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Opioid Use Disorder: Detoxification and Long-Term Treatment

Author: Noah Carpenter, MD and Jennifer McAnally, BS, BSN, DNP and Kellie Wilson, PharmD

CE: 2 hours Pharmacology: 0.5 hour
Rated 4.7 out of 5.0 based on 15424 reviews

Course Summary

Opioids can be extremely valuable medications for pain management but the euphoric properties of opioids can often lead to a substance use disorder. Although the cycle of opioid misuse can be treated, opioid withdrawal is a difficult process that comes with its risks and side effects. Proper medical management of both acute and chronic withdrawal symptoms provides the best opportunity for a permanent positive outcome. Current evidence shows that medical-assisted treatment of opioid use disorder improves a patient’s recovery outcomes. There are ongoing studies on the relapse rate and overdose rate for patients continuing in medical-assisted treatment (MAT). This is particularly true for patients who have completed detoxification because of opioid use. It is vitally important that these patients who, after assessment, are found to have an opioid use disorder, be transitioned into a treatment program to address the opioid use disorder; otherwise, relapse is more likely. The benefit of agonist therapies, methadone and buprenorphine/naloxone are discussed. Reference is also made to the American Society of Addiction Medicine (ASAM) 2015 National Practice Guidelines, which informs providers who are medication-assisted treatment credentialed of current approved agents to treat opioid use and overdose.

Course Format


Course Syllabus

I.      Introduction
II.      Prescription and Illicit Opiates
III.     Substance Use and Withdrawal
               1.   Physical Symptoms
               2.   Psychological Symptoms
IV.      Treatment Programs for Opioid Withdrawal Symptoms
               1.   Outpatient Treatment
               2.   Inpatient Treatment
V.      Potential Complications and Treatment Barriers
               1.   Pregnancy
       2.   Failure to Transition from Detoxification to Long-Term Treatment
                3.   Suicide Risk
VI.     Pharmacologic Detoxification and Medication-assisted Treatment
                1.   Detoxification
                2.   Medication-assisted Treatment (MAT)
                3.   Treatment Options for Withdrawal and Substance Use Disorder
                4.   Cognitive Behavioral Therapy and Relapse Prevention
VII.      Case Study 1: Opioid Use Disorder and Buprenorphine Treatment
VIII.     Case Study 2: Case of Buprenorphine/Naloxone Rapid Taper
IX.       Summary


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