Opioids - Articles | CARLAT PUBLISHING

Expert Q&A

Managing Withdrawal From Multiple Substances

January 1, 2025

Darius Rastegar, MD

Associate professor of medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Dr. Rastegar has no financial relationships with companies related to this material.

Substance use disorders are highly comorbid with one another and it is therefore common to have patients presenting for care withdrawing from multiple substances at one time. Here, Dr. Rastegar discusses how to assess patients with multiple withdrawal syndromes and how to treat them.

Clinical Update

Three Buprenorphine Dosing Strategies When Transitioning From Other Opioids

April 1, 2024

Monthe Kofos, DO and Noah Capurso, MD

Monthe Kofos, DO. Addiction Psychiatry Fellow, Yale University, New Haven, CT.

Noah Capurso, MD, MHS. Associate Professor of Psychiatry, Yale University, New Haven, CT; Editor-in-Chief, The Carlat Addiction Treatment Report.

Dr. Kofos and Dr. Capurso have no financial relationships with companies related to this material.

The process of starting a patient on buprenorphine, called an induction, can be a bit tricky and puts a patient at risk of a precipitated opioid withdrawal. In this article, we discuss the three most common buprenorphine induction approaches, review the pros and cons of each, and include straightforward guidance that will help you perform a successful buprenorphine induction for your patients.

Clinical Update

Xylazine: An Emerging Threat in the Opioid Overdose Epidemic

October 31, 2023

Roberto Sanchez, MD and Noah Capurso, MD

Roberto Sanchez, MD. Addiction psychiatry fellow, Yale University School of Medicine, New Haven, CT.

Noah Capurso, MD, MHS. Assistant professor of psychiatry, Yale University, New Haven, CT; Editor-in-Chief, The Carlat Addiction Treatment Report.

Dr. Sanchez and Dr. Capurso have no financial relationships with companies related to this material.

Xylazine is the latest contaminant being found in the American illicit drug supply. A non-opioid itself, xylazine is usually combined with fentanyl, with which it has synergistic sedative effects. Patients using xylazine can have profound levels of sedation and develop severe peripheral wounds. In this article, we discuss xylazine essentials and cover harm reduction strategies to help keep your patients safe.

Expert Q&A

Managing Substance Use in Older Adults

May 9, 2023

Louis Trevisan, MD.

Louis Trevisan, MD.

Clinical professor of psychiatry, Creighton University School of Medicine, Omaha, NE; associate professor of psychiatry, adjunct, Yale School of Medicine, New Haven, CT.

Dr. Trevisan has no financial relationships with companies related to this material.

How do we best approach screening for substance use disorders in older adults? Dr. Trevisan walks us through his approach to choosing the right screening tools and speaking with patients.

Elvis Presley and Pharmacokinetics - Part 2

February 5, 2023

Chris Aiken, MD and Kellie Newsome, PMHNP

This common pharmacokinetic reaction will help you manage many bad medication reactions in psychiatric practice. But did it lead to Elvis Presley’s death?

Elvis, Adderall, and a Broken Heart - Part 1

January 29, 2023

Kellie Newsome, PMHNP and Chris Aiken, MD

A new medical investigation changes our understanding of Elvis Presley’s untimely death and offer some pearls for modern psychiatric practice.

Throwback Thursday: Lithium’s Medical Benefits

November 10, 2022

Chris Aiken, MD and Kellie Newsome, PMHNP

Lithium has hidden health benefits against stroke, cancer, dementia, and even the coronavirus.

Psychopharm Commandment 5: Benzos Opioids

November 7, 2022

Chris Aiken, MD and Kellie Newsome, PMHNP

Benzos are never safe with opioids, but we clarify when the risk is lower and when the combo is best avoided.

10 Psychopharm Commandments: Med Withdrawal

September 26, 2022

Chris Aiken, MD and Kellie Newsome, PMHNP

When to stop meds quickly, and when to do it slowly, in #2 of our 10 Commandment series.

A Single Prescriber Reduces Risk of Overdose in Patients on Opioid and Benzodiazepine

September 25, 2022

Kamron Fariba, MD

Kamron Fariba, MD. Dr. Fariba, author of this educational activity, has no relevant financial relationship(s) with ineligible companies to disclose.

This large study suggests a practical solution to reduce mortality in patients who are taking both benzodiazepines and opioids.