Promises and perils of the FDA's over-the-counter naloxone reclassification 🔓
The Lancet Regional Health
In this commentary, the authors recognize the significant potential benefits in addressing overdose deaths due to opioid use disorder (OUD) by making naloxone available over the counter (OTC), but they also point out potential risk. Availability of naloxone OTC most significantly should increase the general availability and presence in the community, potentially reduce stigma, and incentivize other pharmaceutical companies to produce naloxone. However, there is the significant risk that reclassification to OTC could result in decreases in coverage by insurance and increases in cost to consumers, which could potentially limit access, particularly among most vulnerable populations with low income.
Comparative acute effects of mescaline, lysergic acid diethylamide, and psilocybin in a randomized, double-blind, placebo-controlled cross-over study in healthy participants 🔓
This study used a randomized, double-blind, placebo-controlled, cross-over design to compare the acute subjective effects, autonomic effects, and pharmacokinetics of typically used, moderate to high doses of mescaline (300 and 500 mg), LSD (100 µg), and psilocybin (20 mg) in 32 healthy participants. Researchers found no evidence of qualitative differences in altered states of consciousness that were induced by equally strong doses of mescaline, LSD, and psilocybin. The results indicate that any differences in the pharmacological profiles of mescaline, LSD, and psilocybin do not translate into relevant differences in the subjective experience.
Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago 🔓
Journal of Substance Use and Addiction Treatment
This retrospective cohort study describes the Chicago-based Community Outreach Intervention Project's (COIP) integrated mobile medical program. The study focused on providing low-threshold buprenorphine and primary care to Chicago communities with the highest overdose rates. Over a one-year period, the unit successfully served nearly 600 patients, with some patients initiating treatment with buprenorphine after presenting for other health concerns. This integrated approach can therefore reach people struggling with OUD who are not yet ready to start treatment.
Assessment of Screening Tools to Identify Substance Use Disorders Among Adolescents 🔓
JAMA Network Open
In this study, researchers examine 3 substance use screening tools: 1) Screening to Brief Intervention (S2BI), 2) Brief Screener for Tobacco, Alcohol, and Drugs (BSTAD), and 3) Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) in adolescents. The authors utilized the recommended screening tool cutoffs and found all 3 tools had adequate properties to identify substance use disorders compared to DSM-5 diagnostic criteria for nicotine, alcohol, or cannabis use disorder. They did not find a significant difference between the tools in this study but did note additional work should be done to determine if one tool has differing properties in different populations.