Category: Overdose

Expanding opioid agonist therapy while learning from HIV/AIDS

This post elaborates on the ideas from a recent freely-available commentary published in the journal Addiction.

Accessing opioid agonist therapy (OAT) and maintaining good adherence faces many barriers which can be geographical, financial, regulatory, situational or logistic. In some settings, lack of services hinders access to treatment for people living with opioid use disorder (OUD). In other settings—even where health‐care and medications are provided free of charge—many people who have OUD do not seek OAT. In the United States, recent ‘estimates suggest a gap between treatment need and capacity of 1.4 and 1.3 million in 2012, respectively’ [4]. The ongoing epidemic of OUD needs to develop strategies to recruit and keep patients on OAT.

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Can prescribers avoid contributing to opioid use disorder?

A 21 y/o has surgery for a condition expected to improve. He fills a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Can prescribers avoid contributing to opioid use disorder? Is a renewal of opioid appropriate, potentially dangerous, or both? Read more

Can prescribers avoid contributing to opioid use disorder?

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Hospital based opioid agonist treatment

Researchers recently found that many people with co-occurring mental health and substance use disorders are admitted to inpatient psychiatric units. According to a 2019 report from the Boston’s Institute for Healthcare Improvement and The Grayken Center, “hospitals have the opportunity to make a major impact in reducing morbidity and mortality related to opioid use.” The present study, therefore, looked at patients admitted to an acute care hospital in Vancouver, British Columbia. It sought to improve our understanding of this population and the care provided so that we can improve patients’ outcomes and care experiences.

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Pain Management with Opioids in 2019-2020

This JAMA Insights Clinical Update reviews evidence-based use of opioids to manage noncancer pain, proposing opioid-sparing pain management.  Based on recent literature and the rapidly evolving nature of the opioid overdose epidemic due to the emergence of fentanyl analogues in the illicit drug supply, there are clearly 3 main clinical scenarios being confronted by clinicians where evidence-based recommendations can be made. (more…)