Podcasts about Buprenorphine

Injectable-Only Overlapping Buprenorphine Starting Protocol in a Low-Threshold Setting  JAMA Network Open  Injectable-only buprenorphine protocols are an exciting new strategy for buprenorphine initiation, particularly in the fentanyl era. This is a cohort study of 95 patients with moderate to severe opioid use disorder who received care in a low-threshold setting in Seattle. 79% of patients included in the study were experiencing homelessness or living in permanent supportive housing. Patients selected a long-acting injectable (LAI) buprenorphine initiation protocol which included three escalating doses of LAI buprenorphine over three days, with no sublingual buprenorphine and without cessation of fentanyl/opioid use. 75% of the patients completed the protocol, and 64% received a second monthly dose of LAI buprenorphine.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Quick summaries of articles 51-60. Enjoy! 51. Fun Activities and Recovery Acuff, S. F., et al. A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092. 52. Buprenorphine-precipitated Fentanyl Withdrawal Thakrar AP, et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895. 53. Methadone Vs. Buprenorphine Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17. 54. High Daily Doses of Buprenorphine Axeen S, et al. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization. JAMA Netw Open. 2024 Sep 3;7(9):e2435478. 55. How Buprenorphine Works in Pregnancy Caritis, Steve N. MD; et al. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024. 56. How Many Quite Attempts Does It Take? Fontes RM, et al. Beyond the first try: How many quit attempts are necessary to achieve substance use cessation? Drug Alcohol Depend. 2024 Dec 8;267:112525. 57. What is Recovery? Zemore SE, et al. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse. 2023 Sep 15;17:11782218231199372. 58. Semaglutide for Alcohol Use Disorder (The RCT) Hendershot CS, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Feb 12:e244789. 59. Low-Dose Buprenorphine Initiation (Micro-induction) Suen LW, et al. Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. 60. Lisdexamfetamine for methamphetamine use disorder Ezard N, et al LiMA Investigator Group. Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial. Addiction. 2024 Dec 19. --- 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

Oral methadone versus sublingual buprenorphine for the treatment of acute opioid withdrawal: A triple-blind, double-dummy, randomized control trial  Drug and Alcohol Dependence Researchers compared oral methadone to sublingual buprenorphine for the management of acute opioid withdrawal. Patients at an inpatient drug treatment center in India were randomly assigned to receive either methadone or buprenorphine titrated over days 1-3 to control opioid withdrawal symptoms. Over days 4-10 medications were tapered and stopped by day 11. Completion of treatment was similar in both groups (83% methadone, 82% buprenorphine). Both subjective (SOWS) and objective (COWS) withdrawal symptoms decreased during the treatment, however the buprenorphine group had significantly greater withdrawal symptoms than the methadone group (p=0.009) at the end of treatment (day 10). Opioid craving also decreased in both groups with no significant difference between groups. Authors conclude that methadone is a safe and effective alternative to buprenorphine for management of opioid withdrawal.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM  

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation's most forward-thinking mobile integrated healthcare programs. Prisma Health's team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically. | MORE: How North Dakota EMS is confronting rising pediatric mental health crises  Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing. Rob is joined by four key voices from the Prisma Health MIH program: Luke Estes, director of MIH Dr. Mirinda Gormley, epidemiologist and biostatistician Wes Wampler, community paramedic specializing in addiction and infectious disease Parker Bailes, community paramedic and research contributor Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn't just novel — it's necessary. This is EMS in its truest public health form. Memorable quotes “You delivered the goods—data-driven, community-connected care — and that's what EMS in 2025 needs more of.” — Rob Lawrence “When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes “One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley “If we can gain their trust, there's a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler “Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,' was a big shift for me.” — Parker Bailes “If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler “As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes Additional resources EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4 Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4 Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn Wesley Wampler | LinkedIn Support for harm reduction by community EMS How does a community re-imagine compassion to avoid crisis whenever possible? Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine Episode timeline 00:51 ­– Introduction to Prisma Health MIH & guests 03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction) 05:00 – Dr. Gormley's public health journey, data-opioid focus 08:00 – Buprenorphine pilot design and research outcomes 10:15 – Challenges: bias, stigma, barriers to addiction care 13:00 – Funding and sustainability conversation 14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care 17:00 – Building trust with vulnerable populations 18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions 21:45 – Alternative destinations, lab draws and high-acuity decisions 25:30 – Training: internal education, ultrasound, medication management 28:15 – Prisma's med school connection and disaster response evolution 30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams 31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals 35:26 – Final reflections from Luke Estes: passion, team strength and mission 38:00 – Rob's call to action: “If you want your own Prisma team — start now.” Enjoying the show? Email editor@ems1.com to share feedback or suggest future guests. 

In episode 63 we discuss the association between buprenorphine dose and neonatal opioid withdrawal syndrome. Marc B, Marion D, François B, Lakshmipriya L. Is buprenorphine maternal dose associated with neonatal opioid withdrawal syndrome severity? Am J Addict. 2025 Jan;34(1):15-20. We also discuss private equity in health care and nitrous oxide (Galaxy Gas). AMA Journal of Ethics: Is Pursuing Profit Commensurable With Providing Good Health Care? David T. Zhu: presentation on private equity at the 2025 From Research to Recovery Conference. Smithsonian Magazine: The Long, Strange History of Nitrous Oxide, a Popular Drug Users Have Been Inhaling for Hundreds of Years --- 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 this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the use of buprenorphine for acute pain management with Thomas Hickey, MD, MS, following the February 2025 publication of “Buprenorphine versus full agonist opioids for acute postoperative pain management: a systematic review and meta-analysis of randomized controlled trials.” Dr. Hickey is full-time staff at the West Haven VA where he is medical director of preoperative evaluation and the PACU, and site director for the anesthesiology residency. Within the VA, he is chairman of the VA New England Healthcare System committee on preoperative evaluation and ERAS, co-chair of the VA's national pain/opioid consortium for research workgroup on perioperative management of medications for opioid use disorder, and a member of the National Anesthesia Program Acute Pain Management Committee. He is board certified in both anesthesiology and addiction medicine. His research interests focus on the overlap between addiction medicine and acute pain management, particularly on the use of buprenorphine for acute pain management. He and his wife are kept busy by their three kids and all their activities. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

In this episode, we explore how to choose between methadone, buprenorphine, and naltrexone for opioid use disorder treatment. With over 100,000 overdose deaths annually, how do we match the right medication to save each patient's life? Faculty: Smita Das, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Pharmacologic Management of Opioid Use Disorder Tailored Patient Assessment: A Key to Effective OUD Treatment  

In this episode, we explore buprenorphine management for opioid use disorder, covering induction protocols, dosing strategies, and long-term maintenance. Why do patients need to be in withdrawal before starting this life-saving medication, and how can we make this challenging process more manageable? Faculty: Smita Das, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Pharmacologic Management of Opioid Use Disorder Buprenorphine for Managing OUD

In this episode, I divide Suboxone, buprenorphine, and naloxone into syllables, tell you which syllables to emphasize, and share my sources. As a bonus, I share my Suboxone mispronunciation from ~2002. The written pronunciations are below and in the show notes on https://www.thepharmacistsvoice.com/podcast.   Note: we don't cover pharmacology in this series. Just pronunciations. The FULL show notes are available at https://www.thepharmacistsvoice.com/podcast.    Suboxone = sub-OX-own Emphasize the second syllable, OX (which sounds like “BOX” when you say Suboxone fast) Sources: For the written pronunciation, read the medication guide for Suboxone https://www.suboxone.com/pdfs/medication-guide.pdf. Spoken pronunciations - google.com, m-w.com, or drugs.com.   buprenorphine = byoo pre NOR feen Emphasize NOR  Sources: Written - medlineplus.gov. Spoken - google.com, m-w.com, or drugs.com    naloxone = nal-OX-one  Emphasize OX (which sounds like “LOX” when you say naloxone fast) Sources: Written - medlineplus.gov. Spoken - google.com, m-w.com, or drugs.com    Thank for listening to the 59th episode in my drug pronunciation series!   If you'd like to recommend a drug name for this series, please reach out through the contact form on my website, thepharmacistsvoice.com.   If you know someone who would like to learn how to say Suboxone, buprenorphine, or naloxone, please share this episode with them. Subscribe for all future episodes. This podcast is on all major podcast players and YouTube. Popular links are below. ⬇️   Apple Podcasts   https://apple.co/42yqXOG  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt   ⭐️ Sign up for The Pharmacist's Voice ® monthly email newsletter! https://bit.ly/3AHJIaF   Host Background: Kim Newlove has been an Ohio pharmacist since 2001 (BS Pharm, Chem Minor). Her experience includes hospital, retail, compounding, and behavioral health. She is also an author, voice actor (medical narrator and audiobook narrator), podcast host, and consultant (audio production and podcasting).    Links for this episode Suboxone written pronunciation (accessed July 17, 2025) https://www.suboxone.com/pdfs/medication-guide.pdf  Buprenorphine written pronunciation (accessed July 17, 2025) https://medlineplus.gov/druginfo/meds/a605002.html Naloxone written pronunciation (accessed July 17, 2025) https://medlineplus.gov/druginfo/meds/a616003.html  Spoken pronunciations for all three drug names today: google.com, m-w.com, and drugs.com Note: I was unable to find the written pronunciations for buprenorphine and naloxone in the USP Dictionary Online. The USP Dictionary Online is my go-to resource for written generic drug pronunciations.    Other episodes in this series The Pharmacist's Voice Podcast Episode 337, Pronunciation Series Episode 58 (rosuvastatin)  The Pharmacist's Voice Podcast Episode 335, Pronunciation Series Episode 57 (QVAR) The Pharmacist's Voice Podcast Episode 333, Pronunciation Series Episode 56 (pantoprazole)  The Pharmacist's Voice Podcast Episode 330, Pronunciation Series Episode 55 (oxcarbazepine) The Pharmacist's Voice Podcast Episode 328, Pronunciation Series Episode 54 (nalmefene) The Pharmacist's Voice Podcast Episode 326, Pronunciation Series Episode 53 (Myrbetriq) The Pharmacist's Voice Podcast Episode 324, Pronunciation Series Episode 52 (liraglutide)  The Pharmacist's Voice Podcast Episode 322, Pronunciation Series Episode 51 (ketamine) The Pharmacist's Voice Podcast Episode 320, Pronunciation Series Episode 50 (Jantoven) The Pharmacist's Voice Podcast Episode 318, Pronunciation Series Episode 49 (ipratropium) The Pharmacist's Voice Podcast Episode 316, Pronunciation Series Episode 48 (hyoscyamine) The Pharmacist's Voice Podcast Episode 313, Pronunciation Series Episode 47 (guaifenesin) The Pharmacist's Voice Podcast Episode 311, Pronunciation Series Episode 46 (fluticasone) The Pharmacist's Voice Podcast Episode 309, Pronunciation Series Episode 45 (empagliflozin) The Pharmacist's Voice Podcast Episode 307, Pronunciation Series Episode 44 (dapagliflozin) The Pharmacist's Voice Podcast Episode 304, Pronunciation Series Episode 43 (cetirizine)  The Pharmacist's Voice Podcast Episode 302, Pronunciation Series Episode 42 (buspirone)  The Pharmacist's Voice Podcast Episode 301, Pronunciation Series Episode 41 (azithromycin) The Pharmacist's Voice Podcast Episode 298, Pronunciation Series Episode 40 (umeclidinium) The Pharmacist's Voice Podcast Episode 296, Pronunciation Series Episode 39 (Januvia)  The Pharmacist's Voice Podcast Episode 294, Pronunciation Series Episode 38 (Yasmin) The Pharmacist's Voice Podcast Episode 292, Pronunciation Series Episode 37 (Xanax, alprazolam) The Pharmacist's Voice Podcast Episode 290, Pronunciation Series Episode 36 (quetiapine)  The Pharmacist's Voice Podcast Episode 287, pronunciation series ep 35 (bupropion) The Pharmacist's Voice Podcast Episode 285, pronunciation series ep 34 (fentanyl) The Pharmacist's Voice Podcast Ep 281, Pronunciation Series Ep 33 levothyroxine (Synthroid) The Pharmacist's Voice ® Podcast Ep 278, Pronunciation Series Ep 32 ondansetron (Zofran) The Pharmacist's Voice ® Podcast Episode 276, pronunciation series episode 31 (tocilizumab-aazg) The Pharmacist's Voice ® Podcast Episode 274, pronunciation series episode 30 (citalopram and escitalopram) The Pharmacist's Voice ® Podcast Episode 272, pronunciation series episode 29 (losartan) The Pharmacist's Voice Podcast Episode 269, pronunciation series episode 28 (tirzepatide) The Pharmacist's Voice Podcast Episode 267, pronunciation series episode 27 (atorvastatin)  The Pharmacist's Voice Podcast Episode 265, pronunciation series episode 26 (omeprazole) The Pharmacist's Voice Podcast Episode 263, pronunciation series episode 25 (PDE-5 inhibitors) The Pharmacist's Voice Podcast Episode 259, pronunciation series episode 24 (ketorolac) The Pharmacist's Voice ® Podcast episode 254, pronunciation series episode 23 (Paxlovid) The Pharmacist's Voice ® Podcast episode 250, pronunciation series episode 22 (metformin/Glucophage) The Pharmacist's Voice Podcast ® episode 245, pronunciation series episode 21 (naltrexone/Vivitrol) The Pharmacist's Voice ® Podcast episode 240, pronunciation series episode 20 (levalbuterol) The Pharmacist's Voice ® Podcast episode 236, pronunciation series episode 19 (phentermine)  The Pharmacist's Voice ® Podcast episode 228, pronunciation series episode 18 (ezetimibe) The Pharmacist's Voice ® Podcast episode 219, pronunciation series episode 17 (semaglutide) The Pharmacist's Voice ® Podcast episode 215, pronunciation series episode 16 (mifepristone and misoprostol) The Pharmacist's Voice ® Podcast episode 211, pronunciation series episode 15 (Humira®) The Pharmacist's Voice ® Podcast episode 202, pronunciation series episode 14 (SMZ-TMP) The Pharmacist's Voice ® Podcast episode 198, pronunciation series episode 13 (carisoprodol) The Pharmacist's Voice ® Podcast episode 194, pronunciation series episode 12 (tianeptine) The Pharmacist's Voice ® Podcast episode 188, pronunciation series episode 11 (insulin icodec)  The Pharmacist's Voice ® Podcast episode 184, pronunciation series episode 10 (phenytoin and isotretinoin) The Pharmacist's Voice ® Podcast episode 180, pronunciation series episode 9 Apretude® (cabotegravir) The Pharmacist's Voice ® Podcast episode 177, pronunciation series episode 8 (metoprolol)  The Pharmacist's Voice ® Podcast episode 164, pronunciation series episode 7 (levetiracetam) The Pharmacist's Voice ® Podcast episode 159, pronunciation series episode 6 (talimogene laherparepvec or T-VEC)  The Pharmacist's Voice ® Podcast episode 155, pronunciation series episode 5 Trulicity® (dulaglutide)  The Pharmacist's Voice ® Podcast episode 148, pronunciation series episode 4 Besponsa® (inotuzumab ozogamicin) The Pharmacist's Voice ® Podcast episode 142, pronunciation series episode 3 Zolmitriptan and Zokinvy The Pharmacist's Voice ® Podcast episode 138, pronunciation series episode 2 Molnupiravir and Taltz The Pharmacist's Voice ® Podcast episode 134, pronunciation series episode 1 Eszopiclone and Qulipta   Kim's websites and social media links: ✅ Guest Application Form (The Pharmacist's Voice Podcast) https://bit.ly/41iGogX ✅ Monthly email newsletter sign-up link https://bit.ly/3AHJIaF  ✅ LinkedIn Newsletter link https://bit.ly/40VmV5B ✅ Business website https://www.thepharmacistsvoice.com ✅ Get my FREE eBook and audiobook about podcasting ✅ The Pharmacist's Voice ® Podcast https://www.thepharmacistsvoice.com/podcast ✅ Drug pronunciation course https://www.kimnewlove.com  ✅ Podcasting course https://www.kimnewlove.com/podcasting  ✅ LinkedIn https://www.linkedin.com/in/kimnewlove ✅ Facebook https://www.facebook.com/kim.newlove.96 ✅ Twitter https://twitter.com/KimNewloveVO ✅ Instagram https://www.instagram.com/kimnewlovevo/ ✅ YouTube https://www.youtube.com/channel/UCA3UyhNBi9CCqIMP8t1wRZQ ✅ ACX (Audiobook Narrator Profile) https://www.acx.com/narrator?p=A10FSORRTANJ4Z ✅ Start a podcast with the same coach who helped me get started (Dave Jackson from The School of Podcasting)! **Affiliate Link - NEW 9-8-23**      Thank you for listening to episode 339 of The Pharmacist's Voice ® Podcast.  If you know someone who would like this episode, please share it with them!

Prescriber-Level Changes in Buprenorphine Dispensing in the USA Before and After Federal Policy Changes Aimed at Increasing Prescribing Journal of General Internal Medicine This study used interrupted-time-series analysis to model prescriber-level trends in buprenorphine prescriptions after recent federal policy changes.  It found that the elimination of the waiver requirement to prescribe buprenorphine in December 2022 was associated with a significant increase in the number of buprenorphine prescribers, but a decrease in the mean number of patients and the mean number of prescriptions per prescriber. Changes in telehealth flexibilities and relaxed training requirements were largely not associated with prescribing changes. This study expands on prior research by providing further insight as to why waiver elimination has not increased the number of patients receiving buprenorphine, as expected.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

In episode 61 we discuss pregnancy outcomes with bup/nlx compared to bup alone. Straub L, et al. Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone. JAMA. 2024 Sep 10;332(10):805-816. doi: 10.1001/jama.2024.11501. We also discuss the elimination of SAMHSA and methamphetamine-related deaths. STAT News:Trump's mental health and addiction problem New York Times:As Fentanyl Deaths Slow, Meth Comes for Maine --- 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 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 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. 

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