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Expert Q&A

Starting Medication for Opioid Use Disorder

May 29, 2023

Gretchen Hermes, MD, PhD.

Medical Director, APT Foundation; Assistant Professor, Department of Psychiatry, Yale School of Medicine, New Haven, CT.

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

Dr. Hermes discusses the intricacies of medications for opioid use disorder by outlining the advantages, disadvantages, and side effect profile of each. She will help you choose the best treatment approach for your patients with opioid use disorder by providing a review of relevant literature and gives you language to use in the clinic.

Clinical Update

Medication Treatments for Alcohol and Opioid Use Disorder in Older Adults

May 11, 2023

Rehan Aziz, MD.

Rehan Aziz, MD. Associate program director, Geriatric Psychiatry Fellowship Program, Jersey Shore University Medical Center, Neptune, NJ; associate professor of psychiatry and neurology, Hackensack Meridian School of Medicine, Nutley, NJ.

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

With three FDA-approved medications for alcohol use disorders and three FDA-approved medications for opioid use disorders, it can be hard to know where to start. Here we review the pros and cons of these six medications—and provide recommendations for their use in older adults.

Expert Q&A

Interpreting Urine Drug Tests

April 1, 2023

Karen Moeller, PharmD

Karen Moeller, PharmD. Clinical professor, Department of Pharmacy Practice, University of Kansas School of Pharmacy. Lawrence, KS. Board-certified psychiatric pharmacist, inpatient psychiatry unit, University of Kansas Health Systems. Kansas City, KS.

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

Drug screen accuracy depends on several factors, including the type of lab test, the number of hours since the patient’s use of the drug, and more.. Dr. Moeller reviews key points.

CLINICAL UPDATE

Perioperative Pain Management in Opioid Use Disorder

March 19, 2021

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.

Previously, clinicians commonly stopped opioid agonists (methadone and buprenorphine) to simplify pain control during and after surgery. New guidance from the American Society of Addiction Medicine now suggests otherwise.

EXPERT Q&A

Opioid Use Disorders and Serious Mental Illness

December 10, 2020

Sandra Gomez-Luna, MD

Sandra Gomez-Luna, MD
Clinical Assistant Professor at Yale University. Adult, adolescent, and child psychiatrist in Darien, CT. Dr. Gomez-Luna has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Those with serious mental illness and unhealthy opioid use have special treatment considerations due to polypharmacy and overlapping stigma. Dr. Gomez-Luna walks us through these nuances and explains microdosing of buprenorphine—a helpful technique for starting treatment in patients who may have other opioids on board.

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.

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.

Treating Addiction in Patients Transitioning to/from Incarceration

August 1, 2019

Karen Cropsey, PsyD

Karen Cropsey, PsyD

Conatser Turner Endowed Professor of Psychiatry, University of Alabama at Birmingham.

Dr. Cropsey has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Addiction treatment during incarceration is limited, and release from incarceration presents its own set of challenges. In this QA interview, Dr. Karen Cropsey discusses effective treatment options for patients with substance use disorders transitioning to or from incarceration.