The Trump administration's plan to address the nation's opioid crisis, announced last week, includes a recommendation for the use of one medication, manufactured by a single company, to treat federal prisoners with opioid addiction, according to a report from STAT.
Here are five things to know.
1. The White House supports the use of naltrexone for one month in prisoners with a history of opioid addiction, according to a fact sheet disseminated among the administration and cited by STAT. A spokesperson for the Trump administration confirmed the document was specifically referencing the injectable form of the drug known as Vivitrol.
2. The biopharmaceutical company Alkermes, which manufactures Vivitrol, faced scrutiny for its marketing practices, including the aggressive promotion of Vivitrol among the criminal justice system. In November 2017, Senator Kamala Harris, D-Calif., launched an investigation into the company's marketing practices allegedly designed to "increase sales of its own product, while contributing to misconceptions about other medications used in the fight to combat the opioid epidemic."
3. Unlike other predominate forms of medication-assisted treatment for opioid addiction such as methadone and buprenorphine, Vivitrol is not an opioid. The drug is a monthly injection designed to block the effects of opioids. Its nonopioid chemical composition eliminates the risk for misuse associated with other forms of MAT, likely contributing to the drug's popularity among some in the criminal justice system.
4. However, some experts contend a Vivitrol-only policy for prisoners is not likely to yield the best results.
"Methadone and buprenorphine have been shown on a variety of metrics to be far superior to Vivitrol — that includes safety, effectiveness and cost," Leo Beletsky, an associate professor of law and public health and drug policy expert at Boston-based Northeastern University, told STAT. "The reason Vivitrol is preferred is that it's a medical version of forced abstinence. That is why it's been the darling of those who rhetorically support medication-assisted treatment."
5. HHS Secretary Alex Azar, who was unfamiliar with the proposal, initially told STAT the exclusive mention of Vivitrol in the fact sheet was likely an "inadvertent reference. I think the key thing was the prison population, as opposed to any one product," according to Mr. Azar later changed his comment and cited a directive from the Substance Abuse and Mental Health Services Administration, which says all individuals coming out of a detox program or prison "should in fact be put on naltrexone, but that doesn't mean it's the best form [of MAT] for all populations."
To read the full STAT report, click here.
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