Opioid Awareness

A Mediaplanet Guide to Opioid Overdose Awareness and Prevention

Opioid Awareness

Dan Schneider & Camille Schrier Dan Schneider, ”The Pharmacist,” and Camille Schrier, Miss America 2020, on their passion for drug safety and awareness How pharmaceutical companies are pivoting to battle the new fentanyl crisis

AUGUST 2021 | FUTUREOFPERSONALHEALTH.COM

Pear Therapeutics’ leadership panel discusses the impact of COVID-19 on substance abuse treatment.

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For the 2 Million People Suffering From Opioid Use Disorder, Help Is Out There

To Cut Overdose Risk, Delay the Age of Initiation Among Teens When it comes to substance use, the earlier teens start, the more likely it is that they’ll struggle with addiction as adults.

The good news is that there are steps parents can take to delay the age of initiation for their teen.

Take a stand Parents must establish a firm standard of, “not in my house.” Know that you have more persuasive authority than you might think you do.

Keep communication open When your teen gets into trouble, it’s important that they feel they can still talk to you about it. These conversations can be awkward at first, but the more you normalize it, the easier it becomes. An approach that is open and understanding rather than explosive and punitive will be more effective.

Spend quality time Teens need a strong sense of connection to family members who are positive influences in their lives. They also need to stay active and occupied, especially with things they enjoy and that bring them a sense of accomplishment. Let them teach you something new. You might be surprised what you learn.

Marc Fishman, M.D., DFASAM, Medical Director, Maryland Treatment Centers

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People across the country may not be aware that they’re part of an ongoing public health crisis — opioid addiction.

Take someone like Chris, who works at a local supermarket. After surgery following a back injury, Chris’s doctor prescribed an opioid pain reliever.

Chris continued to use the opioid pain reliever to feel more relaxed, to sleep, and to just forget his worries.

Before long, Chris developed a need for the medication even though he wanted to stop using it. When the doctor would no longer prescribe the drug, Chris began feeling very sick without it and started using similar medications obtained from friends.

A chronic brain disorder Chris didn’t realize this was the beginning of a chronic brain disorder that, if left untreated, could be life-threatening. Opioid use disorder is a clinical diagnosis that

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a doctor gives to a person addicted to opioids such as prescription pain relievers or heroin. Chris is now one of 2 million Americans who have developed an opioid use disorder.

You or someone you care about may be like Chris, who is facing a critical situation. Preventing an overdose is the first priority, but it’s no less important than being prepared if one should happen. In dire situations, naloxone is used as the antidote to an opioid overdose.

If it is administered promptly, it can reverse opioid overdose.

Getting treatment Opioid use disorder is treatable. Don’t wait for an overdose to happen. The first step is to seek help. If you believe that you are suffering from this disorder, speak with your doctor about your symptoms, especially if you are experiencing increased sensitivity to pain, constipation, nausea, sleepiness, dizziness, confusion, low

sex drive, or depression. Deciding whether to start medication to treat an opioid dependency and which medication to use are critical early decisions to make.

Many people with opioid use disorder may be addicted to other substances or have a mental disorder such as depression. These health conditions need to be treated at the same time. SAMHSA’s online “Decisions in Recovery” tool offers a wide variety of resources that can help you speak with your provider about treatment options.

To learn how to recognize opioid overdose and use naloxone, download SAMHSA’s Opioid Overdose Prevention toolkit. Share it with your healthcare provider so they can prescribe naloxone.

If you or someone you care about is concerned about opioids, contact SAMHSA’s national helpline at 1-800-662-HELP or visit www.samhsa.gov/find-help. n

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Publisher Caroline Dranow Business Developer Katie Konf ino Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Tiffany Jackson Lead Editor Mina Fanous Copy Editor Taylor Rice Director of Content and Production Jordan Hernandez Cover Photo Camille Schrier All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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guides patients through 24 modules or “chats” and uses artificial intelligence (AI) to create a simulated dialogue by tailoring content to the patient’s individual responses.

Depending on what’s most effective for a patient, modia™ changes its tone of voice. modia™ uses a broad range of evidence-based behavioral change techniques, such as mindfulness and motivational interviewing to help patients identify and address their personal triggers so they can develop healthy habits and create their own relapse prevention plan.

Enhancing Treatment for Opioid Use Disorder

Digital healthcare is everywhere these days, from virtual doctor appointments to text-based mental health support.

Now there’s a new digital therapy made for and with patients with opioid use disorder (OUD).

While medications have proven effective in treating OUD, mental and behavioral support is a crucial part of the recovery process. Yet, a resource gap makes receiving ongoing care a challenge, especially for those in rural and underserved areas. Digital therapies can help fill this gap.

Opioid use disorder The Centers for Disease Control and Prevention (CDC) says OUD is “a problematic pattern of opioid use that causes significant impairment or distress.”

Throughout the COVID-19 pandemic, the opioid epidemic has worsened in the United

States. Fatal opioid overdoses reached more than 67,500 — a 36 percent increase — from December 1, 2019 to November 30, 2020.

“The pandemic stripped people of so much, stability, their livelihoods, support systems, and routines, and put many at heightened risk of opioid misuse and overdose,” says Robert DeLuca, President of pharmaceutical company Orexo. “Compounding these issues were stay-at-home orders and a shortage of waivered physicians and qualified mental health professionals, which made it even more difficult to get treatment. We believe there is more that can and must be done.”

The company is committed to meeting unmet patient needs and eliminating mental illness.

Managing OUD Medication assisted treatment (MAT) has long been the stan-

dard of care to manage OUD. When used effectively, MAT tackles both the physical withdrawal symptoms associated with early-stage recovery and the behavioral and mental issues associated with addiction.

Many patients with OUD do not, however, receive the behavioral support they need to achieve long-term recovery.

Barriers to receiving care can include the stigma many associate with OUD, as well as logistical barriers like location, cost, and a lack of qualified providers.

Digital therapeutics — prescribed online programs that deliver medical interventions directly to patients — can eliminate some of those barriers.

“Many digital therapeutics, like Orexo’s deprexis® for depression and vorvida® for problematic alcohol use, use clinical cognitive behavioral therapy (CBT)based techniques and artificial intelligence to tailor information

based on each user’s unique needs,” said DeLuca. “We kept hearing feedback that the same type of technology was needed to fill the gap for patients with OUD, so we created modia™.

Digital therapy modia™ is a digital therapeutic rooted in an evidence-based, CBT treatment approach that’s designed to offer patients with OUD tailored, interactive digital psychotherapy to complement their clinician-supervised medication-assisted treatment program.

Patients with OUD were included in the development and initial product testing of modia™ in order to ensure that the tool meets the specific needs of those with OUD. The platform was also co-developed in partnership with leading global DTx company, GAIA. Over the course of 180 days, the proprietary software

Supporting patients modia™ can be accessed on a mobile device or computer anytime and anywhere there’s internet access, which makes it easy for OUD patients to get care precisely when they need it.

Currently, a pivotal study is underway to evaluate modia™ in combination with sublingual buprenorphine/naloxone and their combined ability to stem illegal opioid drug use.

The goal is to enroll an estimated 400 participants at 35 sites across the country.

With modia™, OUD patients who previously struggled to access quality behavioral health support will have another option to aid their treatment journey – learn more at us.modia.pro. n Kristen Castillo

To read more about modia™ visit us.modia.pro

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The Impacts of COVID-19 & the Rise of Digital OUD Treatment Leadership panel of addiction medicine experts discuss the need for increased accessibility in the opioid use disorder treatment community

The CDC recently reported that drug overdose deaths increased nearly 30 percent in the United States last year. What do you believe accounts for this increase?

Nora Volkow: The COVID-19 pandemic created a devastating collision of health crises in America. Rising fentanyl availability, decreased access to addiction treatment, increased social and economic stressors, and overburdened health departments converged in 2020 to increase drug consumption and overdose deaths.

Lipi Roy: It’s important to point out that drug overdose was an epidemic before COVID-19. But the record rise in drug-related deaths is a reflection of the pandemic’s disruptive effect on society.

Looking back on 2020, how did the effects of COVID-19 exacerbate the OUD crisis? Can you speak to how pandemic-related

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with the care and treatment they need.

Nora D. Volkow, M.D. Director, National Institute on Drug Abuse

Lipi Roy, M.D. Addiction Medicine Physician & Media Personality

stressors contributed to increased substance use?

initial use or relapse with opioids.

NV: This has been an incredibly uncertain and stressful time for many people, and we know that stress increases the risk of substance use. The pandemic led to greater isolation, loss of jobs, economic hardship, evictions, the death of loved ones, and difficulty in accessing life-saving treatment.

What are the barriers to treatment in accessing quality care for a person suffering from OUD?

Yuri Maricich: The COVID pandemic also further complicated recognition of SUD and OUD as well as access to evidence-based care. I’ve personally spoken to many patients who have identified how loss of employment, increased work volume, and social isolation resulted in

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YM: First, there is a lack of clinically proven treatment options.

People living with opioid use disorder have only three classes of similar drug types. Second, of the only 11 percent of patients who do receive medication, the majority don’t receive the required behavioral treatment critical for long-term recovery.

Third, care for addiction is fragmented and separated from other medical services. Lack of virtual treatment options also limits treatment and remains a barrier to care.

Yuri Maricich, M.D. Chief Medical Officer, Pear Therapeutics Knowing the challenges of accessing physical treatments with a doctor, how has the landscape of evidence-based treatment shifted to include prescription digital therapeutics as a treatment option?

NV: It was encouraging to see telehealth options becoming more widely embraced and implemented during the pandemic, and research suggests that this expansion may enable greater access to treatment if continued into the future. Technology, including digital therapeutics, undoubtedly plays an important role in allowing doctors to meet people where they are and support them

How can society embrace this new treatment option and directly address the opioid overdose crisis?

LR: Society needs to understand, first and foremost, that addiction is a chronic disease of the brain. It is not a moral failing. Second, it’s important to recognize that most people with addiction — once connected to the appropriate treatment and recovery services — get better. Unfortunately, of the 23 million Americans with SUD, only 10 percent access treatment. Stigma is a major barrier to treatment and care. People need to learn about evidence-based treatment options such as medications, behavioral therapies, and PDTs. Harm reduction strategies must also be widely implemented.

We need to destigmatize people with SUD and help them receive the care they need and deserve. n

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PUSHING THE BOUNDARIES OF TECHNOLOGY TO TRANSFORM MEDICINE At Pear Therapeutics, we’re operating at the intersection of biology and technology— developers working side-by-side with clinicians to pioneer prescription digital therapeutics (PDTs), researchers and engineers innovating new software to enhance the delivery of treatments for serious disease.

Our groundbreaking PDTs, reSET® and reSET-O®, are transforming the treatment of substance use disorder (SUD) and opioid use disorder (OUD), respectively. Digital medicine enhances outcomes and gives more people access to clinically proven therapies on their phones and

We’re committed to helping people living with serious disease in new and meaningful ways—through digital medicine. Addiction is persistent and the opioid epidemic is devastating. So, as we head into National Recovery Month, we reaffirm our commitment to those in the recovery community.

LEARN MORE ABOUT PEAR’S PRODUCTS, reSET® AND reSET-O®, AT

RESETFORRECOVERY.COM

tablets—anywhere and anytime.

reSET®, reSET-O®, and Pear Therapeutics® are trademarks of Pear Therapeutics. © 2021 Pear Therapeutics, Inc. MKT-00018-21_07 All rights reserved.

Scientific Solutions to the Opioid Crisis: Finding Non-Opioid Options for Pain Long-term solutions to the opioid crisis will require addressing the needs of the millions of Americans with pain.

Chronic pain, lasting months to years, affects 50 million people nationwide. Of these, 25 million report severe pain daily, and 20 million experience high-impact chronic pain that interferes with carrying out the activities of daily life.

Some people who experience daily pain can’t take certain pain medications that interfere with kidney func-

tion. Opioid use rates in these individuals are almost three times that of the general U.S. population over 65. For these people, researchers are testing non-medication approaches as well as safer and less addictive types of opioid medication that can be effective for treating chronic pain.

Personalizing prevention Everyone feels pain differently, meaning that we can’t use a one-size-fits-all approach. Ultimately, people need strategies that work for them, and research is now providing a menu of safe and

effective non-opioid pain relief options. For example, complementary and integrative treatments — such as acupuncture, yoga, mindfulness, and physical therapy — are effective, but they are underused.

Scientists funded by the National Institutes of Health (NIH) are working to increase their use through practical, real-world research to encourage use of these treatments in places where people receive routine care. This will allow the practices to be made more widely available more quickly if successful.

Solutions beyond opioids For all individuals who experience pain, we need solutions beyond opioids. Scientists have been working to develop these for decades, but unfortunately, few potential pain medications ever make it to clinical testing, and only a very small number gain approval from the Food and Drug Administration for use among people with pain. Basic and clinical research funded by the NIH is filling this gap by advancing innovative approaches toward the development of novel medications, devices, and complementary and integrative

approaches to treat pain without the risks of opioids.

The combined serious problems of unmanaged pain, opioid addiction, and opioid overdose deaths continue to evolve and present extremely important needs. Luckily, research is providing answers — and much-needed hope — for the millions of people, families, and communities affected by poorly-treated pain disorders and the opioid crisis. n Rebecca G. Baker, Ph.D., Director of the National Institutes of Health Helping to End Addiction Long-term Initiative

Camille Schrier & Dan Schneider Discuss the Importance of Pharmacovigilance With drug overdose and addiction on the rise since the start of the pandemic, opioid awareness and safety is more imperative than ever.

What does pharmacovigilance mean to you?

Dan Schneider: Of course, pharmacovigilance refers to drug safety, potential drug interactions, and prevention of adverse effects. To me, I think of the pharmacist as a gatekeeper that must be vigilant in warning about addiction and overdose, alerting to potential

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diversion, alerting to unscrupulous doctors, and yet showing empathy and care while informing the patient.

How did you balance being Miss America 2020 with being a pharmacy graduate student? What inspired you to go to pharmacy school?

Camille Schrier: Miss America is a full-time position, which gave me the opportunity to take time away from my education and focus on my advocacy for medication safety and abuse prevention. I chose to attend pharmacy school with

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the intent to pursue a career in business development in a pharmaceutical company, which is still my goal after graduation.

Can you speak to your passion for drug safety and becoming an advocate?

CS: Carrying NARCAN is something I am passionate about because it gives each of us the ability to actively help someone experiencing an overdose before EMTs arrive. The difference in response time of just a few minutes for a patient experiencing an opioid overdose

could make a drastic impact on their outcome and recovery.

DS: My passion concerning drug safety comes from losing my son because of addiction.

Sadly, I couldn’t save my son, but I have been determined to use that wisdom and advocacy to prevent other families from suffering such a tragedy. I have seen his face in those that I have had concerns for.

How important is it in 2021, given the pandemic, to educate Americans on the opioid epidemic as overdose rates increase?

CS: The COVID-19 pandemic has drastically worsened the opioid epidemic, and it’s frankly never been more important to educate Americans about mental health, substance use disorders, and how to prevent overdoses.

DS: Many more die daily in the age group of 15 to 54 from drug overdoses than from COVID-19, and there is no vaccine available. With a 30 percent increase in overdoses in 2020, it now exceeds 250 deaths daily. It is very important that we make Americans aware of this issue.

To End the Overdose Crisis, We Must Confront Stigma As the COVID-19 pandemic continues, we must keep focus on another worsening crisis: the epidemic of drug overdoses.

Predicted data for 2020 shows that 93,000 people died from drug overdoses, marking the largest increase in overdose deaths ever recorded. Seventy-five percent of those deaths involved an opioid, and this rise is largely driven by illicit fentanyl, a synthetic opioid.

These staggering increases in overdose deaths could

be mitigated by expanding access to evidence-based addiction treatments. However, to do so, we must confront the entrenched stigma surrounding addiction and the medications we use to treat it.

A treatable disorder Recognizing addiction as a medical condition, and not a moral failing, is necessary for effective prevention and treatment. Addiction to opioids — the drugs responsible for most overdose deaths —

is treatable using safe and effective medications, but only 18 percent of people with opioid addiction receive them. Treatment-seeking is impeded by stigma towards people with addiction, which is fed by the distorted belief that they can control their drug taking.

Unfortunately, people with addiction often encounter stigma in healthcare settings.

Those seeking help may be distrusted, mistreated, and even turned away by medical professionals. This may lead

them to avoid primary, reproductive, and prenatal care, and to miss opportunities to prevent or treat conditions such as HIV, hepatitis, and mental illnesses.

Reducing stigma Reducing stigma for individuals with addiction is challenged by the fact that the disease itself impacts the brain in a way that changes social behaviors. It can be extremely difficult for loved ones to understand behaviors that may result from

the brain circuitry changes that characterize addiction, like stealing and lying, or the neglect of relationships. Recognizing that these behaviors are due to drug-induced changes in brain function is key for destigmatizing this disorder.

Confronting addiction requires harm reduction, treatment, and compassion, not punishment and stigma.

While expansion of access to quality medical care and proven interventions like syringe service programs are vital to reducing opioid overdoses, illness, and death, a broader approach that encompasses social supports is critical to address the overdose crisis. n Nora D. Volkow, M.D., Director of the National Institute on Drug Abuse SPONSORED

Changing the Opioid Epidemic Demands Innovation “The opioid crisis is now a fentanyl crisis,” says Roger Crystal, M.D., CEO and president of Opiant, a specialty pharmaceutical company developing medicines for addictions and overdose.

Overdoses from illegal synthetic opioids, particularly fentanyl, have skyrocketed, accounting for more than 57,000 deaths in 2020 (rising from 10,000 deaths in 2015).

“Fentanyl is a staggeringly dangerous compound. It acts faster, lasts longer and is more

potent — 50 times more — than heroin,” says Dr. Crystal.

Reversing overdoses Opiant developed NARCAN® Nasal Spray, which reverses an overdose by attaching to opioid receptors in the brain and blocking the effects of the drug.

NARCAN® was FDA-approved in 2015.

The spray has already saved many lives and is carried by first responders, such as EMTs and law enforcement.

The Surgeon General has also advised individuals to carry the rescue drug.

More innovation Opiant is committed to developing more live-saving medicines.

“There aren’t many companies that are exclusively dedicated to developing medicines for addiction and drug overdose,” says Dr. Crystal.

“I’m proud of the products we are developing, including products focused on alcohol use disorder and acute cannabinoid overdose.”

To help address the fentanyl crisis, the NIH is supporting Opiant’s work on a new investigational product in develop-

ment, nasal nalmefene, which has certain attributes that, if proven, could be another therapeutic option to combat the opioid epidemic.

Due to their higher potency and longer half-life, synthetic opioids display much lowered sensitivity to naloxone. In December, the CDC advised multiple doses of naloxone may be needed to reverse a synthetic opioid overdose.

“Even after successfully reviving someone from an overdose, with a synthetic, they can fall back into an overdose,” says Dr. Crystal.

A cruel disease “Addiction is a chronic brain disease,” says Dr. Crystal, “and we must treat it like any other chronic disease, with long-term care and medical treatments.”

He’s optimistic that with more innovation and additional medication options, more lives can be saved.

“Much like diabetes, we can’t cure opioid use disorder.

However, we can enhance therapeutic treatments and drive better outcomes for patients,” he says. n

To learn more, visit opiant.com Kristen Castillo

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