Substance Abuse EHR Software,

Rapastinel Being Researched for Treatment of Withdrawal

Symptoms Associated with Opioid Dependence

What is Rapastinel? It was originally developed by Naurex as an alternative to the antidepressant drug Ketamine which has a number of adverse side-effects and a potential for abuse. Unfortunately, soon after acquiring Naurex in 2016, Allergan was soon met with a disappointment as the drug failed in its clinical trials. SMART offers substance abuse EHR software that helps streamline opioid dependance clinics. 

While it failed as an antidepressant, there is renewed interest in it as a potential treatment for withdrawal symptoms associated with opioid use disorder, as described in this Duke University research abstract:

Pharmacotherapies, such as buprenorphine and methadone, are used to treat those dependent on opioids. However, these commonly used pharmacotherapies are opioid partial agonists and agonists, so the patient remains in an opioid-dependent state throughout treatment.

Treatment requires long-term tapering with buprenorphine or methadone, during which withdrawal symptoms can occur. These limitations show a clear need for a non-opioid pharmacotherapy. SMART can help your treatment center streamline efforts with substance abuse EHR software

Drugs that target the NMDA receptor have been proposed as alternatives to opioid-targeted pharmacotherapies. The NMDA receptor is involved in the maintenance of opioid dependence and its blockade may reverse the neuroadaptive changes induced by opioid dependence. 

Regulation of the NMDA receptor could accelerate treatment of opioid dependency (Glass, 2011).

Ketamine, an NMDA antagonist, has potential as a treatment, but has associated side effects and potential for abuse. Rapastinel is a novel drug marketed as an antidepressant, and it acts as a partial agonist of the NMDA receptor complex. The negative side effects reported with ketamine have not been reported with rapastinel (Moskal et al., 2016). Since rapastinel acts as a partial agonist and has no reported side effects, it may be a more tolerable treatment option for those dependent on opioids.

Current research is limited only to rodents, but the Duke study is hopeful that the continued success of their research will earn the drug clearance for human trials. Those who provide outpatient medication-assisted treatment with methadone and buprenorphine know the efficacy of the treatment. We also know that only a fraction of those who have opioid use disorders actually receive specialty treatment for it. Why is that? Stigma plays a big part. Others simply “don’t want to be in treatment for life” or, at the very least, are concerned about withdrawal symptoms that come with short-term non-medication-assisted therapies.

AddictionCenter.com, an informational web guide for those who are struggling with substance use disorders, states that “A supervised detox is the first step to treating any type of addiction”. According to NIDA, “When people addicted to opioids like heroin first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea,and vomiting), which may be severe. Medications can be helpful in this detoxification stage”; and “While not a treatment for addiction itself, detoxification is a useful first step when it is followed by some form of evidence-based treatment”. 

Medication-assisted detox treatment is not a new concept. It's widely available, relying mostly upon methadone, buprenorphine and naltrexone. Consider a new drug that is effective, non-addictive, has no risk of abuse and no reported side effects. That could be a game-changer in terms of bringing people who need opioid use disorder treatment into treatment. Might Rapastinel might be that drug? Contact SMART today to learn more about how our substance abuse EHR software offers the leading technology and research to help bring hope back for those suffering from the grips of this disorder, and the facilities dedicated to saving lives during this ongoing epidemic. 

substance abuse ehr software

The Future of Healthcare: What Can We Expect by 2025?

In May, 2019, well before the entire healthcare world shifted its attention to the coronavirus pandemic, two New England trade organizations had convened for their annual Spring conferences: the American College of Healthcare Executives (ACHE) of Massachusetts and the New England chapter of the Health Information Management Systems Society (HIMSS). Both shared the same central theme, “human benefits”.

Industry expert Kathy Sucich, Director of Marketing for Dimensional Insight in Burlington, MA, attended both conferences and wrote “we will be able to tackle some big issues in the years ahead”. In her May 2019 article for HealthIT Answers she shared these highlights from what speakers at the conference said they would like to see in healthcare by 2025. Her first two points describe problems needing solutions.

The latter two contribute to the solutions:

1. Capturing the patient’s voice is important:

She notes that “Healthcare organizations should see their patients as human beings, which is not the case right now” and offers this example of how this is changing: Beth Israel Lahey Health (BILH) will be looking to patient feedback to measure their success “by the difference we make in people’s lives”. She also thoughtfully included consideration the supply chain and billing, neither of which are seen as needing to be patient-focused yet have a definite impact on the patient’s overall experience.

2. Providers need to better understand social determinants of health:

As defined by the CDC, social determinants of health (SDOH) are “the circumstances in which
people are born, grow up, live, work, and age”. She writes that SDOH impact patient’s health as well as their quality of care and that understanding SDOH would help close the gap on the health disparities they cause.

3. Data Literacy is critical:

Health data growths at a rate of 36% annually. That’s astounding. If a bank account earned that
much interest, a $5,000 deposit 20 years ago would be worth $2,343,000 today!
Artificial intelligence and machine learning endeavors demonstrate that data can also have a
huge positive impact in point-of-care decision support and other areas. To reap the benefits, organizations will have to both aggregate their data and develop the knowledge and expertise to act on it.

4.  Big tech companies could make a big impact

Amazon, Google, Apple and others are anticipated to make significant positive contributions to
healthcare over the next few years, but they could also disrupt the industry. She cites Amazon,
which has a supply chain that could cause an impact on hospital purchasing.

The problems are not new. Consider these philosophical maxims from William Osler (1849-1919), a Canadian-born physician, which are over 100 years old:

1. “The good physician treats the disease; the great physician treats the patient who has the
disease”.

2. “It is much more important to know what sort of patient has a disease than what sort of disease a patient has”.

Osler’s maxims are just as pertinent today. The first indicates that the patient comes first. The second speaks to social determinants of health. In the substance abuse treatment industry, providers typically “walk the talk” when it comes to both. We do put the patient first. It is also widely accepted that “social determinants of health are increasingly recognized for their important influence on health outcomes”. (Williams, et al, Jul 2019) As Sucich points out, human benefits include not only the patient but also the physicians who treat them. A Mayo Clinic reports that 44% of physicians experience symptoms of burnout and a New England Journal of Medicine survey showed that 95% of medical professionals agree burnout is an issue ( Etactics, Nov 2019 ). The top two factors of burnout are administrative tasks and too little time with patients, both strongly influenced by demands of technology. ( PatientPop, Aug 2019 )

At SMART, we are proud of our history of prioritizing human benefits with our substance abuse EHR software, having always put the patient first and prioritized our associate’s satisfaction. Why is it, then, that for more than a decade the healthcare industry at large has dedicated itself to the advancement of technology rather than the human elements? It’s the need for data.

In order to treat the whole person, all their providers need to know the whole person. That requires all of them to both gather and share of data, which requires technology. Congress, realizing that, enacted the HITECH Act in 2009 which resulted in a feeding frenzy for the $18 billion of funding for the adoption and use of technology, mostly within primary care, hospitals and large medical organizations.

After more than a decade, it’s finally safe to say that “the technology exists”. Now is the time for the healthcare world to shift its focus back to human benefits, something that has always been important for those who care for patients suffering from substance use disorder. Our substance abuse EHR software puts the focus back on human benefits.