August 15, 2018 - Cytoplan introduces three new nutritional supplements
Columbia Opioid Symposium Calls for Research, Action

Columbia Opioid Symposium Calls for Research, Action

image_pdfDownload PDFimage_print

Speakers at an opioid symposium sponsored by the Irving Institute for Clinical and Translational Research are, from left, Harold Pincus, MD; Mary Bassett, MD, MPH; Carlos Blanco, MD, PhD; Mark Olfson, MD, MPH; and Frances Levin, MD. (Photo credit: Chris Leary Photography)

Speakers at an opioid symposium this summer at Columbia University Irving Medical Center challenged participants to reverse the crisis’s grim statistics. In the U.S., opioid overdose deaths have nearly quadrupled since 1999 to more than 64,000 per year, and they account for 20 percent of deaths in young adults. Yet according to the Department of Health and Human Services, just 20 percent of individuals with an opioid use disorder receive any kind of treatment.

Reducing opioid use and overdoses will take more research, most speakers emphasized. Already at Columbia and NewYork-Presbyterian Hospital, such work is getting underway. An opioid brainstorm session was convened late last year to foster collaboration among researchers at Columbia, NewYork-Presbyterian Hospital, industry partners, and the community—and led to the formation of working groups focused on prescribing and pain management, addiction treatment, community engagement, and bench-to-bedside research on pain and addiction. (The session was organized by Columbia’s NIH Clinical and Translational Science Award Program and overseen by the Irving Institute for Clinical and Translational Research, a partnership between Columbia and NewYork-Presbyterian.) The meeting coincided with other initiatives—including NewYork-Presbyterian Hospital’s efforts to monitor and alter opioid prescribing and to increase community-based treatment of addiction.

“With these groups, we’re hoping to spark new ideas and new collaborations about how to address the opioid epidemic,” said Muredach Reilly, MBBCh, MSCE, director of the Irving Institute, Herbert and Florence Irving Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons (VP&S), and an attending physician at NewYork-Presbyterian Hospital.

“We need research and solutions to address the many narratives underlying this crisis—overmedication of chronic pain, undertreatment of opioid use disorder, and systemic medical system, societal, and legal failures—in order to stop people from dying.”

The symposium coincided with the recent launch of the NIH’s HEAL initiative, a $500 million research program to fund interdisciplinary research on addiction and pain.

The participants discussed current approaches toward preventing opioid use disorder and overdose—and how to improve those approaches. Carlos Blanco, MD, PhD, director of epidemiology, services, and prevention research at the National Institute on Drug Abuse, said prevention needs to be a priority, not an afterthought. To do that, he said, more research about who is at risk is needed.

Patients who appear to be most at risk of death from opioid overdose and related problems are those being treated for chronic pain, according to research from Mark Olfson, MD, MPH, professor of psychiatry at VP&S. “Many of these deaths occurred in people who had been prescribed opioids in combination with benzodiazepines in the final month of life, showing us that we have a fair amount of work to do to improve the safety of pain management,” he said.

“We have a fair amount of work to do to improve the safety of pain management,” said Mark Olfson, MD, MPH. (Photo credit: Chris Leary Photography)

The crisis also has affected its victims in other ways that we are just beginning to understand. “A great deal of attention has been placed on the risk of overdose deaths following nonfatal overdoses, but our latest study showed that individuals who survive a nonfatal overdose are also at increased risk of dying from a number of medical conditions, including circulatory and respiratory diseases, suicide, and HIV,” said Olfson.

We need to be more aggressive about using MAT, which will involve overcoming numerous barriers.

For individuals with opioid use disorder, proven treatments are available but underused. Medication addiction therapy (MAT)—including naltrexone, buprenorphine, and methadone—reduces the risk of relapse, overdose, and mortality, said Frances Levin, MD, the Kennedy-Leavy Professor of Psychiatry at VP&S and chief of the Division on Substance Use Disorders at Columbia University Irving Medical Center/New York State Psychiatric Institute. But out of the 20 percent of individuals with opioid use disorder who get treatment, less than a third are treated with MAT. “We need to be more aggressive about using MAT, which will involve overcoming numerous barriers to using and prescribing these medications,” said Levin, who also is a psychiatrist at NewYork-Presbyterian.

MAT medications are often hard to access outside of major metropolitan areas, explaining one barrier. Patients also must remain abstinent for a week before one of the medications (naltrexone) can be used. To remedy these problems, Levin said that faculty at Columbia are working to expand implementation of MAT in community-based settings and to improve naltrexone induction. Other treatments, including opioid vaccines, game-based interventions, and phrenic nerve stimulation to reverse overdose, are also being developed.

Rural America garners much of the media attention on the opioid epidemic, but cities are also affected. Since the introduction of fentanyl to the New York City market a few years ago, someone in our city dies of an opioid overdose every seven hours, said Mary Bassett, MD, MPH, commissioner of the New York City Department of Health and Mental Hygiene.

Slide from NYC Department of Health and Mental Hygiene

New York City has been tackling the opioid crisis on a variety of fronts. Mayor DeBlasio committed $60 million to train 1,500 providers in MAT prescription, open syringe exchange sites in areas most affected by overdose deaths, and develop media campaigns to destigmatize addiction treatment. The investment also will expand the city’s Relay overdose response system, which positions wellness advocates in hospital emergency rooms to guide overdose survivors toward treatment. Bassett also reported that, following a directive from the mayor’s office, 960 pharmacies now offer naloxone, which reverses opioid overdose, without a prescription.

The symposium ended with two concurrent sessions and panel discussions. One session, led by Beatrice Ellerin, director of the Healthcare and Pharmaceutical Management Program at the Columbia Business School, focused on the industry response to the crisis; another, led by the Community Engagement Core Resource of the Irving Institute with NewYork-Presbyterian Hospital, Columbia School of Social Work, and the Washington Heights Corner Project, focused on community responses to the crisis.

In the months ahead, the Irving Institute and partners will continue to challenge and engage researchers, government, and industry and community leaders in tackling the opioid crisis through research and action. “By sparking new ideas and new collaborations, providing seed funding for initial steps, and empowering our working groups to respond to the NIH Heal Initiative and other funding opportunities, we will continue to work with our partners to facilitate research and implementation of science-based solutions to address the many facets of this national crisis,” concluded Reilly.

Tagged with:

About author

Related Articles