Opioid-use-disorder - Articles - Page 2

Management of Opioid Withdrawal in the Emergency Setting

March 19, 2021

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

An emergency department visit can be a “reachable moment” for people with unhealthy opioid use. Here, we review pharmacologic and harm-reduction strategies for use in those settings—and how to advocate for your patients when consulting with emergency clinicians.

Supporting Patients With Pain and Addiction

February 3, 2021

Ajay Manhapra, MD

Ajay Manhapra, MD

Section Chief, Pain Medicine, Department of Physical Medicine & Rehabilitation Services, Hampton VA Medical Center. Assistant Professor, Departments of Physical Medicine & Rehabilitation and Psychiatry, Eastern Virginia Medical School, Norfolk, VA; Lecturer in Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Manhapra has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Manhapra works with patients with disabling chronic pain, many of whom meet criteria for substance use disorders. He describes his approach to these intersecting phenomena, the biology of pain and its relationship to the reward system, and outlines an approach to improving function among patients with addiction and severe pain.

Can Assertive Treatment Improve Treatment Adherence in Young Adults With Opioid Use Disorder?

December 10, 2020

Deepti Anbarasan, MD.

Deepti Anbarasan, MD. Dr. Anbarasan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Adherence may often limit effectiveness of medications for opioid use disorder among youth. In this randomized controlled trial, young adults with opioid use disorder were randomized to either youth opioid recovery support (an assertive intervention designed to increase adherence) or treatment as usual, both involving extended-release naltrexone.

CLINICAL UPDATE

Despair, Loneliness, and Substance Use Disorders

October 21, 2020

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Loneliness is a readily measurable phenomenon and it predicts worse outcomes in addiction treatment on the individual and population levels. What can we do in the clinic to combat loneliness and promote social cohesion?

Faith and Addiction

October 21, 2020

Jesse Koskey, MD.

Jesse Koskey, MD. Psychiatrist at Kaiser Permanente, CA. Dr. Koskey has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Faith may be a protective factor against addiction, and some widely accepted treatments use faith to build recovery capacity. This article reviews the evidence for faith-based treatment and provides suggestions for incorporating faith in the clinic.

“What About the Implant, Doc?” Appraising Various Formulations of Buprenorphine

August 6, 2020

Edmund S. Higgins, MD.

Edmund S. Higgins, MD. Clinical Associate Professor of Psychiatry and Family Medicine, MUSC, Charleston, SC. Dr. Higgins has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buprenorphine can be administered via intravenous, transdermal, sublingual, buccal, and implanted formulations. We appraise the evidence for various formulations and suggest certain populations for which certain formulations may be a better choice.

Updated Guidelines for Treating Opioid Use Disorder

August 6, 2020

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity

The American Society of Addiction Medicine released updated guidelines for the management of opioid use disorder (OUD) in March, 2020. They focus on expanding access to methadone and buprenorphine. Additionally, detailed guidance is given for perioperative management of OUD and pain management in patients with OUD.

A Possible Option in Opioid-Related Harm Reduction

August 6, 2020

Greg Sazima, MD

Greg Sazima, MD Dr. Sazima has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Medications are the mainstay of treatment for opioid use disorder (OUD), but what if patients decline buprenorphine, injectable naltrexone, and methadone? In this randomized trial, authors compared hydromorphone (Dilaudid) with diacetylmorphine (the active ingredient in heroin) among patients who reported injecting heroin.

EXPERT Q&A

Gabapentin Misuse and Diversion

June 10, 2020

Rachel Vickers-Smith, PhD, MPH

Rachel Vickers-Smith, PhD, MPH
Assistant Professor at University of Louisville, KY. Dr. Vickers-Smith has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Clinicians are increasingly turning to gabapentinoids as non-opioid alternatives for pain treatment. Yet we may be inadvertently introducing new risks in so doing. Dr. Vickers-Smith reviews current epidemiology of gabapentinoid use and offers some clues regarding how to turn the tide on gabapentin misuse.

SAMHSA Relaxes Regulations on Methadone and Buprenorphine During COVID-19 Emergency

June 10, 2020

Benjamin Oldfield

Benjamin Oldfield Editor-in-Chief of CATR. Clinical Instructor in Medicine and Pediatrics at Yale School of Medicine; Chief Medical Officer at Fair Haven Community Health Care, CT. Dr. Oldfield has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

In the context of a pandemic, how can and should our practices change to continue to meet the needs of patients with opioid use disorder? We summarize recent changes to the regulations surrounding medications for opioid use disorder: buprenorphine and methadone.