Nicotine and Opioids: a Call for Co-treatment as the Standard of Care.
Monday, June 15, 2020
Posted by: Natalia Gromov
Chad D. Morris, PhD, Christine E. Garver-Apgar, PhD.
Nicotine and Opioids: a Call for Co-treatment as the Standard of Care.
J Behav Health Serv Res. 2020 Jun 3 : 1–13. doi: 10.1007/s11414-020-09712-6 [Epub ahead of print]
The U.S. is in the midst of an opioid epidemic. At the same time, tobacco use remains the
leading cause of preventable death and disability. While the shared biological underpinnings of
nicotine and opioid addiction are well established, clinical implications for co-treatment of these
two substance use disorders has not been emphasized in the literature, nor have researchers,
clinicians, and policy makers adequately outlined pathways for incorporating co-treatment into
existing clinical workflows. The current brief review characterizes the metabolic and neural
mechanisms which mediate co-use of nicotine and opioids, and then outlines clinical and policy
implications for concurrently addressing these two deadly epidemics. Screening, assessment,
medication-assisted treatment (MAT), and tobacco-free policy are discussed. The evidence
suggests that clinical care and policies that facilitate co-treatment are an expedient means of
delivering healthcare to individuals that result in better health for the population while also
meeting patients’ substance abuse disorder recovery goals.
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