Addiction Policy Forum Blog

Mark Gold, MD

Dr. Mark S. Gold is a teacher of the year, translational researcher, author, mentor and inventor best known for his work on the brain systems underlying the effects of opiate drugs, cocaine and food. Read more by Dr. Gold here.

Recent Posts

4 min read

Why are habits so hard to break?

By Mark Gold, MD on May 16, 2019

Addiction, Model-Free Learning, and Reward Devaluation

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4 min read

How Does Spirituality Change the Brain?

By Mark Gold, MD on May 3, 2019

 

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4 min read

Fentanyl-adulterated Cocaine: Strategies to Address the New Normal

By Mark Gold, MD on April 25, 2019

At the center of America’s deadly opioid epidemic, non-pharmaceutical fentanyl appears to be finding its way into illegal stimulants that are sold on the street, such as cocaine. Adulteration with fentanyl is considered a key reason why cocaine’s death toll is escalating. Cocaine and fentanyl are proving to be a lethal combination - cocaine-related death rates have increased according to national survey data. This has important emergency response and harm reduction implications as well—naloxone might reverse such overdoses if administered in time. A recent study by Nolan et. al. assessed the role of opioids, particularly fentanyl, in the increase in cocaine-involved overdose deaths from 2015 to 2016 and found these substances to account for most of this increase.

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3 min read

The Paradox of Diverted Buprenorphine

By Mark Gold, MD on April 19, 2019

Buprenorphine, a μ-opioid (pronounced mu-opioid) receptor partial agonist, is a highly effective, evidence-based medication for treating opioid use disorders (OUD). In order to prescribe buprenorphine, qualifying practitioners must obtain a waiver from the Drug Enforcement Agency (DEA), which places strict limits on the number of patients they may treat annually. Previous legislation and regulation meant buprenorphine treatment existed nearly entirely outside the traditional healthcare system. Despite legislation that increases the number of patients a doctor can prescribe to, and allowing individual medical providers to become certified, there is still hesitation among many providers over becoming certified to prescribe the medication, many waivered physicians do not have many patients on buprenorphine - some waivered physicians have none at all.

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3 min read

Coordinating Care for Pregnant and Postpartum OUD Patients

By Mark Gold, MD on April 11, 2019

Coordinating Care for Pregnant and Postpartum OUD Patients

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4 min read

Geographic Distribution of Opioid-Related Mortality in the Third-Wave Opioid Epidemic

By Mark Gold, MD on April 4, 2019

The opioid epidemic is a devastating public health crisis - over 47,600 overdose deaths in 2017 involved an opioid, and this number has seen a dramatic uptick in the last decade. Opioid-related mortality emerged as a public health issue in the 1990s,  which led to a common cultural understanding of the opioid epidemic as a rural issue (concentrated in the Midwest and Appalachia) caused by an increase in the prescription of oxycodone. Emerging research suggests that the narrative of the current crisis is not so simple - that in fact there are multiple co-occurring and distinct epidemics, characterized by different types of opioids as well as  geographical footprint.

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