Podcasts about Buprenorphine

In this episode, we discuss the fundamentals of treating opioid and alcohol use disorders with medication-assisted approaches. We review how to understand addiction as self-regulation with substances and how healthcare providers can leverage familiar medications alongside specialized treatments to help patients recover.We also discuss• Addiction fundamentally involves helping patients shift from self-regulating with substances to self-regulating without them• Distinguishing opioid dependence (physical brain chemistry changes) from opioid use disorder (psychological addiction)• Buprenorphine as a partial agonist that blocks other opioids, reduces cravings, and decreases overdose risk by 70%• Three FDA-approved medications for alcohol use disorder: disulfiram , naltrexone, and acamprosate• Off-label medications like gabapentin and topiramate can enhance alcohol use disorder treatment• Understanding the fentanyl crisis and emergence of counterfeit pills containing dangerous synthetic opioids• Addressing stigma through person-first language and recognizing addiction as a disorder of executive functioningTo contact Dr. Grover: ammadeeasy@fastmail.com

Memory function in patients with opioid dependence treated with buprenorphine and methadone in comparison with healthy persons  Scientific Reports This study compared memory performance in patients treated with methadone or buprenorphine for drug abuse to healthy controls using the Wechsler Memory Scale. Healthy controls performed better than both treatment groups in mental control. Methadone patients scored higher than controls in personal and general information, while buprenorphine patients scored lower in associate learning. Longer buprenorphine treatment was linked to better overall memory scores, and patients on methadone for over two years showed better awareness of place and time compared to long-term buprenorphine users. Overall, neither medication showed major negative effects on memory except for mental control, which was impaired in both groups. Buprenorphine appeared to better preserve memory function over time than methadone.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Medicaid Unwinding and Changes in Buprenorphine Dispensing  JAMA Network Open Among Medicaid-insured adults with buprenorphine use, this cross-sectional study examined if changes in buprenorphine dispensing were greater among those residing in states with the highest vs lowest decreases in Medicaid enrollment after “Medicaid unwinding” began in April 2023. Researchers used 2017-2023 data from a national prescription dispensing database that included 754,675 person-years from 569,069 patients. They found that patients in states with the highest decreases in Medicaid enrollment were more likely to decrease buprenorphine use, discontinue buprenorphine therapy, and use private insurance or cash to pay for buprenorphine prescriptions. The finding that Medicaid unwinding was associated with disruptions in buprenorphine therapy raises concerns about the potential for increased opioid-related morbidity and mortality.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

On this episode of the Pain Pod, we discuss the details of the PhARM OUD Guidelines with our special guest Dr. Tyler Varisco. We're ready to dive into buprenorphine in community pharmacies, so buckle up and enjoy the ride! Come one, come all, to the Pain Pod!!! PhARM OUD Guidelines • https://forefdn.org/grantee-spotlight-engaging-community-pharmacists-in-improving-treatment-outcomes-for-patients-with-opioid-use-disorder/  Pain Guy • www.painguy.us • PhARM OUD Guideline Link on Pain Guy Website: https://painguy.us/resources  

On this episode of the Pain Pod, we discuss the details of the PhARM OUD Guidelines with our special guest Dr. Tyler Varisco. We're ready to dive into buprenorphine in community pharmacies, so buckle up and enjoy the ride! Come one, come all, to the Pain Pod!!! PhARM OUD Guidelines • https://forefdn.org/grantee-spotlight-engaging-community-pharmacists-in-improving-treatment-outcomes-for-patients-with-opioid-use-disorder/  Pain Guy • www.painguy.us • PhARM OUD Guideline Link on Pain Guy Website: https://painguy.us/resources  

In episode 59 we discuss outpatient low-dose initiation of buprenorphine. Suen LW, Chiang AY, Jones BLH, Soran CS, Geier M, Snyder HR, Neuhaus J, Myers JJ, Knight KR, Bazazi AR, Coffin PO.Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. We also discuss impulse control dysregulation from ropinerole, and the new non-opioid painkiller, suzetrigine. BBC:Prescription medication made me a gambling addict Grall-Bronnec M, et al.Dopamine agonists and impulse control disorders: a complex association. Drug Saf. 2018;41(1):19-75. FDA:FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain Vertex Pharmaceuticals: Randomized, Placebo-Controlled, Phase 3 Trials of Suzetrigine, a Non-Opioid, Pain Signal Inhibitor for Treatment of Acute Pain After Abdominoplasty or Bunionectomy --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go tothis link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visitMI CARES. CME:https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music:composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer:Dr. Patrick Beeman A podcast fromArs Longa Media --- Learn more about your ad choices. Visit megaphone.fm/adchoices

Buprenorphine for opioid use disorder (1:30), triptans for acute migraine (5:30), premenstrual syndrome (6:50), pain management for IUD insertion (11:00), liver fibrosis stage in chronic hepatitis C infection (12:30), and cold water immersion for muscle soreness (14:30).

Listen in as our expert panel discusses medications for management of opioid use disorder. They'll review strategies to optimize buprenorphine use and clarify the role of methadone and naltrexone.Special guest:Tyler J. Varisco, PharmD, PhDUniversity of Houston College of Pharmacy Assistant Professor, Department of Pharmaceutical Health Outcomes and PolicyAssistant Director, The PREMIER CenterYou'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Stephen Carek, MD, CAQSM, DipABLM, Clinical Associate Professor of Family Medicine for the Prisma Health/USC School of Medicine Greenville Family Medicine Residency Program at the University of South Carolina School of Medicine, GreenvilleCraig D. Williams, PharmD, FNLA, BCPS, Clinical Professor of Pharmacy Practice at the Oregon Health and Science UniversityFor the purposes of disclosure, Dr. Varisco reports a financial relationship [cardiology, inflammatory bowel disease] with HEALIX Infusion Therapy (research consultant).The other speakers have nothing to disclose.  All relevant financial relationships have been mitigated.This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in March 2025.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter, Pharmacy Technician's Letter,or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.Claim CreditThe clinical resources mentioned during the podcast are part of a subscription to Pharmacist's Letter, Pharmacy Technician's Letter, and Prescriber Insights: FAQ: Management of Opioid Use DisorderChart: Treatment of Opioid WithdrawalFAQ: Treatment of Acute Pain in Opioid Use DisorderFAQ: Meds for Opioid OverdoseSend us a textIf you're not yet a subscriber, find out more about our product offerings at trchealthcare.com. Follow, rate, and review this show in your favorite podcast app. Find the show on YouTube by searching for ‘TRC Healthcare' or clicking here. You can also reach out to provide feedback or make suggestions by emailing us at ContactUs@trchealthcare.com.

For people addicted to fentanyl, the desire to quit is often overshadowed by the fear of withdrawal. Incredible nerve pain, diarrhea, chills, vomiting. It’s been likened to the worst flu you’ve ever experienced. Buprenorphine, the medication often used to aid in easing addiction, can trigger withdrawal symptoms, making it tough for patients to continue treatment. Here in Seattle, Downtown Emergency Service Center, or DESC, has been trying a new method of administering buprenorphine to ease treatment and curb cravings -- and it’s showing some promising results. Guests: Jeremy Hoog, senior nurse manager at DESC's Opioid Recovery and Care Access. Carson Bell is a care navigator at DESC. Related Links: Substance Use Disorder Treatment - DESC Seattle nonprofit rolling out potential ‘game changer’ for fentanyl addiction | The Seattle Times Thank you to the supporters of KUOW, you help make this show possible! If you want to help out, go to kuow.org/donate/soundsidenotes Soundside is a production of KUOW in Seattle, a proud member of the NPR Network.See omnystudio.com/listener for privacy information.

Click here to send us a topic idea or question for Weekend Wisdom.Are you considering adopting or fostering a child who was exposed prenatally to opioids or opioid-use treatment medication, such as Buprenorphine, methadone, and Suboxone? Are you a grandparent or aunt raising a child who was exposed? Join our discussion with Dr. Jennifer McAllister, the Medical Director of the NOWS Follow-Up Clinic at Cincinnati Children's Hospital Medical Center and the Medical Director of the University of Cincinnati Newborn Nursery.In this episode, we discuss:Terminology: What is the difference between opiates and opioids?What are the most common opioids being abused?What are the common treatment medications/drugs given to those with opioid use disorder? What are the brand names for these medications?How do these medications work?Are substance-use medications safe to use during pregnancy?What are the short- and long-term impacts on infants exposed to opioids?What are the short- and long-term impacts of infants exposed to opioid-use medications in pregnancy? Do the impacts differ?Does the dosage of opioid-use medications change the impact they have on the baby?What are the short- and long-term impacts of infants exposed to fentanyl in pregnancy?Is there a safer time for a fetus to be exposed to opioids or opioid-use medications in utero?Is it true that if the child is not born experiencing signs of withdrawal or with drugs in their system, the prognosis is better? Or conversely, if the child is born dependent and has to go through withdrawals, they will suffer more impact from in-utero drug exposure?How dangerous is drug dependency and withdrawal for the infant?How are Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) treated in babies?If a mom is taking opioid-use medications during her pregnancy, is it recommended that she breastfeed the infant to help with withdrawal? How long does withdrawal in an infant born dependent last?How do you foster attachment while the baby is experiencing withdrawal?You often hear that “early intervention is key” and that a baby's brain can be rewired during the first couple of years with the right treatments or therapy. What exactly does that therapy entail? What strategies should you be using at home with your child with a diagnosis of prenatal drug exposure?When a child has drug exposure and trauma, is it possible to tell the difference in what is causing specific problems, and is the treatment different depending on the cause?Are children who are exposed prenatally to any drug, but specifically to opioids, at a greater risk for substance abuse disorder as teens and adults if they were adopted and not raised in an environment that exposed them to drug use?What are the most common blood-borne diseases that women who have IV drug use?What is the risk to a baby whose mother has HIV or Hepatitis C?Support the showPlease leave us a rating or review. This podcast is produced by www.CreatingaFamily.org. We are a national non-profit with the mission to strengthen and inspire adoptive, foster & kinship parents and the professionals who support them.Creating a Family brings you the following trauma-informed, expert-based content: Weekly podcasts Weekly articles/blog posts Resource pages on all aspects of family building

Join me, Dr. Casey Grover, as I provide a comprehensive guide to treating opioid use disorder during pregnancy, examining evidence-based approaches that protect both mother and baby through critical periods of care. The statistics are sobering - opioid use disorder in pregnancy has more than doubled in recent years, with overdoses now a leading cause of pregnancy-associated death.• Two major medical societies (ACOG and ASAM) recommend treating with methadone or buprenorphine rather than attempting medication-free withdrawal• Buprenorphine shows slight advantages over methadone for pregnancy outcomes, but the best choice is whichever medication keeps the mother sober• Neonatal abstinence syndrome occurs when babies experience withdrawal after birth, but can often be managed with supportive care rather than medication• Medication dosages often need adjustment during pregnancy as increased blood volume dilutes medication concentration• Breastfeeding is compatible with both methadone and buprenorphine treatment• The postpartum period brings unique challenges that increase relapse risk, requiring enhanced support for new mothers• Two patient cases illustrate both successful treatment and the challenges of maintaining recovery while parenting a newbornVisit centralcoastoverdoseprevention.org to learn more about preventing overdose deaths in your community.To contact Dr. Grover: ammadeeasy@fastmail.com

The association between buprenorphine doses above 16 milligrams and treatment retention in a multi-payer national sample in the United States, 2014 to 2021 Addiction Buprenorphine labeling identifies 16 mg as the “target dose,” supported by prior evidence that higher doses (≥16 mg) were associated with increased retention in treatment. Studies comparing doses above 16 mg to 16 mg, particularly in the era of fentanyl, have been very limited. The authors conducted a cohort study to look at retention for those receiving 24, 32, and 40 mg compared to 16 mg. Overall, higher doses were associated with increased retention, as follows: 1) 24 mg was more effective than 16 mg at 1 (aOR=1.52) and 18 months (aOR=1.17), 2) 32 mg was more effective than 24 mg at 6 (aOR=1.06), 12 (aOR=1.09), and 18 months (aOR=1.12), and 3) 40 mg was more effective than 24 mg at 12 (aOR=1.10) and 18 months (aOR=1.18). The authors suggest updates to label language and recommendations are prudent, while also supporting more research on long-term treatment with these higher doses.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

In today's episode, we explore the evolving landscape of buprenorphine prescribing through telemedicine with Dr. Stuart Gitlow, a distinguished expert in addiction medicine. Dr. Gitlow returns to discuss the Biden administration's new ruling that enables providers to prescribe buprenorphine via telehealth, including audio-only visits, without requiring initial in-person evaluation.Building on our previous conversation about the elimination of the DATA waiver, we examine how physicians have responded to these expanded prescribing capabilities. Dr. Gitlow shares insights from his extensive experience with telemedicine during COVID-19 and addresses the implications of allowing 6-month prescriptions through virtual visits.We also discuss critical aspects of this new framework, including pharmacy verification requirements and the role of emergency departments in initiating buprenorphine treatment. Join us for this timely conversation about expanding access to addiction treatment while maintaining appropriate safeguards and quality of care.For listeners new to our series, we recommend listening to our earlier episode "History and the Elimination of the DATA Waiver" featuring Dr. Gitlow, where we explored the historical context of addiction treatment regulations.

Dr. Tamara Ruggles:  www.linkedin.com/in/tamara-ruggles-491882251 Dr. Sing Ping Show:  https://www.linkedin.com/in/sing-ping-chow-pharm-d-bcps-497365175/ Understanding Buprenorphine for Use in Chronic Pain: Expert Opinion:  https://pubmed.ncbi.nlm.nih.gov/31917418/ 

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Linda Brubaker, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from February 15-21, 2025. Related Content: Reaffirming the JAMA Network Commitment to the Health of Patients and the Public

Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl JAMA Network Open The accumulation of fentanyl in fat is likely responsible for the risk of precipitated withdrawal when buprenorphine is initiated. Low dose initiation (LDI) of buprenorphine attempts to minimize this risk. This retrospective study included 126 individuals making 175 LDI attempts in an outpatient setting. Patients chose either a 4 day or 7 day LDI protocol with buprenorphine monoproduct. Both protocols begin with buprenorphine 0.5mg, increasing to 8mg tid. Overall LDI was successful in 34% of attempts (with no difference between the protocols) and one month retention on buprenorphine was 21%. Repeated LDI attempts were less likely to be successful (second attempt aOR 0.3). Unhoused people had lower odds of success (OR 0.4). The authors conclude that people with OUD using fentanyl attempting outpatient LDI of buprenorphine had low odds of success.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Hennepin EMS in Minnesota is breaking new ground in prehospital care with the introduction of a clinical pharmacist consulting role, designed to tackle complex challenges and foster collaboration between paramedics and pharmacists through hands-on support and cutting-edge research. The clinical pharmacist acts as a bridge between hospital and field operations, ensuring prehospital teams have the support they need to improve patient outcomes. A critical part of the pharmacist's responsibilities includes hands-on engagement. From participating in ambulance ride-alongs to hosting open-door consultations, this role prioritizes practical and actionable solutions. At the heart of this initiative is Holly Drone, PharmD, Hennepin EMS's clinical pharmacist. Not only has Holly been integral to placing this program into action, but she's also contributing to the field through her research. Her studies focus on essential topics such as Sodium Nitrate Overdose management, the initiation of Buprenorphine in prehospital settings, and the use of Oral Risperidone by EMS providers in the field. To learn more about this innovative role and hear directly about her experiences and research, check out her recent interview on the podcast “EMS Research with Professor Bram.” Holly provides unique insights into the evolving relationship between paramedics and pharmacists as well as the critical role clinical pharmacy plays in improving prehospital care.

Clinical Pearls, Pain Pod edition: Pain Pearls Part 1 (of many)! A cornucopia of pain conundrums and potential solutions and/or tools to help mitigate. All here, nicely packaged, randomly, in one episode of the Pain Pod! One of many more to come, in a miniseries titled: “Pain Pearls”, only here on the Pain Pod! Come one, come all, to the Pain Pod!!! P.S. Want to contribute or hear about a pain pearl of your own? Message Pain Guy on www.painguy.us to directly reach Mark and have your voice heard! Pain Guy • www.painguy.us DVPRS (Pain Scale) • https://www.va.gov/PAINMANAGEMENT/docs/DVPRS_2slides_and_references.pdf  Opioid Risk Screenings • www.opioidrisk.com  2022 CDC Opioid Guideline Update • Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. Buprenorphine Induction Resources • Kampman K and Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. Sep-Oct 2015;9(5):358-67. • Ahmed, S. Bhivandkar S, et. al. Microinduction of Buprenorphine/Naloxone: A Review of the Literature. The American Journal on Addictions, 30: 305–315, 2021. • Privia A. Randhawa, Rupinder Brar and Seonaid Nolan. Buprenorphine–naloxone “microdosing”: an alternative induction approach for the treatment of opioid use disorder in the wake of North America's increasingly potent illicit drug market CMAJ January 20, 2020 192 (3) E73. MOUD Minimum Durations Study • Michael L. Dennis, Mark A. Foss, and Christy K. Scott. An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review 2007 31:6, 585-612

Moderator: James P. Rathmell, M.D. Participants: James Hitt, M.D., Ph.D. and Mark C Bicket, M.D., Ph.D. Articles Discussed: Continuation versus Interruption of Buprenorphine/Naloxone in Adult Veterans Undergoing Surgery: Examination of Postoperative Pain and Opioid Utilization in a National Retrospective Cohort Study Building a Better Base for Keeping Buprenorphine on Board for Surgery Transcript

Clinical Pearls, Pain Pod edition: Pain Pearls Part 1 (of many)! A cornucopia of pain conundrums and potential solutions and/or tools to help mitigate. All here, nicely packaged, randomly, in one episode of the Pain Pod! One of many more to come, in a miniseries titled: “Pain Pearls”, only here on the Pain Pod! Come one, come all, to the Pain Pod!!! P.S. Want to contribute or hear about a pain pearl of your own? Message Pain Guy on www.painguy.us to directly reach Mark and have your voice heard! Pain Guy • www.painguy.us DVPRS (Pain Scale) • https://www.va.gov/PAINMANAGEMENT/docs/DVPRS_2slides_and_references.pdf  Opioid Risk Screenings • www.opioidrisk.com  2022 CDC Opioid Guideline Update • Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. Buprenorphine Induction Resources • Kampman K and Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. J Addict Med. Sep-Oct 2015;9(5):358-67. • Ahmed, S. Bhivandkar S, et. al. Microinduction of Buprenorphine/Naloxone: A Review of the Literature. The American Journal on Addictions, 30: 305–315, 2021. • Privia A. Randhawa, Rupinder Brar and Seonaid Nolan. Buprenorphine–naloxone “microdosing”: an alternative induction approach for the treatment of opioid use disorder in the wake of North America's increasingly potent illicit drug market CMAJ January 20, 2020 192 (3) E73. MOUD Minimum Durations Study • Michael L. Dennis, Mark A. Foss, and Christy K. Scott. An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review 2007 31:6, 585-612

In episode 55 we discuss the pharmacokinetics and pharmacodynamics of buprenorphine in pregnancy.    Caritis, Steve N. MD; Venkataramanan, Raman PhD. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024.    We also discuss fraud in Baltimore recovery houses, and the doubling of alcohol-related deaths.    The New York Times: They Entered Treatment. Drugs, Overdoses and Deaths Followed.  The New York Times: Alcohol Deaths Have More Than Doubled in Two Decades, Study Finds  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/  ---  Original theme music: composed and performed by Benjamin Kennedy  Audio editing: Michael Bonanno  Executive producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.     The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.  Email: addictionmedicinejournalclub@gmail.com   Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC   Threads: @AddictionMedJC  YouTube: addictionmedicinejournalclub   Twitter/X: @AddictionMedJC   Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.  Learn more about your ad choices. Visit megaphone.fm/adchoices

In episode 54 we discuss an article about 24-mg daily of buprenorphine and behavioral health hospitalizations.    Axeen S, Pacula RL, Merlin JS, Gordon AJ, Stein BD. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization. JAMA Netw Open. 2024 Sep 3;7(9):e2435478.     We also discuss the decline in overdose deaths and RFK's experience with recovery.    The White House: Biden-⁠Harris Administration Marks Historic Progress Reducing Overdoses Across the Country   The New York Times: ROBERT KENNEDY JR. ADMITS HE IS GUILTY IN POSSESSING HEROIN  Robert F. Kennedy: Recovering America - A Film About Healing Our Addiction Crisis  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/  ---  Original theme music: composed and performed by Benjamin Kennedy  Audio editing: Michael Bonanno  Executive producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.     The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.  Email: addictionmedicinejournalclub@gmail.com   Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC   Threads: @AddictionMedJC  YouTube: addictionmedicinejournalclub   Twitter/X: @AddictionMedJC   Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. 

In episode 53 we discuss an article comparing treatment retention and mortality in patients who are prescribed methadone vs. buprenorphine/naloxone for treatment of opioid use disorder.    Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17.     We also discuss the Modernizing Opioid Treatment Access Act, engaging non-abstinent patients in treatment, and hostility to medications with the recovery community.    Modernizing Opioid Treatment Access Act (MOTAA) (H.R.1359 / S. 644)  ASAM: Engagement and Retention of Nonabstinent Patients in Substance Use Treatment  STAT News: The recovery community says it offers refuge from opioid addiction. But it's still hostile to lifesaving addiction medications  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/   ---  Original theme music: composed and performed by Benjamin Kennedy  Audio editing: Michael Bonanno  Executive producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.     The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.  Email: addictionmedicinejournalclub@gmail.com   Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC   Threads: @AddictionMedJC  YouTube: addictionmedicinejournalclub   Twitter/X: @AddictionMedJC   Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. 

Vermont's largest city has launched a new initiative that allows first responders to administer opioid addiction treatment medication at the scene of overdoses. Research indicates it's an effective way to get more people who struggle with opioid misuse into treatment.

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from December 21-27, 2024.

In episode 52 we discuss precipitated withdrawal in the era of fentanyl.    Thakrar AP, Et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895.     We also discuss kratom, brain injury after overdose, and syringe services.  The Kratom Sobriety Podcast  Making Kratom Safer  The Conversation: Brain injury after overdose is a hidden epidemic  NIDA: Syringe services for people who inject drugs are enormously effective, but remain underused  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/   ---  Original theme music: composed and performed by Benjamin Kennedy  Audio editing: Michael Bonanno  Executive producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.     The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.  Email: addictionmedicinejournalclub@gmail.com   Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC   Threads: @AddictionMedJC  YouTube: addictionmedicinejournalclub   Twitter/X: @AddictionMedJC    Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. 

In this episode, Joe interviews Howard Kornfeld, MD: renowned pain medicine expert, addiction specialist, early pioneer in psychedelic medicine, and currently the director of recovery medicine at Recovery Without Walls. As a leader in the utilization of buprenorphine, he talks about how it came about as a treatment for addiction and chronic pain, its similarities to MDMA, and how its fast-tracked FDA approval could give us clues on how to get MDMA approved. He also dives into the history of ketamine, its unique effects compared to other substances, its potential for abuse, and what can happen with overuse. And he talks a lot about the connection he sees between psychedelics and the prevention of nuclear war, inspired by Sasha Shulgin's opinion that nothing changes minds faster than psychedelics. He points out that when there is darkness, there is light: Albert Hofmann's famed bicycle trip on acid happened 3 months after the nuclear chain reaction was invented. Can the growing use of psychedelics inspire the kind of change we need to save the world? He also discusses: The need for new study designs as we come to terms with the fact that double-blind studies don't really work with psychedelics Criticisms of the FDA's denial of MDMA: Was the process unfair? His predictions that advocates will begin pushing to decriminalize MDMA at the state level The books, Tripping on Utopia and Drugged How he played a part in prisons ending the practice of killing prisoners with cyanide gas and more!  For links, head to the show notes page. 

Katie Bye, PharmD shares insights on buprenorphine induction strategies for opioid use disorders.   For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes.  You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on X @MayoMedE 

Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder JAMA Network This population-based retrospective cohort study assessed whether the use of buprenorphine/naloxone is associated with lower risk of treatment discontinuation and mortality compared with methadone. It included 30,891 individuals initiating treatment for the first time during the study period and found that  the risk of treatment discontinuation was higher among recipients of buprenorphine/naloxone compared with methadone (88.8% vs 81.5% within 24 months). The risk of mortality was low while in either form of treatment (0.08% vs 0.13%).  Individuals receiving methadone had a lower risk of treatment discontinuation compared with those who received buprenorphine/naloxone. The risk of mortality while receiving treatment was similar between medications.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization 

Facilitators of and barriers to buprenorphine initiation in the emergency department: a scoping review  The Lancet Regional Health Americas In the context of the opioid overdose epidemic, great efforts have been made to increase access to medication for opioid use disorder (MOUD), specifically buprenorphine. Initiation of buprenorphine in emergency departments (ED) has been a focus of these efforts. While initiation has been increasing, only 3-15% of persons treated in EDs fill a prescription. In this summary literature review, authors examined potential barriers and facilitators to initiation. Having care-coordination with streamlined and easy connection to outpatient treatment was associated with increased initiation. Conversely, the absence of care-coordination was associated with decreased uptake. Additionally, provider training and comfort increased uptake as did flexibility in induction strategies.    Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM  

In this episode, Kathleen Page, MD, and Glenn J. Treisman, MD, PhD, discuss the interplay between addiction and HIV. Learn as they share their approaches to reframing the conversation about addiction and overcoming barriers to effective addiction care for people living with HIV.Presenters:Kathleen Page, MDProfessorInfectious DiseasesJohns Hopkins School of MedicineBaltimore, Maryland Glenn J. Treisman, MD, PhDEugene Meyer III Professor of Psychiatry and MedicineJohns Hopkins University School of MedicineBaltimore, MarylandDownloadable slides:https://bit.ly/3TR3OVVProgram:https://bit.ly/3WB2VCO

Host Shawn McNeil, MD, is joined by Michelle Lofwall, MD, DFAPA, DFASAM,  a professor in the Department of Behavioral Science and Psychiatry at the University of Kentucky and Medical Director of UK's Robert Straus and First Bridge Clinics, which provide comprehensive OUD treatment within the UK Center on Drug and Alcohol Research. Dr. Lofwall and  her co-authors examined the relationship between the dose in the early stages of treatment and the subsequent risk of death and found some surprising results.   Higher First 30-Day Dose of Buprenorphine for Opioid Use Disorder Treatment Is Associated With Decreased Mortality   Journal of Addiction Medicine 18(3):p 319-326, 5/6 2024 May-June 2024

Funding for this initiative was made possible (in part) by grant no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Funding for this initiative was made possible (in part) by grant no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

In episode 47 we discuss the effectiveness of sublingual and injectable buprenorphine for patients with OUD, with and without fentanyl.    Nunes EV, Comer SD, Lofwall MR, Walsh SL, Peterson S, Tiberg F, Hjelmstrom P, Budilovsky-Kelley NR. Extended-Release Injection vs Sublingual Buprenorphine for Opioid Use Disorder With Fentanyl Use: A Post Hoc Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2024 Jun 3;7(6):e2417377.    We also discuss the AMA's Support of drug decriminalization, and the rise of alcohol-related health problems.    New York Times: Oregon Is Recriminalizing Drugs. Here's What Portland Learned  Med Page Today: AMA's House of Delegates Says Yes to Drug Decriminalization  Stat News: By the numbers: America's alcohol-related health problems are rising fast  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  ---  Original theme music: composed and performed by Benjamin Kennedy  Audio Editing by Michael Bonanno Executive Producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.    The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.    Email: addictionmedicinejournalclub@gmail.com  Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC  Threads: @AddictionMedJC  Twitter/X: @AddictionMedJC   YouTube: addictionmedicinejournalclub    Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. 

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we are back with our second part to the two-part series focused on the intricate world of addiction treatment.Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, Dr. Mong and Dr. Lamba will shed light on the promise and perils of new treatment approaches, underscore the necessity of comprehensive support systems, and point to the pivotal role of social supports and stable housing in fostering sustainable recovery.We also tackle the cultural and historical context of the opioid crisis, including the profound impact of Purdue Pharma and the Sackler family. Dispelling misconceptions about fentanyl, you'll learn about the real risks, the invaluable role of naloxone, and practical steps for overdose prevention.This episode is not just about groundbreaking therapies; we will discuss the critical need for rigorous, high-quality data to back new treatments and reflect on the significant influence of private companies in the field. Our guests will emphasize the paramount importance of addressing the root causes of substance use, building life skills, and creating supportive networks to prevent relapses.Lastly, this episode will feature discussions on opioid tolerance, withdrawal management, and the nuanced balance between the risks of prescribing medications versus the risks of untreated withdrawal. You'll gain insights into how healthcare teams can shift their perceptions and practices to better support patients with substance use disordersStay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!04:17 Challenges and future of addiction treatment discussed.09:36 Understanding withdrawal challenges in hospitals with unknown dosages.12:02 Provide proper care despite addiction-related complications.16:20 Colleague's guarded due to personal trauma, concerns.20:05 Conversations led hospital to adopt PICC lines.21:54 New grads integrate social responsibility with medical care.27:20 Risk from checking on overdose is minimal.29:15 There can't be too much widely accessible Narcan.34:00 Need rigorous study for psychedelics in treatment.35:39 Concerned new treatments overshadow foundational patient support measures.41:40 "Cured" involves functional life, stability, coping mechanisms.42:52 Substance use disorder: Patients can achieve long-term remission.46:01 Meet needs without substances to avoid relapse.

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we're embarking on the first of a two-part series focused on the intricate world of addiction treatment.Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, we'll explore the complexities of managing and treating addiction within hospital settings, the profound challenges faced by patients and healthcare providers alike, and the life-saving implications of treatments like opioid agonist therapy.In this episode, we tackle the high relapse rates among opiate users, the effectiveness of medications for alcohol use disorders, and the importance of patient readiness in overcoming substance use. We'll also delve into the value of motivational interviewing in fostering patient cooperation and the evolving role of addiction medicine in modern healthcare.Dr. Bonta reflects on his experiences and frustrations with addiction treatment, emphasizing the need for evidence-based approaches and reducing harm. We'll discuss the broader implications of addiction treatments, including societal perceptions and the importance of treating addiction as a complex, multifaceted issue.Stay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!06:28 Biopsychosocial overview and social determinants of health.08:33 Addiction perception varies; harm reduction prioritizes context.12:42 Substance use disorder defined by the four C's.15:24 Challenges of informing patients about health impacts succinctly.20:11 Enjoyed working with you; motivational interviewing technique.21:40 Promote cooperation and autonomy in medical interactions.24:38 Brief interventions reveal deeper patient issues for treatment.30:23 Support for treating illness without moral judgment.31:43 Understanding treatments can improve patient prognosis discussions.34:59 Medication modulates neurotransmitters for alcohol use disorder.39:44 Four reasons to start opioid agonist therapy.42:14 Discharged patients risk fatal overdose; opioid therapy saves.46:42 Patients generally agree with treatment but resist lifestyle changes.49:00 Importance of discussing addiction and enabling behaviors.

State-level racial and ethnic disparities in buprenorphine treatment duration in the United States  The American Journal on Addictions National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. This study examined such disparities at the state level. Analyzing 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data, the study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and 8 states displayed similar trends among episodes lasting ≥180 days. Longer treatment durations for White people in both overall and long-term episodes were exhibited in 5 states, and 15 states showed no racial and ethnic disparities.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM  

takeawaysDr. Corsa has a diverse background in public service and EMS, including working as a firefighter, paramedic, and trauma surgeon.Providing medical care in rural and isolated areas presents unique challenges, such as limited access to hospitals and unreliable transportation.Having progressive protocols, advanced equipment, and highly skilled paramedics is crucial in delivering quality care in remote locations.Pre-hospital innovations, such as ultrasound and ventilators, have significantly improved patient care and outcomes.Longevity and experience among paramedics in remote areas can be both beneficial and challenging, as retirements may lead to the need for training new personnel. The greatest innovation in EMS is the increased knowledge and capabilities of paramedics and EMTs.Advancements in equipment, such as the stair chair and power stretcher, have greatly improved patient care.Safety is a crucial aspect of helicopter operations, and the dedication of rescue technicians is commendable.Medical program directors play a vital role in coordinating and implementing programs to address the opioid crisis.Buprenorphine can be used in the field to help patients in withdrawal and connect them with follow-up care.Prolonged field care requires a different mindset and planning to provide care in remote and austere environments. The future of EMS lies in recognizing the importance of tailoring care to the specific needs of each community.Critical thinking skills are essential in EMS and should be integrated into training programs.Coordination and communication are crucial in mass casualty incidents, involving multiple agencies and organizations.Comprehensive triage systems, such as the RAMP method, can help prioritize patients in mass casualty incidents.There is a need for improved pre-hospital pain management, including the use of over-the-counter medications, which could be administered by EMTs.

takeawaysDr. Corsa has a diverse background in public service and EMS, including working as a firefighter, paramedic, and trauma surgeon.Providing medical care in rural and isolated areas presents unique challenges, such as limited access to hospitals and unreliable transportation.Having progressive protocols, advanced equipment, and highly skilled paramedics is crucial in delivering quality care in remote locations.Pre-hospital innovations, such as ultrasound and ventilators, have significantly improved patient care and outcomes.Longevity and experience among paramedics in remote areas can be both beneficial and challenging, as retirements may lead to the need for training new personnel. The greatest innovation in EMS is the increased knowledge and capabilities of paramedics and EMTs.Advancements in equipment, such as the stair chair and power stretcher, have greatly improved patient care.Safety is a crucial aspect of helicopter operations, and the dedication of rescue technicians is commendable.Medical program directors play a vital role in coordinating and implementing programs to address the opioid crisis.Buprenorphine can be used in the field to help patients in withdrawal and connect them with follow-up care.Prolonged field care requires a different mindset and planning to provide care in remote and austere environments. The future of EMS lies in recognizing the importance of tailoring care to the specific needs of each community.Critical thinking skills are essential in EMS and should be integrated into training programs.Coordination and communication are crucial in mass casualty incidents, involving multiple agencies and organizations.Comprehensive triage systems, such as the RAMP method, can help prioritize patients in mass casualty incidents.There is a need for improved pre-hospital pain management, including the use of over-the-counter medications, which could be administered by EMTs.

Dr. Drew is a double board certified internist and addiction medicine specialist. For over 30 years he has been a beacon of truth, integrity, fairness, and common sense. In this episode of Keeping It Real he answers Jillian's questions about RFK's previous heroin addiction and whether or not an addict is safe to put in the Oval Office. Then he digs in on all things addiction, Suboxone, Opioids, Buprenorphine the origin of pain management medicine and more. He also covers the damage done by arbitrary pandemic protocols and how we can do it better if there is a next time!Finding Dr. Drew:https://drdrew.com/https://www.youtube.com/DrDrewhttps://podcastone.com/Dr-Drew-Showhttps://x.com/drdrewhttps://www.instagram.com/drdrewpinsky/?hl=enSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Discover the life-saving potential of buprenorphine in the fight against opioid overdoses with Dr. Casey Grover on the latest episode of Addiction Medicine Made Easy. We start with a poignant patient story that showcases the remarkable impact of addiction medicine using Topamax for alcohol use disorder. From there, we shift our focus to the powerful effects of buprenorphine in reducing fatal opioid overdoses, especially in the context of acute fentanyl exposures. Drawing on a pivotal 2020 study from the Journal of Substance Use and Addiction Treatment, we unpack the pharmacological magic behind buprenorphine's ability to block full agonist opioids and explore its potential to protect during the fentanyl crisis.Effective communication with patients about buprenorphine is key, and Dr. Grover emphasizes the importance of this in reducing overdose risks. Reflecting on his own practice, he shares how he now approaches conversations about the medication, underlining that while buprenorphine substantially lowers the risk of fatal overdoses, it doesn't offer complete protection, particularly if not taken regularly. Tune in for actionable advice and insightful discussions designed to elevate your approach to addiction medicine.

Summary Brandi Mac (Host) is an Acute Care Nurse Practitioner, and mother of an adult child in recovery from substance use disorder.  Dr. Taylor Nichols, a certified addiction physician and ER doctor, discusses his journey from working in the emergency department to specializing in addiction medicine. He shares his experiences of seeing the broken healthcare system and the harm it causes to people who use drugs. Dr. Nichols emphasizes the importance of harm reduction and reducing stigma in healthcare. He also addresses misconceptions about medications like Suboxone and buprenorphine and provides insights into managing pain in patients with opioid use disorder. In this part of the conversation, Dr. Taylor Nichols discusses the process of tapering off opioids, specifically focusing on the use of buprenorphine and the medications Sublicade and Brixadi.  He explains how buprenorphine works to replace opioids in the brain and reduce withdrawal symptoms. Dr. Nichols also discusses the challenges of tapering off fentanyl and the importance of finding the right dose of buprenorphine to effectively manage withdrawal. She highlights the Bernese method as an alternative approach to tapering and explains the differences between Sublicade and Brixadi. Additionally, Dr. Nichols addresses the concerns of families and loved ones of individuals with substance use disorder, emphasizing the importance of supporting the individual's goals and providing them with evidence-based treatment options. Dr. Nichols TikTok: Click Here Dr. Nichols Website: Click Here Recovery Reform Podcast by Dr. Nichols and McCauley Sexton: Click Here Recovery Reform YouTube Channel: Click Here Article: Naloxone to Buprenorphine Chapters 00:00 Introduction and Background 03:46 Harm Reduction and Stigma 10:38 Respecting Autonomy and Challenging Stigma 14:46 Debunking Misconceptions about Naloxone and Buprenorphine 18:23 Physician Fear and the Opioid Crackdown 25:16 The Functionality of Naloxone in Suboxone 32:54 The Ceiling Effect of Buprenorphine 36:26 Managing Pain in Patients with Opioid Use Disorder 38:25 Understanding the Role of Buprenorphine 41:21 Managing Withdrawal Symptoms 44:04 Long-Acting Injectable Buprenorphine 50:43 Comparing Sublicade and Brixadi 55:27 Supporting Individuals and Families 01:02:16 Empowering Individuals to Make Decisions

Spark your learning We cover clinical pearls from graduating addiction medicine fellows by covering ACAAM's annual lighting round presentation.  Learn about tianeptine, buprenorphine starts in patients with acute hepatitis, vaccinations for persons who inject drugs, and more!  Claim CME for this episode at curbsiders.vcuhealth.org! Listening to this episode and completing CME, can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME! Credits Producer, Show Notes, Infographics: Carolyn Chan Hosts: Carolyn Chan, MD. MHS, Shawn Cohen, MD, Kenneth Morford, MD, Natalie Stahl, MD MPHS Reviewer: Sarah Leyde, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Show Segments 00:00 Intro, disclaimer 03:00 Picks of the week 07:00 Buprenorphine and hepatitis 16:30 Ketamine for withdrawal 24:00 Hepatitis B 28:20 Tianeptine 35:30 Hepatitis C treatment 39:00 PETH 47:40 Unintended phenobarbital consequences 53:40 TBI and overdose risk 58:00 Outro

We're welcoming back Tiffany Tathata and Bryce de Venecia for part 2 of an educational series that explores basic treatments for opioid and alcohol use disorder. Tiffany and Bryce are both Addiction Medicine fellows at Rush University Medical Center. Today, they focus on buprenorphine, precipitated withdrawal, and innovations in treatment with long acting injectable buprenorphine. The goal of this three-part podcast series is to educate non-addiction medicine specialists on the various treatments available for their patients with opioid and alcohol use disorder. ResourcesSAMHSA - https://www.samhsa.gov/  Buprenorphine quick-start guide for new prescribers https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf Addiction Medicine Podcast – The Curbsiders - https://thecurbsiders.com/addictionBridge to Treatment - https://nida.nih.gov/  

Today, Tiffany Tathata and Bryce de Venecia join us for an educational series that explores basic treatments for opioid and alcohol use disorder. Tiffany and Bryce are both Addiction Medicine fellows at Rush University Medical Center in Chicago, Illinois. This goal of their three-part series is to educate non-addiction medicine specialists on the various treatments available for their patients with opioid and alcohol use disorder. This episode focuses on primary care physician management, referrals, screening, naloxone, opioid use disorder, methadone basics, and insightful case studies. The conversation is a basic overview, and if you have any additional interest in the information provided please check out the resources below.ResourcesSAMHSA - https://www.samhsa.gov/  Buprenorphine quick-start guide for new prescribers https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf Addiction Medicine Podcast – The Curbsiders - https://thecurbsiders.com/addictionBridge to Treatment - https://nida.nih.gov/  

Broadcast on KSQD Santa Cruz on 7-05-2024: Guest introduction and Background Introduction of Rita Hewitt, regional director for Central Coast overdose prevention, and her professional background. Overview of Rita's notable achievements and roles in various healthcare and harm reduction initiatives. Rita's journey from a licensed pharmacy technician to her current role in overdose prevention. Impact of the prescription opioid epidemic on her career choices and motivation to address addiction and overdose issues. Stories from Rita's early career, including encounters with prescription opioid misuse and its consequences. Challenges in Opioid Prescription and Addiction Discussion on the challenges faced by healthcare providers in managing pain and the consequences of opioid prescriptions. Examples of misuse and the impact of addiction on individuals and the community. Historical Context of Opioid Epidemic Examination of the history of opioid use and misuse, from pharmaceutical origins to current trends. The role of pharmaceutical companies and legislation in shaping the opioid crisis. Pendulum Swing in Opioid Prescribing Practices Analysis of the shifting attitudes towards opioid prescribing over the decades. The impact of educational mandates and legislation on prescribing practices and patient care. Current Strategies for Harm Reduction Overview of harm reduction initiatives and resources available in the community. Discussion on the effectiveness of buprenorphine and other medications in treating opioid addiction. Emerging Drug Threats Introduction of new substances like Xylazine and their impact on the community. Challenges in addressing these new threats and the limitations of existing overdose reversal medications. Testing and Safety Measures Importance of fentanyl test strips and other tools in preventing overdoses. Availability and distribution of test strips and Narcan within the community. Legislation and Policy Initiatives Recent laws and mandates aimed at improving opioid prescription practices and overdose prevention. Discussion on potential future initiatives to enhance harm reduction and public safety. Pendulum Swing in Opioid Prescribing Practices Continued discussion on the history of opioid prescribing and the shifts in attitudes over the decades. Impact of legislation and educational mandates on opioid prescribing practices and patient care. Challenges and Personal Experiences in Addiction Rita shares personal experiences and anecdotes about friends and community members affected by opioid addiction. Dr. Dawn shares a story about a patient with a severe infection due to opioid misuse and the challenges in managing their pain and treatment. Current Strategies for Harm Reduction Overview of harm reduction strategies and resources available in the community. Discussion on the effectiveness and benefits of buprenorphine and other medications in treating opioid addiction. Emerging Drug Threats Introduction of new substances like Xylazine and their impact on the community. Challenges in addressing these new threats and the limitations of existing overdose reversal medications like Narcan. Statistics and Trends in Overdose Fatalities Examination of the current statistics and trends in overdose fatalities in the local community and nationally. Discussion on the increase in fentanyl-related fatalities and the ongoing challenges in addressing the crisis. Testing and Safety Measures Importance of fentanyl test strips and other tools in preventing overdoses. Availability and distribution of test strips and Narcan within the community. Legislation and Policy Initiatives Recent laws and mandates aimed at improving opioid prescription practices and overdose prevention. Discussion on potential future initiatives to enhance harm reduction and public safety. Community Initiatives and Collaboration Overview of local initiatives and collaborations aimed at addressing the opioid crisis and improving public health outcomes. Importance of community engagement and support in harm reduction efforts. Future Directions and Goals Rita's vision and goals for future harm reduction initiatives and policies. Discussion on the potential impact of upcoming legislation and community efforts on the opioid crisis.

In episode 42 we discuss how buprenorphine protects against fentanyl overdose.    Zheng Dai, et al. Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures. Journal of Substance Use and Addiction Treatment, Volume 158, 2024. 209252, ISSN 2949-8759.    We also discuss semaglutide for alcohol use disorder.    Richards JR, et al. Significant Decrease in Alcohol Use Disorder Symptoms Secondary to Semaglutide Therapy for Weight Loss: A Case Series. J Clin Psychiatry. 2023 Nov 27;85(1):23m15068.  ---  This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES.  ---  Original theme music: composed and performed by Benjamin Kennedy  Audio production: Erin McCue  Executive Producer: Dr. Patrick Beeman  A podcast from Ars Longa Media  ---  This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice.     The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group.    Email: addictionmedicinejournalclub@gmail.com   Facebook: @AddictionMedJC  Facebook Group: Addiction Medicine Journal Club  Instagram: @AddictionMedJC   Threads: @AddictionMedJC  Twitter/X: @AddictionMedJC    YouTube: addictionmedicinejournalclub    Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of opioid use disorder with buprenorphine can also precipitate withdrawal Opioid withdrawal symptoms include nausea, vomiting, diarrhea, and agitation Buprenorphine works as a partial agonist at mu-opioid receptors, which may alleviate withdrawal symptoms The preferred dose of buprenorphine is 16 mg Treatment of buprenorphine-induced opioid withdrawal is additional buprenorphine Adjunctive treatments may be used for other opioid withdrawal symptoms Nausea with ondansetron Diarrhea with loperamide Agitation with hydroxyzine References 1. Quattlebaum THN, Kiyokawa M, Murata KA. A case of buprenorphine-precipitated withdrawal managed with high-dose buprenorphine. Fam Pract. 2022;39(2):292-294. doi:10.1093/fampra/cmab073 2. Spadaro A, Long B, Koyfman A, Perrone J. Buprenorphine precipitated opioid withdrawal: Prevention and management in the ED setting. Am J Emerg Med. 2022;58:22-26. doi:10.1016/j.ajem.2022.05.013 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit