Sarah Akerman, M.D., Senior Medical Director at Alkermes
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Combating Opioid Addiction
Sarah Akerman, M.D., Senior Medical Director at Alkermes, talks about the industry’s role in opioid use disorder.
PV: What are some of the biggest issues around the current treatment system for addiction?
Akerman: The current treatment system for opioid addiction is inadequate; there is a lack of scientific innovation in this field. Less than 10% receive any form of treatment. Even more concerning is that fewer than 3% of treatment programs offer all three types of FDA-approved medications — buprenorphine, methadone, and extended-release naltrexone — for the treatment of opioid use disorder. The challenge is that patients do not receive these medications, in part, due to a dysfunctional treatment system.
This means that the majority of patients do not receive evidence-based care. Many patients who undergo medically supervised withdrawal or detoxification treatment from opioids are released back into the community with no medication. This places them at high risk for overdose and death.
Because no one medication is right for every patient, it’s critical that patients and their families are aware of all of the treatment options. In addition to the limited awareness, there are not enough treatment providers offering all these options. Therefore, many patients only have access to what the treatment facility has to offer. Patients need to understand they have options and those options are available. We owe it to patients to address this inequity in the system.
PV: What can be done to bring more innovation to the opioid treatment space?
Akerman: More pharmaceutical companies are needed in the opioid use disorder treatment space. The challenge is, however, that even the most innovative medication may well fail unless the treatment paradigm changes and there is greater acceptance of evidence-based medication plans.
There are a handful of opioid use disorder drugs currently in development as well as some reformulations of already approved medications. This is in contrast to the impressive and effective work that’s being done in, for example, the oncology space where there are more than a thousand drugs currently in development.
PV: What role does Alkermes play to address opioid abuse and misuse?
Akerman: Alkermes has been in the addiction space for many years. We market Vivitrol, an extended-release injectable suspension of naltrexone for the treatment of alcohol dependence as well as for the prevention of relapse to opioid dependence, following opioid detoxification. We believe more scientific innovation is required to change the treatment paradigm.
We support the mental health and addiction community through our Inspiration Grants. We also support independent scientific researchers through our investigator-sponsored studies program and our junior investigator award program called Pathways. We also support independent medical education and healthcare-related events and initiatives.
PV: What is Alkermes’ Inspiration Grants?
Akerman: Our Inspiration Grants program focuses on two key areas: improving and enhancing support and resources for people affected by mental health or substance use disorders. The awards are given to select national and local nonprofit community organizations that are implementing innovative, high-impact, replicable programs designed to support people affected by mental health and substance use disorders. The community-based program reaches patients and families directly.
We are proud to support these amazing organizations and are humbled by their relentless commitment to support patients, families, and communities.
This year, we evaluated more than 300 proposals and awarded grants to 14 programs that demonstrate creative approaches to help support the needs of people with mental health challenges or substance use disorders. In total, we offered $1 million in grants for the implementation of these programs.(PV)
The Opioid Abuse Problem
The overuse of many opiate-based pain medications approved in the last 30 years has produced a highly visible crisis in public health. Every day, more than 115 people in the U.S. die after overdosing on opioids, according to the National Institutes of Health. The misuse of and addiction to opioids, including prescription pain relievers, heroin, and synthetic opioids such as fentanyl is a serious national crisis that affects public health as well as social and economic welfare.
About 11.4 million Americans misused prescription pain medicine in 2016 and 2017, according to the
Department of Health and Human Services. About 886,000 people used heroin. The National Institute on Drug Abuse estimates that half of young people who inject heroin turned to the street drug after abusing prescription painkillers. Additionally, three in four new heroin users start out using prescription drugs.
The CDC estimates that the total economic burden of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.