This Pulse Check is a report of national trends in illicit drug abuse and drug markets in the United States. The report draws on conversations with ethnographers and epidemiologists working in the drug field, law enforcement agents, and drug treatment providers across the United States. Information from each of these sources is summarized in narrative form broken down by drug type and presented in detailed tables at the end of the report. The four groupings of drugs are heroin, cocaine, marijuana, and emerging drugs. Results show that the market for heroin and cocaine remains fairly stable. Marijuana continues to be popular among young people and is frequently used with alcohol, hallucinogens, cocaine, or methamphetamines. Among the emerging drugs, methamphetamine continues to be a problem in the West and parts of the South, its low price making it an easily accessible drug. "Club drugs," such as Lysergic Acid Diethylamide (LSD) and Ketamine, are part of the drug scene in most areas, with many young people using a combination of these substances. (RJM) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** Office of National Drug Control Policy PULSE CHECK National Trends in Drug Abuse Executive Office of the President Office of National Drug Control Policy Barry R. McCaffrey, Director

Office of national drug control policy

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis.

/pdf/stigma-as-a-fundamental-hindrance-to-the-united-states-41pv6l4iaj.pdf

Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Changes to the landscape of opioid use have occurred throughout the past two decades. Opioid agonist treatment (OAT) plays an important role in reducing opioid-related harms. Yet, people with opioid use disorder (PWOUD) face issues with access and retention. This scoping review sought to provide an up-to-date synthesis on barriers and facilitators to OAT. Ninety-three studies were included. Major barriers included cost, waiting lists, and negative public attitudes toward treatment. Prominent facilitators included OAT education and flexible treatment conditions such as telehealth-delivered OAT. In prison settings, limited support with treatment referral was a barrier. Fear of judgement was a challenge for pregnant people. There was a lack of information on barriers and facilitators specific to PWOUD dealing with chronic pain or mental health comorbidities. Results highlight new challenges in reaching an increasingly heterogeneous PWOUD population. Findings underline the potential for recent advancements in treatment modalities to promote access and retention.

New Challenges and Opportunities for Opioid Agonist Treatment Access and Retention: A Scoping Review

Objectives: For patients with opioid addiction seeking treatment, an effective option is Medication-assisted Treatment (MAT). In Albuquerque, the city with the greatest number of people who use opioids in New Mexico, the demand for MAT exceeds the number of patients receiving treatment. The authors hypothesized that a primary factor in patients’ ability to access treatment is clinic payment options, rather than the traditionally cited availability of providers. Methods: The authors conducted a survey assessing payment methods and corresponding availability in MAT programs for 53 of Albuquerque’s ~70 providers. Results: The authors found a statistically significant (P<0.01) imbalance in treatment availability between insurance-accepting clinics (10.1% had ≥1 openings) and cash clinics (100% had ≥1 openings). Conclusions: These findings suggest that a lack of clinics accepting Medicaid and third party insurance may pose a significant treatment barrier. The authors thus conclude that more focus should be placed on increasing the number of clinicians and clinics accepting insurance.

Clinic Payment Options as a Barrier to Accessing Medication-assisted Treatment for Opioid Use in Albuquerque, New Mexico

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Clinic Payment Options as a Barrier to Accessing Medication-assisted Treatment for Opioid Use in Albuquerque, New Mexico