Brief Report: Rates of Fentanyl Use Among Psychiatric Emergency Room Patients

Opioid use disorder: current trends and potential treatments

Opioid use disorder (OUD) is a major public health threat, contributing to morbidity and mortality from addiction, overdose, and related medical conditions. Despite our increasing knowledge about the pathophysiology and existing medical treatments of OUD, it has remained a relapsing and remitting disorder for decades, with rising deaths from overdoses, rather than declining. The COVID-19 pandemic has accelerated the increase in overall substance use and interrupted access to treatment. If increased naloxone access, more buprenorphine prescribers, greater access to treatment, enhanced reimbursement, less stigma and various harm reduction strategies were effective for OUD, overdose deaths would not be at an all-time high. Different prevention and treatment approaches are needed to reverse the concerning trend in OUD. This article will review the recent trends and limitations on existing medications for OUD and briefly review novel approaches to treatment that have the potential to be more durable and effective than existing medications. The focus will be on promising interventional treatments, psychedelics, neuroimmune, neutraceutical, and electromagnetic therapies. At different phases of investigation and FDA approval, these novel approaches have the potential to not just reduce overdoses and deaths, but attenuate OUD, as well as address existing comorbid disorders.

COVID-19 Vaccine Administration and Hesitation Among Psychiatric Emergency Services Patients

Psychiatric Emergency Services (PES) at Connecticut Department of Veterans Affairs (VACT) began offering the COVID-19 vaccine to eligible veterans in February 2021. From February 10 to March 17, 2021 there were 110 encounters where a veteran was offered the vaccine (96 unique veterans). Of those 96 veterans, 39 (40.6%) were interested in receiving the vaccine. Of those, 23 (60.0%) veterans received the first dose of the Pfizer-BioNTech vaccine and among those, 21 (91.3%) eventually received the second dose. Sixteen veterans were interested but unable to receive the vaccine due to PES-related obstacles. Common themes regarding vaccine hesitancy among this population include vaccine mistrust and concerns about side effects. Offering the vaccine to PES patients allowed VACT to reach a vulnerable subset of veterans who may be at higher risk of contracting the virus and experience worse disease outcomes.