This Week's News in Substance Use: 3/15/19

Ned Sharpless, Director of The National Cancer Institute, To Be Named Acting FDA Commissioner, STAT News

Health secretary Alex Azar confirmed the announcement at a hearing before the House Energy and Commerce health subcommittee. The news was first reported by Fox Business Network.

Sharpless, a physician-scientist, ran the Lineberger Comprehensive Cancer Center at the University of North Carolina before taking over the NCI in October 2017.

“Dr. Sharpless’ deep scientific background and expertise will make him a strong leader for FDA,” Azar said in a statement. “There will be no let-up in the agency’s focus, from ongoing efforts on drug approvals and combating the opioid crisis to modernizing food safety and addressing the rapid rise in youth use of e-cigarettes.”

How Addiction Treatment Falls Short, And What Is Being Done About It, The Boston Globe

The vast majority of addiction treatment centers are not accredited by a standard-setting organization, in contrast with hospitals, nursing homes, and other providers.

The Commission on Accreditation of Rehabilitation Facilities has recently joined forces with the American Society of Addiction Medicine to define three levels of inpatient addiction care, specifying what services should be provided at each level.

Consumers will be able to seek out certified programs, knowing what services to expect. That program is expected to start this year.

Separately, the national advocacy group Shatterproof is working with Massachusetts and other states to develop a rating system for addiction treatment, expected to launch in 2020.

Opioid Litigation Brings Company Secrets into The Public Eye, NPR

America's big drugmakers and pharmacy chains are scrambling to respond to hundreds of lawsuits tied to the deadly opioid epidemic. Billions of dollars are at stake if the companies are found liable for fueling the crisis.

Even before judgments are rendered, companies like Purdue Pharma, Johnson & Johnson and CVS are already suffering damage to their reputations as evidence in civil suits reveals more about their internal workings.

"The narrative is clearly shifting on this story," said David Armstrong, a senior reporter with ProPublica, who has covered the drug industry for years. "People want some sort of reckoning, some sort of accounting."

Teens Need the Truth About Drugs, The Wall Street Journal

During the 1980s, drug prevention took the form of the ubiquitous slogan popularized by Nancy Reagan: Just Say No. Decades later, many teenagers are still forced to endure similar approaches, despite the many studies over the years showing that programs demanding abstinence not only haven’t lowered drug use but may have increased it.

Today more than two-thirds of teenagers try alcohol and half take other drugs before they reach their senior year, according to the National Institute on Drug Abuse. A study published in JAMA Network in December shows that in the past two decades, the rate of overdose deaths among teens has tripled.

But this dismal track record shouldn’t dissuade us from trying to prevent children from using drugs, which is particularly dangerous for them because of the effects on their developing brains. Preventing teenage use is the best way to prevent addiction: Nine out of 10 people who become addicted tried drugs before the age of 18, according to a 2011 study by researchers at Columbia University. As the Surgeon General concluded in a report a few years ago, “The earlier the exposure, the greater the risk.”

What’s needed is a shift in focus from simply warning about drugs to understanding why teens use them and giving them facts to counter destructive myths. We need programs based on the idea of Just Say Know.

In Rhode Island, Some Get Addiction Care at The Pharmacy, The Boston Globe

A unique experiment in Rhode Island will provide care for opioid addiction in an unexpected place — the local pharmacy.

Under the proposal, some 125 patients will receive much more than their medication when they fill their doctor’s prescriptions for anti-addiction treatments at six pharmacies. The pharmacist will take over their ongoing care, with broad discretion to change doses and frequency of visits. This will free up physicians to treat more patients and to focus on the most complex cases.

For now, the program is just a study, but if successful it could open a new pathway to treatment for people addicted to opioids, amid a crisis that has affected Rhode Island as badly as Massachusetts. In 2017, according to federal data, Massachusetts had the 10th-highest death rate from overdoses; Rhode Island took 11th place.

“The real lesson I’ve learned from the opioid crisis is we need everybody,” said Traci C. Green, a Brown University addiction researcher, who is leading the study. “We’re not putting anyone out of any jobs. It’s a growth industry, unfortunately.”