Please note: This is the pharmacology version of the course: Opioid Use Disorder: Detoxification and Long-Term Treatment N164D. Click here to take the general version (no pharmacology CEs).

Course Summary

Expiration Date: 12/26/2028

Opioid Use Disorder presents significant challenges due to its euphoric properties and the severe withdrawal symptoms experienced upon cessation. Effective management requires a comprehensive approach, transitioning patients from initial detoxification to long-term treatment. This includes Medication-Assisted Treatment such as buprenorphine/naloxone and methadone, combined with counseling and behavioral therapies. While these treatments are effective in reducing cravings, illicit opioid use, and mortality, rapid discontinuation carries a high risk of relapse and overdose. Barriers to successful treatment include stigma, accessibility issues, co-occurring disorders, and adherence challenges. Continuous, individualized care and a focus on long-term engagement are crucial for sustained recovery.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • Prescription and Illicit Opiates
  • Substance Use and Withdrawal
    • Physical Symptoms
    • Psychological Symptoms
  • Treatment Programs for Opioid Withdrawal Symptoms
    • Outpatient versus Inpatient Treatment
    • Complications and Treatment Barriers
    • Failure to Transition from Detoxification to Long-Term Treatment
  • Detoxification and Medication-assisted Treatment
    • History of MAT: SUPPORT for Patients and Communities Act
    • Prescription Drug Monitoring Program
    • Methadone
    • Buprenorphine
    • Naltrexone
    • Withdrawal Management with Alpha-2 Adrenergic Agonists: Lofexidine and Clonidine
    • Naloxone
    • Evidence Supporting MAT
    • Future Research
    • Psychosocial Treatment and Relapse Prevention
  • Case Study 1: OUD and Buprenorphine Treatment
  • Case Study 2: Case of Buprenorphine/Naloxone Rapid Taper
  • Summary

Author

Marilyn Lajoie, MD, DC, CCSP

Dr. Marilyn Lajoie obtained her medical degree from Saba University School of Medicine in 1999, Her residency began with one year of Anatomical and Surgical Pathology at Orlando Regional Medical Center, before transferring within the same post-graduate residency program to Internal Medicine. Upon completion of residency, she went into private practice in Orlando, where she specialized in Internal Medicine, Sports Medicine and Rehab, as well as acute and chronic pain management. Before becoming a medical doctor, she had practiced as a Chiropractic Physician, graduating from New York Chiropractic College in 1980, practicing initially on Long Island, N.Y., before moving to Florida where she had a successful chiropractic practice and physical rehabilitation center, and gained recognition as a Certified Chiropractic Sports Physician. Dr. Lajoie was also the Director of Physical Therapy at Horizon Hospital, a residential and outpatient psychiatric hospital, and later, continued in the same capacity at Horizon’s sister psychiatric hospital in Brooksville, Florida. Dr. Lajoie maintained her chiropractic license and continued to practice both Internal Medicine and Chiropractic throughout private practice, until moving to the Veterans Healthcare System in 2014. Continuing in both fields, she became the Deputy Chief of Staff for the Montana VA, where she completed her service in 2021. Dr. Lajoie now works predominantly in telemedicine, and in an Expert Witness capacity for both medical and chiropractic cases. Still living in Montana, she enjoys being able to treat not only the rural areas of the state through this technology, but also patients across the US where she maintains multiple active state licenses. She and her husband also own a llama ranch with over thirty llamas that are hand selected for rare genetics. At the llama ranch, the public is invited to come and visit to learn about these elegant creatures, and to see ranch life firsthand – llama style! Dr. Lajoie and her husband have six adult children, as well as seven dogs.