stat investigation
The War on Recovery: How 'liquid handcuffs' make recovery harder
Alex Hogan / STAT
Highly effective at treating opioid addiction, methadone can also make people prisoners of the drug-treatment system, requiring them to travel each day to wait in line before swallowing a small cup's worth of medication. For Rebecca Smith in Detroit, that meant quitting her job. "This is not helping me in my recovery," she said.
She is not alone.
Lev's investigation shows that many of the nation's methadone clinics rely on controlling and punitive strategies that make it harder for patients to maintain their recovery. Patients at methadone clinics go to extraordinary lengths to receive their medication, complying with rules and suffering indignities that would be unthinkable in any other health care setting. Patients call their medications "liquid handcuffs."
Clinics' rigid policies have made methadone treatment so difficult that some patients contemplate swearing off the medication altogether. In many cases, those who did give up on methadone returned to using heroin or fentanyl almost immediately.
"Almost every single person I know who has overdosed has been on methadone at some point, and couldn't hack the restrictions or was terminated for some arbitrary reason," said Caty Simon, an advocate with the Urban Survivors Union and co-author of the "Methadone Manifesto," a 2021 call for major reforms to the methadone treatment system.
Read more on today's methadone clinics and how new rules might shift treatment in the future.
health tech
Beware blind spots in medical devices and algorithms, U.K. researchers warn
Medical devices like pulse oximeters and AI tools trained on only light skin tones to detect skin cancer can harm underrepresented racial and ethnic groups, said a U.K. review released yesterday. The report also sounded an alarm on algorithms that might underestimate heart disease risk in women and genomic tests such as polygenic risk scores based on limited populations. Originally commissioned by the U.K government after problems with pulse oximeters emerged in 2022, the report's remit was extended to AI-enabled programs and certain genomic tests.
"Few outside the health system may appreciate the extent to which AI has become incorporated into every aspect of health care, from prevention and screening to diagnostics and clinical decision-making, such as when to increase intensity of care," the researchers wrote. STAT's Andrew Joseph has more.
biotech
First drug to treat MASH may win approval soon
The serious liver disease known as MASH may soon get its first medicine developed specifically for patients with advanced disease. The FDA is expected to approve resmetirom, a daily pill made by Madrigal Pharmaceuticals, as soon as this week, STAT's Adam Feuerstein reports. MASH stands for metabolic dysfunction-associated steatohepatitis, an illness previously called NASH that often comes with obesity. Accumulated fat in the liver causes inflammation, which leads to liver scarring that can progress to cirrhosis, cancer, and the need for a liver transplant.
Resmetirom targets a protein in the liver that reduces liver fat, inflammation, and scarring. It would help people when diet, exercise, or the blockbuster GLP-1 drugs Wegovy and Zepbound are no longer beneficial. "This is like taking the floaties off and jumping into the deep end of the pool, because we can now have real conversations and offer real treatment to our patients," said Stephen Harrison, who led resmetirom's Phase 3 study. Read more.
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