Thank you!
Your support is sustaining the future of local news in our communities.

Treating opioid abuse: costly research is well worth it

We like every catastrophe to have a single cause because a villain, especially one that had been identified, is a satisfying thing. In the case of opioid use disorder, one villain is Purdue Pharma, makers of OxyContin, a powerful pain reliever and euphoric that the company claimed was not addictive. It is addictive, but so are   enormous profits. Purdue is getting its slow-drip punishment, in the form of massive lawsuits, and it faces insolvency.

Opioids, whether from Purdue or heroin pushers, fall on receptive ground. Millions of people have been treated with OxyContin and were not addicted. Others, seeking pain relief, or who were stressed or traumatized, became addicted, particularly in West Virginia, Ohio and New Hampshire. Others were thrill-seekers and got trapped. If we lay the map of overdose deaths by region onto maps of poverty and despair, they overlap. This is as much a disease of social disruption, family trauma, boredom and the effects of war as of over-prescription. Picking a single villain narrows the targets. Purdue’s practices have been curtailed, but the epidemic continues. 

The second failure is that we have not applied what we know. Some people can stop taking opioids and remain drug-free. Leaving dependence behind in one step is preferable for many reasons, not least convenience, employability and expense.  Unfortunately, quitting without Medically Assisted Treatment (MAT) often fails. As an earlier column explained, most deaths from opioids come soon after detox, because opioid receptors on neurons that control breathing have been reactivated during abstinence. This makes them very sensitive to heroin or fentanyl. A single miscalculated first dose is enough to stop breathing.  

Buprenorphine (Suboxone), methadone, and extended release naltrexone (Vivitrol) all prevent craving for heroin of similar drugs. They activate the opioid receptor, but less (or perhaps differently) than heroin and fentanyl do. Patients do not experience euphoria or have cravings for heroin. Clinical trial results from The National Institutes on Drug Abuse indicate that MAT using these drugs reduces relapse and overdose deaths, curbs criminal activity and reduces infections from contaminated needles (see: www.drugabuse.gov). MAT is now established therapy, and with long acting formulations has become more convenient (see below). Strangely, its use is not universal and some reports suggest that treatment with these substances after acute detox has been decreasing. 

Why is this? Buprenorphine, methadone and extended release naltrexone are all opioids and some therapists object that one addiction is being exchanged for another. The 12-step programs and their social support often successfully treat alcoholism, but demand complete abstinence. Such programs are usually not sufficient for severe opioid dependence. Switching one addiction for another, as opponents put it, allowing patients to become functional with buprenorphine and not die of overdoses seems vastly preferable to following programs that demand complete abstinence. It is sobering that 72,000 people died of overdoses in 2017, at least 50,000 of them from opioids, the rest from other drugs like meth or mixtures of different drugs. Millions more are chronic users.

Despite the current political paralysis in Washington, The National Institutes of Health (NIH) has received extra funding (billions) to study opioid addiction. They, of course, have come up with an acronym for their program: HEAL, for Helping to End Addiction Long Term. Many projects are being supported, including a new drug (ANS-6637) to limit opioid cravings, which has entered formal clinical trials. Clinicaltrials.gov lists 307 trials involving opioids. The website of The National Institute of Drug Abuse (NIDA), part of the NIH, is also a good source of information. 

υ  υ  υ

Opioid users lead complicated lives and it is challenging to do clinical trials because patients often drop out, but Drs. Ismene Petrakis and Sandra Springer, both physicians at the Yale School of Medicine and attending physicians at the VA Connecticut Healthcare System, have received a grant to test the effectiveness of two forms of long-acting buprenorphine (one injectable and one in pill form). 

The VA is experienced with the many needs of traumatized veterans and the regulatory rules that come with clinical trials, as is Yale, which runs a residency program in addiction medicine. This study will last a year and enroll hundreds of patients in 20 VA hospitals. Addicted veterans, possibly already patients of the VA, will be followed for adherence to the protocols and their physical conditions, including the infectious diseases that are associated with intravenous drug use.  

The study will cost $40 million. If it yields actionable results it will be worth it. We are not looking to “end addiction long term” as the HEAL acronym suggests. A few score people restored to a useful life and a better way to accomplish that for veterans would be sufficient.

 

I am grateful to Ziba Kashef of YaleNews (ziba.kashef@Yale.edu) for alerting me to this study. Richard Kessin is Professor of Pathology and Cell Biology Emeritus at the Columbia University Irving Medical Center.  He can be reached at Richard.Kessin@gmail.com.

Latest News

Francis Lynehan

Francis Lynehan

DOVER PLAINS — Francis “Butch” Lynehan, 75, a twenty-year resident of Dover Plains, New York, formerly of Sharon, passed away unexpectedly on Thursday, May 7, 2026 at Vassar Bros. Medical Center in Poughkeepsie, New York.

Born Aug. 29, 1950, in Sharon, he was the son of the late William W. and Nellie (Kluun) Lynehan.

Keep ReadingShow less

Richard McGriff

Richard McGriff

TACONIC — Richard McGriff died unexpectedly on May 16, 2026. This is a collection of loving reminiscences.

With a smile like that and a laugh like that and a soul like that, how could you not love him? Macey Levin and Gloria Miller

Keep ReadingShow less
Juneteenth graduation celebrates Berkshire’s next generation of leaders

Cohort 2026 members Abigail Horace, Adam Liccardi, Adrian Lynch, Cameo Brown, Chauncey Dozier, Claudette Grant, Erline Saintilet, Harmony Edwards, Kamayue Gomes, Mackenzie Colvin, Otis West, Shadre Domingo, TJ West and Tyeesha Keele-Kedroe and Blackshires’ leadership team John Lewis, Patrick Danahey, Dubois Thomas and Julie Haagenson gather at the Blackshires City Hall Fishbowl alongside Mayor Peter Marchetti and city officials Michael Obasohan, Brandon Gill, Katherine VanBramer, Heather Brazeau, Justine Dodds and Jesse Tobin McCauley.

Provided

When designer Abigail Horace joined the Blackshires Leadership Accelerator, she was looking for support as the founder of the Black Berkshires Social Club, which creates culturally grounded social spaces for Black and BIPOC residents in the region. What she found was something deeper: a community of peers invested in one another’s success.

“Finding Blackshires has been transformative,” Horace said. “Being a BIPOC founder in this region can feel isolating, and this community has changed that. They see my work, champion my business and have opened doors I couldn’t have opened alone.”

Keep ReadingShow less
google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.

Forged by curiosity: Art, craftsmanship and big fun with Izzy Fitch

Izzy Fitch at Battle Hill Forge in Wassaic.

Madi Long
I’m not really inventing anything new. I just tweak it a little bit.— Izzy Fitch

A steel praying mantis stands among garden accents at Battle Hill Forge in Wassaic, its folded forelegs ready for prayer and mischief in equal measure.

“She’s very nice,” said blacksmith, sculptor and Battle Hill Forge owner Izzy Fitch, patting the giant insect affectionately. Then he added, “Just don’t go out to dinner with her.”

Keep ReadingShow less
Unexpected subjects, familiar beauty in new Kent exhibits
Millerton-based artist Alexis England with her flamingo and mandrill portraits at Peggy Mercury in Kent.
D.H. Callahan

Kent Barns was alive with art on Saturday, June 13, as three new shows opened at Peggy Mercury and Kenise Barnes Fine Art, featuring a variety of fascinating paintings and drawings from four local artists.

Peggy Mercury, which in just two years has earned a reputation for curating remarkable collections of fine beauty products and accessories, continues to find exciting art to complement its offerings. The new show, “Portraits,” features four pairs of paintings by Millerton-based artist Alexis England. The “portraits” she paints, however, feature some pretty unexpected sitters.

Keep ReadingShow less
Stonewood Farm launches chefs in residence program
Jocelyn Ueng is the first Chef in Residence at Stonewood Farm.
Provided

Stonewood Farm in Millbrook is expanding its educational and community food programs this summer with the launch of a new Chefs in Residence program, an eight-week immersion that brings culinary professionals to the nonprofit farm to live, cook, teach and work alongside farmers.

The program is led by Kristen Essig, Stonewood’s director of culinary outreach and development, an award-winning chef whose background includes work with Emeril Lagasse and multiple James Beard Award nominations.

Keep ReadingShow less
google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.

google preferred source

Want more of our stories on Google? Click here to make us a Preferred Source.