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Letter from Stop Stigma Now 
President: Sy Demsky

The World According to Zoom
 
The world is changing…the world has changed. The corona virus pandemic continues to haunt us with new waves already appearing in Georgia and Texas after they opened up perhaps too early. Nonetheless we should not forget about the opioid “pandemic” and its accompanying HIV and HCV Pandemics.
The latest statistics continue to see a surge in the number of   deaths due to opioids that may be in some way due to the corona virus   lockdown and lockdown-based barriers to care, such as stigma and the inability to get to access  medication assisted treatment.….and so the struggle continues  on both fronts to save lives.

We, at Stop Stigma Now (SSN), have not let up in the battle to de-stigmatize the use of medications such as methadone, buprenorphine and vivitriol to treat opioid addiction. We strongly believe that Medication Assisted Treatment (MAT) saves lives and the data from multiple studies supports this.

The past 4 months of confinement have not confined us in our work. With the advent of ZOOM, we have redesigned our meetings to continue our work on behalf of providers, communities and patients we work with. We are officially functioning in the virtual realm and excited at the prospects it offers us in bringing our services to you. Our normal attendance at a Board meeting prior to the corona virus was 10-12, and now  ZOOM virtual meetings have attendance of  more than 25 including  members from 11 States including Arkansas, California, DC, Ohio and Oregon , plus Board member from Australia and from guests  from Ireland. Our agendas have been robust with new hard working departments such as Policy-Robert Lubran-chair from Maryland, Research -Dr Phil Paris-chair- from California, Digital Outreach and Education  chair- W. Calvin Anderson from Georgia, Advocacy and Education- chair-Dan McGill from NY, Grants-  chair-Joe Lunievicz) from NY, and Reviewing  Materials- chair -Megan Marx-from Oregon. Every board member,  is a working member and has volunteered for a job.

The goals of all departments collectively is to assist in educating  communities  better about MAT, to reduce stigma as an access barrier….and to help patients not be afraid nor embarrassed to ask for life saving medications that will help them beat opioid use disorder.

Our latest projects are the translation of the SSN brochure into Spanish…thanks to Megan and  beginning  a major study interviewing 25 MAT programs across the country to see how they are doing during the corona virus pandemic. Stop Stigma Now ( SSN) and New York University (NYU) will be conducting this study-Principal Investigators (Dr. Phil Paris, SSN) and Dr Lloyd Goldsamt (NYU) leading the research team. Nine states have already volunteered to be part of this study at this time.

This is an effort to get information rapidly from the field on what is working and what isn’t and get that data into the hands of OTP’s as soon as possible-quality and timely data is the key and that is what SSN aims to do.

As a reminder to our friends that receive this newsletter, SSN is made of  mostly retired professionals with no paid staff trying to help the general public understand MAT, reduce stigma as an access barrier…and to help patients get the treatment that they need.

We need all the help we can get from you in our ongoing mission. Please send donations thru our webpage…stopstigmanow.org
 
Sy Demsky
 

From the Editor: Robert Sage, Ph.D. 

Welcome to the next addition of the SSN Newsletter.

The current COVID-19 pandemic has made a significant impact upon the treatment of those patients receiving Medication Assisted Treatment and behavioral health support services as well as upon the providers. SSN's Research Department, under the leadership of Dr. Phil Paris, has embarked on an important and exciting study of how the pandemic's impact has led to a review of, and implementation of new policies and procedures for delivering MAT care, and our Newsletter includes a summary of the project as well as our intention to publish the findings.

Our newsletter is also providing a summary of our activities during 2019 to inform all members and the public of our contributions. Board Member Steven Rabinowitz has prepared this summary which will inform readers of the important work being undertaken and accomplished by SSN.

Other articles of interest include an early article published by Dr. Vincent Dole in 1991 addressing addiction as a public health problem and the role of MAT. Two articles addressing stigma are included that were published by Dr. Nora Valkow and others, Dr. David Norvick's article on the impact of fentanyl in the opioid crisis, the role and impact of mobile vans in the expansion of, and access to MAT: and Board Member Joycelyn Woods' article on the role of the MARS Peer Project addressing patient support and MAT stigma.

As always, we welcome your comments and suggestions.
We're a 501(c)3 organization and in need of your support. Please consider becoming a member and receive member benefits. 
A Message From Phil Paris, MD

Stop Stigma Now COVID Study Group

    By Phil Paris, Chair of the SSN Research Department

The Covid-19 emergency has affected our MAT programs like nothing we have ever experienced.  Stop Stigma Now (SSN) has been in the forefront in advocating for our programs and our patients.  With this in mind, SSN has initiated a study of how these changes are affecting all of us.  In collaboration with the New York University Rory Meyers College of Nursing, SSN will be studying how programs are reacting to the recent pandemic  We will conduct interviews with 15-20 program directors nationally who are well known to our SSN leadership. 

What policies and procedures have been put in place in response to the need for social distance? We are most interested in the changes in regulations with regard to counseling and the increase in take home medication now allowed for all patients.  While stable patients are currently permitted one, two or four weeks of take home methadone, even “unstable” patients are permitted one week of medication to take home.  None of these new allowances are mandatory.  Each program has had to work out their own policy and procedures.  

With regard to counseling, while there remains some face to face discussion, so much more of the counseling has been conducted via telemedicine, by Zoom or some other mechanism.  All of these new procedures must be having a profound change in the treatment process.  Both the staff and the patients have had to deal with a sudden change in their normal day to day activities.  Have these changes been of benefit to patients and staff? Or have they been damaging to what has been a stable operating condition for many years?  

We at Stop Stigma Now plan to publish our study findings and to disseminate the results to many interested parties, including treatment programs, social agencies, key politicians and the general public.

List of Agencies Supporting
Medication Assisted Treatment  
UNITED STATES GOVERNMENT
Office for National Drug Control Policy
Substance Abuse and Mental Health Services Administration
US Surgeon General
National Institute on Drug Abuse
Addiction Technology Transfer Center Network
National Institute of Health
Federal Drug Administration (FDA)
 
ORGANIZATIONS
 American Association for the Treatment of Opiate Dependence
American Society for Addiction Medicine
American Medical Association
New York Academy of Science
National Alliance for Medication Assisted Recovery
Harm Reduction Coalition
Legal Action Center (New York & Washington, DC)
National Alliance for Pregnant Women
National Assn of County Behavioral Health and Developmental
Disability Directors
Faces and Voices of Recovery
National Alliance of Advocates for Buprenorphine Treatment
The Rockefeller University of New York
Partnership for Drug Free Kids
National Association of State and Alcohol Abuse Directors
 
INTERNATIONAL ORGANIZATIONS
 World Health Organization
United Nations Office on Drugs and Crime (UNODC)
UNAIDS
International Doctors for Healthy Drug Policies (IDHDP)
Global Commission on Drug Policy
Open Society Institute
European Opiate Addiction Treatment Association
International Harm Reduction Coalition
Canadian Centre on Substance Abuse
European Association for the Treatment of Addiction
International AIDS Society
International Society of Addiction Medicine
Society for the Study of Addictions
MEMBERS OF THE Stop Stigma Now board at a meeting earlier this year. 
Commentary
Barriers to Medications for Addiction Treatment: Hows Stigma Kills
Sarah E. Wakeman and Josiah D. Rich from Taylor & Friends Group, LLC, discuss the limitations in obtaining lifesaving medication for the methadone addiction. Read the article that was published in 2018.
Click Here For Article
A Look Back: Addiction as a
Public Health Problem 
A landmark article written in 1991 by Vincent Dole looks at how addiction should be looked at as a public health emergency. 
 
Download the full article here.

Is This The End of MARS?

By Joycelyn Woods'
NAMA Recovery, MARS Project, Stop Stigma Now


This Spring as usual the MARS Project (Medication Assisted Recovery Support) applied for a SAMHSA (Substance Abuse and Mental Health Systems Administration) grant. It was a long wait. SAMHSA has been one of the few agencies and organizations that provides enough funds to operate a recovery center.  In April when the few recovery grants were announced the MARS Project developed by the National Alliance for Medication Assisted Recovery was not one of the winners.
 
The MARS Project is the only Recovery Center specifically for Medication Assisted Treatment (MAT) patients. Generally, Recovery Centers have been developed by persons whose recovery was abstinent oriented and although they may try to provide support to MAT patients they simply do not understand. And because of the prejudice experienced by MAT patients they do not feel comfortable and somewhat overwhelmed in a generalized Recovery Center. 

The MARS Project is a “true” peer project created by MAT patients for MAT patients and the staff are all MAT patients themselves.  That’s why the MARS Project works – we understand each other and we know the problems that MAT patients have. 

MAT patients are continually assailed with negative information about them and the treatment they chose. They see negative press, television, comments from family and friends and just during their daily lives.  Others in recovery do not understand the impact that this can have on ones self esteem and confidence.  MAT patients learn the truth about medications at MARS; how effective it is and that it is called the “Gold Standard.”

All MARS peers take the Core Training that includes information about the neuroscience of addiction, how medications work, regulations and that they are candidates for recovery.  Yes, MAT patients have been told that they are not in recovery until they get off their medication.  And very often they have been told this by persons in “so called” recovery.  But MARS gives them the information to challenge these statements.

The COVID-19 epidemic has been difficult for MAT patients and many are African American and Hispanic the populations that have been hit the hardest.  Now is the time that they need support – and support from other MAT patients that they feel comfortable with. MARS can provide support for the numerous new patients that entered treatment because of COVID19 and of course to our current peers that have depended on the project.

It will be very difficult when MARS reopens after having to close because of the COVID19 pandemic – and then having to tell the peers that MARS will be closing.

Politico: Pandemic Unleashes
A Spike In Overdose Deaths
Disturbing news amid the COVID-19 crisis shows an 11% increase in the number of overdose deaths year over year, according to data released by the White House. The increase in deaths correlates with another statistical increase on a related topic. 
Read The Article
Fake Heroin
The Need For Effective Treatment Of Opioid Addiction
Is Even More Urgent
By David M. Novick, MD

When buying drugs on the street, “Let the Buyer Beware” has always been very good advice. Recent experience suggests that in 2018, failure to heed this warning could not only be dangerous, but fatal.

I treat patients with opioid use disorder primarily using Suboxone (buprenorphine with naloxone), which is taken under the tongue daily. The patients come to the office every 1-4 weeks, submit a urine, are interviewed and examined, and receive their prescription. The urine is submitted directly into a specialized test cup which can quickly detect the presence or absence of 12 drugs and also measures the urine temperature, which documents that the specimen is fresh and has originated from the patient who is being seen. In May or June, four different patients acknowledged a relapse to heroin use, but the urine test was negative for opioids (heroin is expected to test positive on the opioid section). All patients tested positive for methamphetamine, a powerful stimulant, and some specimens also tested positive for cocaine.

These urine samples were sent to a reference laboratory for confirmatory testing. In addition to confirming the methamphetamine and cocaine, we requested testing for fentanyl. All specimens tested were positive for fentanyl and its metabolite, norfentanyl, neither of which is assessed by the test cup. Some of the samples had levels of fentanyl or norfentanyl greater than 90,000 picograms per milliliter, i.e. the levels exceeded the upper limit of what the lab usually measures.

The high death rate in the opioid epidemic in recent years has been due in large part to the use of fentanyl and related compounds. Fentanyl is a synthetic opioid which is 50 times more potent than heroin and 100 times more potent than morphine. Some derivatives of fentanyl are even more potent: carfentanil, used as a tranquilizer for elephants and other large mammals, is 10,000 times more potent than morphine. Fentanyl is manufactured legally in the United States and used in anesthesia for humans and as a patch and in other forms for treatment of chronic pain. Fentanyl and related drugs are increasingly manufactured illicitly outside the United States and smuggled in. They are mixed with heroin by drug dealers to increase the potency, leading to overdoses which may be fatal or may respond only to multiple doses of the drug-reversal agent naloxone. Drug dealers lack the ability to reliably measure the amount of fentanyl in each sample, or they may not care to do so. Overdose deaths of their customers have not been harmful for business because of the high demand, and some people reportedly seek out the dealers of those with fatal overdoses, in order to acquire the most potent substances.

What is different about the “fake heroin” episodes that I have seen is that the recipients were not seeking fentanyl, and they were surprised to learn that their urine contained fentanyl. Whether the realization that they actually could have died will lead to better adherence to treatment remains to be seen. But these episodes highlight the risk of buying any drug on the street, as you never know what you are getting.

Some people who inject opioids are using fentanyl test strips to test their drugs before using them. If positive, they may take steps to modify their behavior, such as not using the drug, injecting more slowly, or having someone present who has naloxone. Further information is available on the Harm Reduction Coalition website,
www.harmreduction.org   Overdoses, however, can still occur despite these measures or even with a negative test.
The significant risk of death from opioid use, as well as the many other medical, legal, and social consequences, makes it imperative to provide treatment of opioid use disorder to all who need it. The most effective treatment is with the long-acting opioid medications Suboxone or methadone, or the extended-release form of the opioid antagonist naltrexone (known as Vivitrol). These medications are most effective when combined with counseling and other social services. Suboxone and methadone are effective because their duration of action is greater than 24 hours, so that when taken daily there is a stable level of drug in the blood and other tissues; this prevents opioid withdrawal symptoms and reduces drug craving.  Candidates for these medications are accustomed to taking opioids, i.e. they have a high tolerance because of previous extensive opioid use, and they do not experience a “high” or euphoria from these medications with appropriate doses. The net effect is that people who take these medications feel normal and can engage more fully in counseling and social rehabilitation.

Extended-release naltrexone works by blocking opioid receptors for 28 days. Its very long duration helps to reduce drug craving, and in a recent 6-month comparative study, patients started on this medication did as well as those on buprenorphine. A major drawback of extended-release naltrexone is that a patient must be completely opioid-free for about 10 days, because if it is given in the presence of opioids, drug withdrawal will be triggered. Many patients with opioid use disorder are unwilling to go through withdrawal, even if we provide some non-opioid medications to ameliorate the symptoms. Very recently, a monthly buprenorphine injection has been approved, but use is currently limited until insurance companies decide on payment policies.

The accidental overdose death rate in Montgomery County has decreased significantly in the second half of 2017 and even more in the first half of 2018, though the 2018 numbers are preliminary and subject to change. There were 338 such deaths in the first half of 2017, 119 in the second half on 2017, and 84 in the first five months of 2018 (source:
www.phdmc.org ). This decline is not necessarily a result of fewer overdoses, but may reflect the effective use of naloxone by first responders. This very positive change does not detract from the need for treatment expansion. People who survive an overdose urgently need treatment, and a recent study showed that starting buprenorphine or methadone treatment quickly after an overdose reduced the death rate at one year by 40-60% (Larochelle MR,et.al., Annals of Internal Medicine 2018; 169: 137-45). The Spring 2018 Buprenorphine Prescriber News, published by SAMHSA, a division of the Department of Health and Human Services, indicates that Ohio is the state with the third greatest need for additional physicians who can prescribe buprenorphine (an 8-hour course is required). There is still much to be done in order to get the opioid epidemic under control.
 
David M. Novick, MD is a board-certified in Gastroenterology and Addiction Medicine and has practiced both specialties in the Greater Dayton, Ohio area. He has published extensively on substance use issues. His first book, A Gastroenterologist’s Guide to Gut Health, was published in 2017. This article was published originally in the Dayton City Paper, August 21,2018.

 
STOP STIGMA NOW appeared at several events earlier this year.
2019: Stop Stigma Now on the move
 
By Steven Rabinowitz
Stop Stigma Now (SSN) continued its forward trajectory in 2019 toward its mission “to change prevailing attitudes towards people suffering from substance use disorders, which are preventing them from entering into and remaining in treatment” through education on and promotion of medication assisted treatment and recovery as a key element of a comprehensive treatment system.  We began the year with a Board meeting where we did a thorough assessment of our successes and challenges, and the areas where there had been major progress toward achieving our goals and those where there was still much work to be done. The active participation and candor of our Board members in that assessment process showed their professionalism and their commitment to working to ensuring that those struggling with opioid use disorders and other substance use disorders have he tools and resources that they need to live better and healthier lives.  
 
Toward that end, we took on a number of tasks that we felt were needed to make SSN a more effective means to achieve its own goals.    Accordingly, during 2019 we were able to accomplish the following:
 
  • Organizational/Financial—We expanded Board membership from 13-18 and added 2 members to our Advisory Board, as well as added eight new paying members.  We also formed a Policy/Advocacy Committee to replace our former Criminal Justice Committee and broaden its tasks.   We also gained two additional sponsors.
     
  • Outreach/Education— Over 2019 SSN tabled at the AATOD, NY State Drug Court, and the National Association of Drug Court Professionals All Rise national conferences. At the All Rise 2019 conference there were over 5500 drug court, mental health court, and veteran court team members in attendance from all 50 states including judges, district attorneys, defense counsel, probation officers, police officers, treatment providers, and peer advocates. At that conference alone 3500 publications were distributed and 6500 were distributed in all.  We mailed over 100 packages of 2500 publications as well.  
We also updated our literature, including our Information Book (which now contains a section on Accreditation), along with the development of a new brochure “Abstracts of Research Articles on MAT”.  In fact, our growth in literature supplies required us to lease storage space for our materials.   
 
  • Geographic—SSN expanded State representatives from 8 to11, and is now in Arkansas, California, Maryland, New York, New Jersey , North Carolina ,Pennsylvania, Washington DC, Georgia, Oregon, Michigan  as well as Ireland and Australia. 
     
  • Electronic Media—SSN expanded and improved it.   
  • A webpage in 2019 and produced 2 quarterly electronic newsletters, being our 3rd and 4th editions. 
Accordingly, in 2020 we can say proudly that SSN has five main programmatic arms through which it conducts education and advocacy 
  • Materials publication and distribution – SSN has created a series of cutting edge publications for providers on MAT and the impact of stigma on prevention of opioid overdose —with distribution through the SSN website electronically and through tabling at treatment and criminal justice state-wide and national conferences.
     
  • Speakers Bureau -- Over the last year SSN conducted a dozen presentations for treatment programs ranging from short introductory presentations to hour-long workshops on MAT and stigma.
     
  • Social Media Presence - SSN utilizes social media—Facebook, Twitter, and Instagram—to promote and share educational articles, essays and blog posts in addition to surveys and original content on MAT, stigma and the opioid epidemic. As an example our Facebook page has 2301 followers and per month averages 40 page views, 400 post reaches, and 300 post engagements.
     
  • Quarterly Electronic Newsletter - SSN’s quarterly newsletter containing original work from SSN content experts and selected articles from the last quarter rolls out electronically to a national subscription list of over 1,300 drug treatment and criminal justice providers.
     
  • Website – The www.stopstigmanow.org website provides information about the intersection of the opioid epidemic, MAT and stigma; SSN publications in downloadable format; the Quarterly Newsletter; a Media Library featuring our Steppin’ Out Radio web series interviews and Archived Webinars; Oral histories of people with lived experience of opioid use disorder, and a Resource Library.  
But SSN is not done moving forward by any means.  We know that there is still a great deal of education, discussion and advocacy that has to be done to reach our goals.  Including building on our gains and successes, we now need to confront the impact of COVID-19 on our community of patients and providers, and we have committed to examining that with regard to: 
  • the rapid growth of telemedicine as part of the crisis and how it has impacted the treatment system
  • the changes in dosing schedules, use of drug toxicology and other aspects of the clinic systems in the past that have also changed dramatically due to the crisis
  • the changes in clinical relationships, the expanding and changing role of MAT and the reimbursement systems that support our programs’ 
Our Board has committed, working with its research experts, to taking an active role in examining these issues and sharing that information with our entire community of members and associates. 
 
In addition SSN continues to grow its efforts to reach out to providers and community stakeholders to educate them on our goals, to improve its Board participation in its various committees and workgroups, and to involve itself in the discussions and debates that pertain to the delivery of SUD treatment services. As in the past, we welcome your active participation and collaboration with all of our work. Please contact us and together we can make a brighter future for those in need.
From the President of NAMA-R: A Letter To The U.S. Department of Justice Supporting Proposed Rulemaking RIN 1117-AB43 
April 27, 2020
 
U.S. Department of Justice
Drug Enforcement Administration
8701 Morrissette Drive
Spingfield, VA 22152
 
RE: RIN 1117-AB43/Docket No. DEA-459
 
To Whom It May Concern:
 
The National Alliance for Medication Assisted Recovery (NAMA Recovery) has had the privilege and responsibility of representing the collective voices of individuals in medication supported recovery from opioid use disorder since 1988. Of the patients whose interests we represent, approximately 450,000 of them are estimated to be enrolled in Narcotic Treatment Programs (NTPs) receiving methadone, buprenorphine, or naltrexone as part of their treatment for opioid use disorder. NAMA Recovery is the longest continuing and largest medication assisted treatment (MAT)- specific patient advocacy organization in the world.
 
NAMA Recovery fully supports Notice of Proposed Rulemaking RIN 1117-AB43 and appreciates the Drug Enforcement Administration’s efforts to increase access to vitally needed comprehensive services in treating opioid use disorder. NAMA Recovery concurs with the American Association for the Treatment of Opioid Dependence (AATOD) that there are three ways this new treatment setting may be utilized once the final rule is published in the Federal Register, and we appreciate the opportunity to leave comment from the perspective of the MAT patients who stand to benefit the most from this rulemaking process.
 
Mobile Vans in Rural and Underserved Areas
 
Lack of access to comprehensive medication assisted treatment (MAT) with methadone or buprenorphine for individuals residing in rural or frontier communities and underserved areas is a concern that has been raised by NAMA Recovery and our membership across the United States for many years. This lack of access to comprehensive MAT has contributed to the current opioid epidemic that continues to have devastating consequences in communities across the country. It is significant to note that a variety of factors perpetuate this lack of access to comprehensive MAT, including socioeconomics, geography, lack of adequate transportation and stigma. Delivery of these services to rural, frontier and underserved areas via a mobile van can successfully address each of these factors. We understand that funding from the Department of Agriculture (DOA) is available to purchase mobile vans if Narcotic Treatment Programs (NTPs) meet DOA criteria in serving rural communities as defined by a population of 50,000 or less. We will advise our members residing in rural, frontier and underserved areas to actively engage with their NTP providers and their State Opioid Treatment Authorities to pursue this funding opportunity.
 
Mobile Vans in Correctional Facilities
 
We also understand that NTPs will be able to work with State Opioid Treatment Authorities and the State Department of Corrections in addition to Sheriff’s Offices in expanding access to mobile van services in correctional programs. Comprehensive services would be provided including assessments, induction, and dose stabilization. Maintenance on medication would be provided as well as counseling services. Facilitated referrals to an NTP in the community would be made upon release. We know that providing access to medication assisted treatment during incarceration and following up to ensure that patients continue to access medication assisted treatment will significantly decrease opioid overdose deaths and improve recidivism rates. We will encourage our members to advocate for the use of mobile vans in correctional facilities with their State Opioid Treatment Authorities and local law enforcement agencies.
 
Mobile Vans in Urban and Suburban Areas 
We also believe that mobile vans will play an important role in the delivery of medication assisted treatment in urban and suburban areas that currently do not provide these services, or where these services are under provided. We are aware that services provided in these areas would not qualify for DOA funds. We will advocate for State Opioid Treatment Authorities and SAMHSA officials to fund the use of mobile vans in these areas.
 
General Comments and Observations 
NAMA Recovery is aware that some individuals and/or organizations without a firm understanding of the treatment delivery system and related policy in the United States are recommending that the final rule eliminate the provision requiring Mobile Vans to operate only within the state of their NTP originating site. While NAMA Recovery agrees with the basic premise that lack of access to these essential medical services are not defined by state borders, we also understand the regulatory conflict the elimination of this provision would create. Since the passage of the Narcotic Addict Treatment Act of 1974 that established the Narcotic Treatment Program (NTP) system, states have had the authority and right to promulgate state NTP regulations as long as they do not conflict with the federal regulations now codified in 42 CFR Part 8. Because state regulations can vary greatly, NAMA Recovery is aware of the immediate regulatory crisis that would exist if the Drug Enforcement Administration promulgated federal regulations around Mobile Vans that are permissive of the vans crossing state lines. As such, NAMA Recovery is concerned that any potential for conflict within the treatment delivery system could put patient care in jeopardy and foster confusion that may fuel additional stigma against an already overly stigmatized medical treatment. The furtherance of confusion and stigma harms patients the most.
 
Since Mobile Vans are governed by state regulations in addition to the federal regulations promulgated by the Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration (SAMHSA), operating a Mobile Van across state lines would call into question which state has oversight and how the originating state could enforce their rules on a Mobile Van that is not located within their borders. Until such time as all NTPs operate under a unified set of regulations, NAMA Recovery supports the current language restricting Mobile Vans to the state of their originating NTP site.
In closing, we are grateful for your work and appreciate the ability to leave comments through the federal register on these proposed rules, and we appreciate your consideration of the MAT patient perspective.
 
Because treatment works,
 
Zachary C. Talbott, MSW, CAADC, CCS, CMA
President
Stigma And The Toll of Addiction
The stigma surrounding drug abuse has not gone away, despite stigmas lifted for mental health conditions. according to Nora D. Volkow, M.D. in the New England Journal of Medicine. 
Click Here To Read Article

Study Report: Pharmacy-Based
Methadone Distribution

"Eight investigators from medical centers in the U.S. and Canada recently looked into methadone access in the U.S., and evaluated the current availability of methadone treatment for opioid use disorder (OUD)."

Read more in Addiction Treatment Forum.
Click Here To Read Article
Read It: July 2020 Newsletter For
Alcoholism & Drug Abuse Weekly
The latest newsletter by Alcoholism & Drug Abuse Weekly brings you a variety of related topics that include a study the finds low-risk alcohol relapsers have same brain volume as abstainers, and more. 
Read The Newsletter
Help Us. Help You
DONATE
Newsletter published by David Cruz. If you have any comments about our newsletter please email our editor, Robert Sage at resage@gmail.com
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