opioid-epidemic - Page 1 | CARLAT PUBLISHING

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.

Psychopharm Commandment 7A: Red Flags & Controlled Meds

April 3, 2023

Chris Aiken, MD and Kellie Newsome, PMHNP

The DEA has warned pharmacists to watch for Red Flags in controlled prescriptions, and we’ll show you what they are and how to use them therapeutically in practice.

Drug Overdoses in the US: Trends and Prevention Strategies

November 5, 2021

Joshua Sharfstein, MD

Joshua Sharfstein, MD

Professor of the Practice of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

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

Increases in drug overdose mortality continues unabated around the country driven by widespread availability of illicit fentanyl and methamphetamines. Dr. Sharfstein provides context to these concerning trends and discusses prevention and harm reduction strategies clinicians can implement for their patients.

Naloxone Prescribing

July 3, 2021

Phillip Coffin, MD

Phillip Coffin, MD
Director of Substance Use Research, San Francisco Department of Public Health, San Francisco, CA. Dr. Coffin has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Coffin provides our readers with everything there is to know about the nuts and bolts of naloxone prescribing for opioid use disorder. He tells us how patients can get their hands on naloxone, reviews the pros, cons, and costs of various naloxone formulations, and covers current naloxone laws.

“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.

EXPERT Q&A

Benzodiazepines: Old Medicines, New Concerns

June 10, 2020

Kenneth Morford, MD

Kenneth Morford, MD
Assistant Professor and Program Director, Collaborative Behavioral Health & Addiction Medicine in Primary Care (CHAMP) at Yale School of Medicine. Dr. Morford has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Benzodiazepine use is on the rise, and is implicated with a significant portion of opioid-related overdose deaths. Dr. Morford gives the latest on benzodiazepine prevalence and suggests strategies to employ in addiction treatment settings when working with patients who use benzodiazepines.