Thursday, July 29, 2021

Pet food shortages leave owners on the hunt for kibble and cat treats

By Tom Polansek and Richa Naidu
© Reuters/Muhammad Hamed FILE PHOTO: A cat eats in a home in Amman

CHICAGO (Reuters) - Black short-haired kitty Astra, one of millions of pets acquired during the COVID-19 pandemic last year, had to go without salmon-flavored Whiskas treats that were sold out at stores in New Orleans this month.

Loki, an Alaskan malamute dog in Ontario, Canada, did not have his usual Royal Canin kibble in the food bowl.

North American pet owners are struggling to track down certain foods from major retailers like Amazon.com, Target Corp and PetSmart as the sector grapples with increased demand and strains on the supply chain.

Costs for pet food ingredients have climbed 8% to 20% since the pandemic began, according to U.S. industry group the Pet Food Institute, outpacing a 5.4% jump in consumer prices in the 12 months through June.

Higher prices of basic foodstuffs such as corn, soy and meat, on top of rising transportation and labor costs, are affecting all food supplies - both for animals and people - as the U.S. economy picks up steam.

"The pet supply chain isn't that different from the food supply chain," said Coye Nokes, partner at OC&C Strategy Consultants. "That has obviously been really stressed by COVID – whether it's the ingredients, raw materials, processing or downtime at different facilities."

Prices for U.S. corn and soybeans, key ingredients in many pet foods, reached eight-year highs this spring, pinching manufacturers that use the crops.

Pet food makers are also facing increased competition for animal- and plant-based oils because more of those are going into renewable fuel supplies, according to the Pet Food Institute.

"Unprecedented price increases for ingredients and equipment jeopardize U.S. pet food makers' ability to plan and execute strategies that will ensure America's dog and cat food bowls are filled," the institute warned U.S. agriculture officials in a June letter.

Supply constraints are taking pet owners by surprise, and there are many more owners since the pandemic began. About 12.6 million U.S. households indicated they acquired a new pet from March to December 2020, according to the American Pet Products Association.

In New Orleans, Aura Bishop, 39, searched local stores for weeks to find her cat Astra's favorite treats, made by Mars Petcare. The company, the world's biggest pet food producer, declined to comment.

The shortages were an inconvenience for the writer and actress, who said Astra helped her cope with anxiety and depression during the pandemic.

"I wish she was less of a finicky eater and would eat other flavors," Bishop said. "It does feel a little silly to go on this quest to find specific flavors of kibble and treats."

EXTRA WORK FOR CHARITIES 

Limited supplies have made extra work for animal charities like the South Shore Pet Food Pantry near Boston.

Cofounder Kristen Clancy said she reviews online wish lists for pet food on sites like Amazon and Target about every two weeks, instead of every two to three months previously, because products are more frequently sold out. She updates the lists manually to provide alterative items for donors to buy.

Over the U.S. Independence Day holiday weekend, Clancy said she updated all the items on her Target list because they were not available.

"It can be time consuming because we're looking for substitutions that are beneficial for the animals but are also cost effective for the people who are making a donation," she said.

Target declined to comment.

Amazon said pet food manufacturers are prioritizing top-selling items over niche products because of increased demand. Pet treats and food brands that focus on health and wellness are popular as more people treat their animals as family, according to the company. 


SHOPPING PATTERNS CHANGE

Retailers are working with suppliers to keep pace with customers' demand and changes in shopping patterns so they do not lose business.

U.S. consumers spent nearly $26 billion on pet food from July 2020 to July 2021, up 4.7% from a year earlier and 7.8% from two years earlier, according to NielsenIQ.

Supply shortages reduced online retailer Chewy's net sales by $40 million in the quarter that ended May 2, but they were still up 31.7% from a year earlier at $2.1 billion, the company said.

Operating profits for General Mills' pet division rose 6% to $415 million in the fiscal year ended May 30 as bigger net sales trumped higher input costs. The company, which sells Blue Buffalo pet food, recently bought Tyson Foods' pet treats business for $1.2 billion. "Everything is doing well, because there's more pets and more premiumization, but you're seeing people switch faster than we've ever seen," said Bethany Quam, president of General Mills' pet segment, about changes in where people shop.

In Ontario, Mariella Garcia, 20, said she came up empty in June when she searched Amazon and PetSmart websites for a Royal Canin dog food made by Mars. At the time, COVID-19 restrictions prevented her from entering retail pet stores to shop for her dog Loki, named after the Marvel comic character.

"I was just in shock," Garcia said. "It's usually always in stock."

(Reporting by Tom Polansek and Richa Naidu in Chicago; Editing by Simon Webb and Lisa Shumaker)
Watch a Bipedal Robot Named Cassie Make History by Running Her First Outdoor 5K

Annie Hayes

Should you need inspiration to lace up today, take it from Cassie: a bipdal robot that just made history by running its first outdoor 5k.


Built by Oregon State University and Agility Robotics, the robot tackled the distance totally untethered – and on a single battery charge – completing the race in 53 minutes, which is about the same speed as a gentle stroll for humans.


Though admittedly unlikely to beat any human records anytime soon, Cassie's historic race is all the more remarkable given the robot taught itself to run using a deep reinforcement learning algorithm.

'Deep reinforcement learning is a powerful method in AI that opens up skills like running, skipping and walking up and down stairs,' said Yesh Godse, an undergraduate in the Dynamic Robotics Laboratory at Oregon State University.

Running requires you to maintain your balance while switching positions, so Cassie has learned to make infinite subtle adjustments to stay upright on the move. Designed with knees that bend like an ostrich, it's the first robot to successfully maintain a running gait on outdoor terrain.

© Boston Dynamics/YouTube Can you beat her time?

'Cassie is a very efficient robot because of how it has been designed and built, and we were really able to reach the limits of the hardware and show what it can do,' added Jeremy Dao, a Ph.D. student in same lab.

Unfortunately, the run wasn't all smooth sailing. Cassie's race time included around 6.5 minutes of troubleshooting. The engineers dealt with an overheated computer that caused the robot to collapse – relatable in this heatwave – and a high-speed turn that knocked it off its legs.

'In the not very distant future, everyone will see and interact with robots in many places in their everyday lives, robots that work alongside us and improve our quality of life,' said robotics professor Jonathan Hurst. So, expect to see Cassie at a parkrun near you in the not-too-distant future.


'Very stretchy much strong': Aussie kayaker fixes boat break with condom to aid Olympic bronze run

Ryan Pyette 

Who needs duct tape?
© Provided by National Post Jessica Fox of Australia competes in the Tokyo 2020 Olympics Canoe Slalom Women's C1 - Final at the Kasai Canoe Slalom Centre in Tokyo, Japan on July 29, 2021.

Australian kayaker Jess Fox used a condom in a pinch to fix the damaged nose of her kayak and went on to secure an Olympic bronze medal in the women’s K1 event at the Kasai Canoe Slalom Centre in Tokyo earlier this week.

On her Instagram page, she filmed a member of her crew covering the kayak’s end with a carbon mixture, then stretching the prophylactic over top to secure it.

“Bet you never knew condoms could be used for kayak repairs,” the 27-year-old wrote. “Very stretchy, much strong. It gives the carbon a smooth finish.”

The Tokyo Organizing Committee plans on distributing 150,000 condoms during the Games, but only as athletes leave the socially distant village bubble. They are intended to be used once the athletes return home.

Fox and her team, however, came to the Games prepared with their bizarre kayak band-aid. She comes from a family of Olympic kayakers with parents Richard and Myriam combining for seven world titles.

On Thursday, three-time Olympian Fox finally climbed the podium top, securing an elusive gold in the canoe slalom C1 final — an event she pushed hard to see added to the program this year.

Canada's women's eight rowing crew captures Olympic gold for 1st time in 29 years

Zack Smart 

© Adrian Wyld/The Canadian Press Canadian rowers Lisa Roman, Kasia Gruchalla-Wesierski, Christine Roper, Andrea Proske, Susanne Grainger, Madison Mailey, Sydney Payne, Avalon Wasteneys and Kristen Kit powered their way to a gold in the women's eight final…

Canada's women's eight crew captured gold on the final day of Olympic rowing at the Sea Forest Waterway in Tokyo on Friday, winning the event for the first time in 29 years.

New Zealand claimed silver, finishing ahead of bronze winners China.

The Canadians pulled into the lead and continued to accelerate beyond the pack after a great start, making it clear the crew was bound for the podium.

Canada found itself leading after the first 1,000 metres ahead of Australia and New Zealand, and relentless momentum propelled the unstoppable Canadian boat as the race progressed. Medal favourite Romania fell out of the picture entirely.

The determined Canadians set an unmatchable pace with their lead continuing to grow through 1,500 metres.

New Zealand powered into second and attempted to make a late push, while the Chinese crew also began to make their move, coming seemingly out of nowhere to storm into bronze position.

It was a moment of redemption for returning Olympians Susanne Grainger, Lisa Roman and Christine Roper, who have now helped lead Canada to Olympic glory along with Kristen Kit, Sydney Payne, Madison Mailey, Kasia Gruchalla-Wesierski, Avalon Wasteneys and Andrea Proske.

The only other Olympic gold for Canada in women's eight came at the Barcelona Olympics in 1992, their first time reaching the Olympic podium. Canada's crew enjoyed continued success with silver in 1996 and bronze in 2000.

Canada claimed silver in the women's eight event at the 2012 London Olympics before missing the podium in Rio with a fifth place finish.


GUTLESS UCP BLAMES THE DOCTOR FOR THEIR PANDEMIC STUPIDITY


Alberta's top doctor came up with plan to lift all COVID-19 orders: health minister

CALGARY — Alberta's health minister says it was the idea of the province's chief medical health officer to end isolation requirements for those who test positive for COVID-19 or who have been in close contact with someone who has.
© Provided by The Canadian Press

Tyler Shandro said Dr. Deena Hinshaw came to the government with the plan. He said the government agreed with science and data supporting it and wanted to respect the independence of her position.


“It came from Dr. Hinshaw,” Shandro said Thursday when asked about the province's strategy. “This is work that was developed by those who are in public health."

He acknowledged concerns about moving forward so quickly. “We have many different opinions in the medical community and that’s to be expected and that’s encouraged.”

He also said that while Alberta is alone in Canada in the approach, others will eventually follow suit.


"We are leading the way in moving to the endemic (phase of the COVID-19) response. We've led the way throughout in the response to the pandemic quite frankly."

Hinshaw has always said she presents scientific evidence, numbers and trends, but the final decision on how to respond to pandemic developments lies with the government.

Close contacts of positive cases are no longer notified of exposure by contact tracers, nor are they required to isolate. The government has also ended asymptomatic testing.

As of Aug. 16, individuals who test positive won't be legally required to isolate either — although it will still be recommended. Isolation hotels will close and quarantine supports will end.

Reaction to Hinshaw's announcement Wednesday was swift and critical — much of it on Twitter. Opposition politicians, the medical community and private citizens all weighed in.

On Thursday, Dr. Daniel Gregson, an infectious disease specialist with the University of Calgary, said the government's decision to end mandated isolation is irresponsible.

“The message we’re sending is that if you have an infection with COVID, or think you might have an infection with COVID, you can do whatever you want," said Gregson. "I would not agree with that."

Video: Albertans losing trust in province's COVID-19 messaging, Edmonton doctor says (cbc.ca)

He said a fourth wave is inevitable, primarily among young and healthy individuals. “We are going to see a bump in our hospitalizations. The question is how much?”

Calgary Mayor Naheed Nenshi said it's inconceivable Alberta is eliminating almost all of its remaining COVID-19 public health orders as cases climb in the province.

"It is the height of insanity," Nenshi said.


"It is putting the health of Albertans at risk to stop contact tracing, to stop testing people for the coronavirus and to become one of the first — if not the first — jurisdictions in the world to say that people who have tested positive, who are infectious, can just go about their lives."

Nenshi said if he were in another jurisdiction he would contemplate travel restrictions on Albertans starting Aug. 16.

"I'm aware of no science that backs this up," he said. "Even the most fervent of the anti-maskers wouldn't say (to) unleash people who are actually infectious into the population."


Nenshi said he worries the decision to lift the orders is politically motivated and has nothing to do with science.

Rida Abboud also questioned the province's motives.

Abboud, who teaches at Calgary's Mount Royal University and has a child starting kindergarten in the fall, said the United Conservatives are taking a gamble and the odds aren't in their favour.

"I feel like I'm sending my child into the COVID Wild Wild West," said Abboud. "It really feels like this government has no interest whatsoever in supporting families in ... diminishing the risks to anyone under the age of 12 who can't get vaccinated."

She's also worried about returning to the classroom come September. Abboud said poorly ventilated rooms and teaching an age cohort with lower vaccination rates is concerning, especially as it will be unknown who's infected.

"This government likes to gamble on a lot of different approaches. They've lost in many ways and this is, I think, unfortunately, another one," she said. "It's just so shocking and saddening that it's on the backs of parents and women, in particular."

Opposition NDP Leader Rachel Notley urged the government to reverse course with necessary resources.

“This isn’t fair to Albertans. It’s not fair for them to be exposed and not know,” Notley said. “It’s also quite reasonable to keep asking Albertans who are infected to stay home until they are no longer contagious."


She said the changes will do little to encourage uptake of vaccines.

This report by The Canadian Press was first published July 29, 2021.

— With files from Dean Bennett in Edmonton

Bill Graveland and Alanna Smith, The Canadian Press

 

Hemp goes ‘hot’ due to genetics, not environmental stress

Peer-Reviewed Publication

CORNELL UNIVERSITY

ITHACA, N.Y. – Contrary to claims that environmental or biological stresses cause an increase in THC production in hemp, a new Cornell University study finds no evidence that stress on hemp plants increases THC concentrations or ratios of CBD to THC.

Growing hemp for CBD (cannabidiol) is a burgeoning industry, but when hemp contains more than the legal limit of THC, the plants can test “hot.” State and federal regulations classify hemp as containing 0.3% or less THC; when plants exceed that amount, farmers can lose their entire crop.

“One of our goals in our research and in fulfilling our extension mission is to reduce the risks to growers as much as possible,” said Larry Smart, senior author of the study and professor in the horticulture section of the School of Integrative Plant Science in the College of Agriculture and Life Sciences. “With this research, growers should feel some comfort that stresses do not seem to have a strong effect on changing the ratio of CBD to THC.”

In the study, lead author Jacob Toth, a graduate student in Smart’s lab, created a series of plots in Geneva, New York, that included control plots and five stress treatments applied to three genetically unrelated high-CBD hemp cultivars. Stress treatments included flood conditions; exposure to a plant growth regulator called ethephon, used to promote fruit ripening; powdery mildew; herbicide; and physical wounding. They then tested THC and CBD content over a four-week period when the flowers matured.

“What we found over the weeks that we were sampling, the amounts of CBD and THC went up proportionately in all of these different cultivars for all of these different stresses,” Toth said.

By week four, at harvest time, they found that nearly every plant (except those treated with herbicide, which were nearly dead) produced the expected ratio of CBD to THC, with high levels of CBD corresponding to levels of THC above the 0.3% THC threshold.

The study further proves that genetics, rather than environment, determine the THC content and CBD to THC ratios in hemp, Smart said.

More research and breeding is needed to select appropriate genetics that lead to high CBD but low THC, and regulatory testing may be needed earlier, before harvest and before plants reach high THC levels, Toth said.

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The research from Smart’s lab has assisted the U.S. Department of Agriculture in developing hemp regulations that focus more on genetics rather than environmental stress leading to noncompliant THC levels.

The study published July 28 in the journal Global Change Biology-Bioenergy.

For additional information, see this Cornell Chronicle story.

 

 

Study: Public private partnerships better at promoting equity than widely assumed


University of Maryland researchers find P3 projects set higher DBE goals compared to “design-bid-build”

Peer-Reviewed Publication

UNIVERSITY OF MARYLAND

Adjusted DBE Goals and Adjusted DBE Attainment 

IMAGE: DISTRIBUTIONS OF ADJUSTED DBE GOAL AND ADJUSTED DBE ATTAINMENT BY DELIVERY METHOD view more 

CREDIT: A. JAMES CLARK SCHOOL OF ENGINEERING. UNIVERSITY OF MARYLAND

COLLEGE PARK, Maryland--Public private partnerships have a better track record in promoting equity than many assume, researchers at the University of Maryland’s (UMD) A. James Clark School of Engineering have found.

In fact, they generally set higher U.S. Department of Transportation’s (USDOT) Disadvantaged Business Enterprise (DBE) program goals than do Design-Bid-Build (DBB) projects, the findings suggest.

The newly-released study, conducted by UMD civil and environmental engineering professor Qingbin Cui and doctoral student Kunqi Zhang, and published this month by Transportation Research Record, is the first ever to empirically test how different delivery methods correlate with the setting and attainment of DBE goals--typically expressed in terms of the percentage of contract dollars expected and actually awarded to minority and women-owned businesses that participate in federally-funded transportation projects.

Drawing from the U.S. Major Highway Projects Database, Cui and Zhang sampled 134 federally assisted contracts. Linear regression models created by the team showed that two delivery methods--Design Build/Construction Manager at Risk and P3--outpace DBB in setting equity-related goals.

“In this case, conventional wisdom turns out to be wrong,” Cui said. 

In Ohio, for instance, value-weighted DBE goals stood at 14.3% for P3, 10.7% for Design Build/Construction Manager at Risk, and 9.2% for DBB; in Texas, the numbers were 12.8%, 9.9%. And 8.0%. Similar trends were found nationwide, and DBE goals were also found to be the most robust predictor of actual DBE attainment.

Contract size is an important factor, Cui and Zhang found: the larger the contract, the more opportunities for subcontractors, in turn fostering a greater capacity to meet DBE goals. And both P3 and DB/CMAR dwarf DBB when it comes to contract size, with average amounts of $954.2 million, $466.6 million, and $89.1 million, respectively.

“Larger-scale contracts offer more opportunities for business that might otherwise not be able to get a foot in the door,” Zhang said.

P3 projects may also have an incentive to promote diversity and equity because of the amount of public scrutiny these large, high profile projects often generate. “There’s a public relations component,” Cui said. “Companies involved in these projects are in the media spotlight and they want to be seen as doing the right thing.”

Cui and Zhang conducted their research in partnership with the Maryland Transportation Institute, a UMD research hub that brings together experts from across the University of Maryland System.

The primary source for the study--the U.S. Major Highway Projects Database--was also developed at UMD, under Cui’s direction. Unveiled in 2019, the tool covers nearly two decades of highway projects and allows researchers a ready means to make cross-project comparisons.

###

The A. James Clark School of Engineering at the University of Maryland serves as the catalyst for high-quality research, innovation, and learning, delivering on a promise that all graduates will leave ready to impact the Grand Challenges of the 21st century. The Clark School is dedicated to leading and transforming the engineering discipline and profession, to accelerating entrepreneurship, and to transforming research and learning activities into new innovations that benefit millions.

JOURNAL

Transportation Research Record

DOI

10.1177/03611981211031210

Common floral bacteria can induce pollen germination


The bacteria can double amount of protein released from pollen


Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - DAVIS

Pollen with Acinetobacter 

IMAGE: THIS IMAGE SHOWS WHAT POLLEN LOOKS LIKE WITH ACINETOBACTER, A GENUS OF BACTERIA COMMON IN FLOWERS. MANY OF THE POLLEN GRAINS ARE GERMINATING AND BURSTING. view more 

CREDIT: SHAWN CHRISTENSEN, UC DAVIS

Certain species of floral bacteria can enhance pollen germination, according to a study published today from the University of California, Davis in the journal Current Biology.

“This is the first paper documenting stimulation of pollen germination by non-plants,” said first author Shawn Christensen, a doctoral candidate in associate professor Rachel Vannette’s laboratory in the Department of Entomology and Nematology. “Nectar-dwelling Acinetobacter bacteria stimulate protein release by inducing pollen to germinate and burst, benefitting Acinetobacter.”

Acinetobacter is a genus of bacteria very common in flowers. They are usually among the most abundant bacteria in nectar and are often found on other floral tissues, including pollen and stigmas.

The authors collected California poppies from the UC Davis Arboretum and Public Garden, and Acinetobacter primarily from nearby Stebbins Cold Canyon Reserve, which is part of the UC Natural Reserve System.

“Despite the essential nutritional role of pollen for bees and other pollinators, we still know very little about how pollen is digested by anything,” Christensen said. “We found out that certain bacteria in flowers, Acinetobactercan send a chemical signal to pollen that hijacks its systems and tells it to open the door from the inside--releasing protein and nutrients for the bacteria.”

Christensen said the bacteria can double the amount of protein released from pollen. That makes it important for bacterial growth, but it could also be exploited by bees or other pollen consumers to get more nutrition from their food.

The question of how organisms actually eat pollen has been a long-standing one. Pollen is well-protected by layers of resistant biopolymers, and it's unclear how pollen-eaters get through those protective layers.

“The bacteria have found what looks like a fairly unique and very effective way to get nutrients, which are otherwise scarce in a flower environment,” said Vannette, a UC Davis Hellman Fellow. “It's a very neat biological trick. This finding opens the door for a lot of exciting new research: How do the bacteria do it? Given that Acinetobacter is often found on pollinators, do pollinators benefit from this? Could bacterial action on pollen make it more, or less, beneficial to pollen-eaters? And what about plants? Could the bacteria be reducing pollination by causing pollen to germinate before fertilization? We aim to investigate many of these possibilities in future work.” 

Additional co-authors include Ivan Munkres of UC Davis.

The research was funded by the National Science Foundation, Davis Botanical Society, and UC Davis Microbiology Graduate Group Diversity Equity and Inclusion Award.

 











 

Has the billion dollar crusade to eradicate polio come to an end?


Special report explores WHO’s shift away from global eradication

Peer-Reviewed Publication

BMJ

The polio juggernaut, which has skidded past eradication deadline after deadline, seems to have finally run out of fuel, suggests an investigation published by The BMJ today.

Journalist Robert Fortner reveals that the World Health Organization (WHO) has already fired 500 staff on the polio programme - “perhaps ending a decades long, multibillion dollar crusade engineered by some of the most powerful actors in global health.”

According to Fortner, not even the Bill & Melinda Gates Foundation - topmost funder of polio initiatives and behind only the US government as the largest funder of WHO - knew about these plans.

Since the effort to eradicate polio began in 1988, the Global Polio Eradication Initiative (GPEI) has pushed polio to near annihilation, reducing cases by 99.99%.

Yet the GPEI has been perched, exhaustingly and expensively, at the cusp of success for years, writes Fortner. In 2017, for example, Bill Gates predicted that “humanity will see its last case of polio this year.” Instead, cases surged.

The pandemic put polio efforts on hiatus for several months in 2020. Then in December, WHO decided to speed up integration of the polio programme into existing immunisation services - something that for decades has been considered anathema.

This was followed by WHO’s regional office for Africa (AFRO) firing some 500 polio programme staff - surprising GPEI’s partner groups and donor nations including the UK’s Foreign, Commonwealth & Development Office, and the US Agency for International Development (USAID).

The GPEI explicitly separated polio from routine immunisation because eradication requires very high coverage rates: 90% or more. Yet some argue that the money lavished on polio has left millions of children vulnerable to other, often deadly, vaccine preventable diseases, such as measles. 

Polio funds from abroad have also led to local brain drains - into eradication and away from local and locally funded health priorities.

Aidan O’Leary, who took over as director for polio eradication at WHO after the December transition decision had been taken, describes GPEI partners’ commitment to eradication as “pretty unequivocal.” 

But Fortner notes that the once indomitable tone now seems muted, and he points to funding cuts and challenges in Afghanistan and Pakistan (the two remaining countries where polio remains endemic) as factors that could sink eradication.

Even if we bravely assume adequate funding, would integrated health service delivery also deliver eradication, he asks? 

Integrated delivery has “not ever really been tested for an eradication programme,” says Nicholas Grassly, an epidemiologist at Imperial College London and an independent adviser to GPEI. 

Meanwhile, a paper published in The Lancet earlier this year, entitled “Polio eradication at the crossroads” suggests that eradication of all poliovirus from the planet has never actually been possible. The reasons include the likelihood of containment breaches of the virus kept in scientific facilities and the ability to synthesise polio.

The problems aren’t new, but the authors use them as the basis for a new policy direction, notes Fortner: “The objective of our efforts should be to eliminate the disease, not the virus.” We can still “eradicate polio” because in lay terms both the disease and the virus go by the same name. The means proposed, much as envisaged in the new polio strategic plan, are “global immunisation programmes.”

Zulfiqar Bhutta, a paediatrician at Aga Khan University, says that GPEI “may need to call the new reality the new eradication.”

 

 #LEGALIZEDRUGS

Ease access to opioid addiction medication, new research suggests


OHSU evidence review encourages the use of primary care clinics to improve access to methadone treatment for opioid use disorder

Peer-Reviewed Publication

OREGON HEALTH & SCIENCE UNIVERSITY

With overdose deaths surging during the COVID-19 pandemic, new findings from researchers at Oregon Health & Science University suggest easing access to a key medication to treat addiction.

An evidence review published today in the American Journal of Psychiatry recommends making methadone more widely available through office-based visits with primary care physicians. The current federal standard largely requires it to be administered only through specialized clinics.

The study is one of five evidence reviews led by Dennis McCarty, Ph.D., professor emeritus of public health and preventive medicine in the OHSU School of Medicine and the OHSU-Portland State University School of Public Health, and Roger Chou, M.D., director of the OHSU Pacific Northwest Evidence-Based Practice Center.

“Methadone is the most highly regulated medical treatment in the U.S.,” McCarty said.

It is one of three medicines approved by the Food and Drug Administration to treat opioid dependence, along with buprenorphine and naltrexone. Methadone is a full agonist, meaning it fully acts on the same targets in the brain as prescription opioids or heroin. Buprenorphine is a partial agonist, and naltrexone is an opioid antagonist. Methadone and buprenorphine inhibit opioid withdrawal symptoms, while naltrexone blocks the euphoric effect of opioids.

Federal regulations originally established in 1971 require methadone to be administered through federally certified opioid treatment programs, to reduce the risk of overdose among people who are less tolerant as well as the risk of patients “diverting” it to sell to people without a prescription.

The study published today suggests the need to revisit regulations requiring methadone to be administered only in specialized clinics. McCarty noted that allowing methadone to be administered and dispensed in primary care clinics will reduce hefty transportation costs currently paid by Medicaid while also greatly improving access and convenience for patients with addiction.

“If you’re on the coast and you have to drive to a methadone clinic in Roseburg, that’s a two-hour drive,” McCarty said.

McCarty and Chou found 18 studies of methadone completed in office-based settings such as primary care, and that patients in those settings had better treatment retention rates and greater satisfaction compared to patients who received care in opioid treatment programs. However, their study was limited by the fact that only highly stable patients were recruited to participate in these studies.

It remains to be seen whether it would work for all patients.

“We don’t know, because nobody’s tried it,” McCarty said. “Some patients stabilize very quickly. They have a job, they have a family and their life is in pretty good order.”

The nation’s opioid epidemic has worsened during the pandemic.

Provisional data from the U.S. Centers of Disease Control and Prevention found the number of drug overdose deaths in the United States exceeded 90,000 for the calendar year that ended in December, up 29% from the previous year.

The OHSU research was supported by Arnold Ventures, which contracted with McCarty and Chou to conduct a broad review of methadone policy research with recommendations for changes in federal regulations.

The work culminated in five publications, including the one published today in the American Journey of Psychiatry.

Each study generally suggested easing access to methadone:

  • Interim methadone: Federal regulations require patients to be assigned to a counselor at the initiation of methadone treatment, with an exception granted for clinics with a full caseload. They found six studies that consistently found that patients treated through this exception found quicker access to medication, decreased drug use, enhanced retention and better outcomes than those forced to wait. Published online in the journal Drug and Alcohol Dependence.
  • Mobile methadone medication units: In a study published online in the Journal of Substance Abuse Treatment, researchers found only four poorly controlled studies regarding the effectiveness of mobile medication units allowed by the U.S. Drug Enforcement Administration to administer and dispense methadone in rural communities and other underserved locations. They conclude that new regulations should create opportunities for more research and economic analysis of mobile services, which do appear to improve access to people living in rural areas, living with housing instability and having more severe cases of opioid use disorder.
  • Adolescents and young adults: An OHSU review in the Journal of Addiction Medicine found that access to mediations for opioid use disorder increased with age, and that federal regulations should be reviewed to encourage development of age-appropriate services for younger people with opioid use disorder.
  • Telemedicine: With the onset of the COVID-19 pandemic, federal authorities loosened regulations to allow treatment programs to use telehealth services. OHSU’s review of studies conducted to date suggest that telemedicine outcomes were comparable to in-person care, and that access to telemedicine care should become routine in opioid treatment programs and in primary care settings.

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