Neurological Injury and Outcomes in Fentanyl-related Cardiac Arrest - PubMed Cardiac arrest associated with fentanyl use was linked to decreased rates of bystander cardiopulmonary resuscitation, increased incidence of nonshockable Rhythms, and greater neurological injury as in...

Fentanyl-related cardiac arrests had less bystander CPR, fewer shockable rhythms, and more severe brain injury on EEG, but good neurological outcomes were similar to other causes. This highlights unique challenges in fentanyl-linked cardiac arrest cases.

pubmed.ncbi.nlm.nih.gov/40747898/

Early Change in Depressive Symptom Severity With Naltrexone-Bupropion Combination and Its Association With Reduction in Methamphetamine Use in ADAPT-2 Trial - PubMed <span><b>Objective:</b> This study evaluated whether depressive symptom severity improved early with extended-release naltrexone and bupropion combination (naltrexone bupropion) compared to a placebo ...

ADAPT-2 found naltrexone-bupropion quickly cut depression in meth users, boosting remission and reducing use. Early depression drop explained ~25% of its success.

pubmed.ncbi.nlm.nih.gov/40767786/

The Association of Perceived Risk for Opioid Overdose and Subsequent Overdose Among a Cohort of Opioid Overdose Survivors Who Use Nonprescribed Opioids - PubMed Incorporating an assessment of risk perception into opioid overdose prevention efforts may help prioritize prevention efforts.

This study found that opioid overdose survivors who perceive themselves at higher risk are over twice as likely to overdose again within four months. Assessing risk perception can help target and improve overdose prevention efforts.

pubmed.ncbi.nlm.nih.gov/40698403/

Emergency medical system response, emergency department visits, and hospital admissions in response to non-fatal opioid overdoses reported by a cohort of overdose survivors in San Francisco and Boston... Non-fatal opioid overdoses that do not result in an emergency medical system (EMS), emergency department or hospital encounter are not tracked. We aim…

Among opioid OD survivors, less than half of OD's involved EMS, about one-third led to emergency visits, & few resulted in hospitalization. Most overdoses had naloxone given by bystanders. Relying only on healthcare data underestimates non-fatal overdose rates.

www.sciencedirect.com/science/arti...

Craving, Impulsivity, and Subsequent Methamphetamine Use With Naltrexone-Bupropion Versus Placebo: Findings From a Randomized Clinical Trial - PubMed Further investigations are necessary to optimize NTX-BUP treatment, focusing on the impact of craving and impulsivity on outcomes.

The ADAPT-2 trial found, higher craving and impulsivity predicted worse outcomes in methamphetamine treatment with naltrexone and bupropion. Targeting these factors may improve treatment response.

Receipt of prescribed opioids is associated with achieving quality healthcare indicators among patients with chronic non-cancer pain - Journal of Public Health Background In response to increasing opioid overdose, US providers reduced opioid prescribing, resulting in several unintended consequences. Methods We assessed the impact of opioid receipt on quality...

Patients with chronic pain who continued receiving opioids were more likely to get recommended preventive care. Those who lost access received less. Opioid stewardship should include support for ongoing healthcare engagement.

NEI Podcast: E257 - (CME) Stimulating Solutions: Advances in Treating Stimulant Use Disorders In this CME podcast episode, Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health in San Francisco, CA, about the management of stimulant use disorders. ...

Check out this dynamic Conversation with Mental Health Experts (CME) podcast episode as Dr. Andrew Cutler interviews Dr. Phillip Coffin, Director of the Center on Substance Use and Health, about managing stimulant use disorders. Explore treatment challenges and how harm reduction is changing lives.

Mirtazapine reduces hypothetical methamphetamine demand in humans Previous trials showed mirtazapine reduces methamphetamine use. The present study determined the influence of mirtazapine treatment on the acute effec…

In the M3 study, mirtazapine reduced methamphetamine demand without changing its effects or safety profile. All treatments were well tolerated, supporting mirtazapine's potential as a treatment for methamphetamine use disorder.

Everything in moderation, even naloxone Click on the article title to read more.

In this commentary, Dr Coffin clarifies the role of naloxone in reversing overdose, and notes that more is not necessarily better.

Thematic analysis of medical examiner narratives to understand the socio-spatial context, recency of drug use, and likely mechanism of stimulant toxicity deaths Drug toxicity as a cause of death is challenging to establish and may be based on limited evidence, especially in deaths attributed to stimulants. We …

New CSUH paper published in Drug and Alcohol Dependence:

Many stimulant-only drug deaths are witnessed and often linked to heart issues, unlike opioid cases. Analyzing medical examiner records helps uncover patterns and improve prevention efforts.

Stimulant use and opioid-related harm in patients on long-term opioids for chronic pain - PubMed Despite no association between a stimulant-positive UDT and subsequent opioid-related harm, there was an association with subsequent LTOT discontinuation, with heterogeneity across clinical groups. De...

Study of 600 opioid patients: Stimulant use didn’t boost emergencies or deaths, yet those positive were nearly three times as likely to have treatment stopped. Researchers urge discussing substance use rather than automatically halting opioids.

Test-Retest Reliability of a Timeline Follow-back Method to Assess Opioid Use and Treatment - PubMed The adapted TLFB had very high reliability for self-reported opioid and MOUD use over 120 days. For less frequent outcomes, including overdose, a higher frequency or larger sample size is needed to as...

CSUH collaborated with Boston Medical Center to demonstrate the reliability of self-reported substance use data over a 4-month lookback period!

Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl This cohort study assesses rates of successful buprenorphine initiation and retention among adults who use fentanyl receiving a low-dose buprenorphine initiation protocol in the outpatient setting to ...

During the pandemic, doctors tried microdosing buprenorphine to help fentanyl users avoid withdrawal and start treatment. A UC San Francisco study found this low-dose approach worked only 34% of the time, with most patients unable to reach a full dose despite gradual increases over several days.

Identification of Behavioral, Clinical, and Psychological Antecedents of Acute Stimulant Poisoning: Development and Implementation of a Mixed Methods Psychological Autopsy Study - PubMed In developing and implementing PA research on fatal stimulant poisoning, we noted the importance of recruitment language regarding cause of death and condolences with collateral informants. Compassion...

CSUH conducted a highly innovative study to better understand deaths attributed to stimulants. Lots more to come!

Commentary on Stam et al.: The substantial and dynamic contribution of opioid potency to total overdose risk Click on the article title to read more.

Dr Coffin published a commentary in Addiction this week noting that high and variable opioid potency has a dynamic impact on overdose risk, limiting the impact of our traditional overdose prevention strategies.

Check out the full publication here: