PrintKenneth M. Carpenter, Ph.D. | Columbia University Medical Center, New York, NY, Center for Motivation and Change, New York, NY;
Nicole Kosanke, Ph.D. | Center for Motivation and Change, New York, NY
This module provides an overview of four principles that may play an important role in facilitating behavior change among substance dependent individuals. The combination of psychosocial and medication assisted treatment protocols can provide an additive benefit to individuals striving to alter their substance use. Read more
Benzodiazepines in Chronic Pain: Benefits, Risks, Abuse
By Edward Covington, MD, Cleveland Clinic Foundation
Chronic benzodiazepine use has not been shown to be useful, especially in those with chronic pain. They are hazardous due to overdose deaths, accidents, and cognitive impairment. Read more
Management of Opioid Withdrawal and Overdose II
Christina Brezing, MD | Assistant Professor, Division on Substance Use Disorders, Columbia University Medical Center, New York State Psychiatric Institute
This module describes the management of opioid withdrawal, including induction on to maintenance medication treatment, and overdose. Given the current dimensions of the opioid epidemic and elevated rates of prescribing high-potency opioids, we will focus on strategies for implementing effective treatments for opioid use disorder.
Read more
Hepatitis A, B & C Prevention and Treatment in Persons who Use Drugs
Sandra A. Springer, MD | Associate Professor of Medicine, Department of Internal Medicine, Section of Infectious Disease, Yale School of Medicine
This presentation provides an overview of the epidemiology of Hepatitis A, B and C infection among persons who use drugs in the United States as well as an overview of current recommendations on diagnosis and treatment for these infections.
Read more
Naltrexone Treatment for Opioid Use Disorder: Training for Clinicians (Part 3)
Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY
The third module highlights various aspects of maintenance treatment with naltrexone such as side-effects and safety concerns including ongoing opioid use and the risk of overdose. Clinical challenges seen during treatment with naltrexone and strategies to manage them are discussed as well as the management of relapse, treatment of pain, and mood effects. Finally, the module examines the logistics of using an injectable form of naltrexone.
Read more
Naltrexone Treatment for Opioid Use Disorder: Training for Clinicians (Part 2)
Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY
The second module focuses on the selection of potential candidate patients for naltrexone and procedures to initiate treatment with naltrexone. The module reviews several treatment initiation scenarios that clinicians might face. Detailed protocols to treat opioid withdrawal are offered, each matching patient’s physiological conditions, to assure that patients can be successfully and safely inducted onto naltrexone. Behavioral strategies to increase patient’s engagement in treatment during the induction process are also discussed.
Read more
Introduction to Medication Assisted Treatment (MAT)
Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY
This introductory module is a case-based discussion of the general approach to evaluation and treatment of patients presenting with problematic opioid use. Benefits and limitations of available medications and differences between them are described. An approach to choosing first and second line treatments is also presented. Read more
A Primer on Antagonist-Based Treatment of Opioid Use Disorder in the Office Setting
Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY
Naltrexone, an opioid receptor antagonist, is one of only three medications approved by the FDA to treat opioid use disorder (OUD). Use of naltrexone is presently limited to specialized addiction treatment settings, in part because of the few training opportunities for medical providers on the use of naltrexone. This module presents a summary of a 4-modules training program on the use of naltrexone developed by PCSS. Read more
Naltrexone Treatment for Opioid Use Disorder: Training for Clinicians (Part 1)
Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY
The first module presents background information on the use of opioid antagonists in treatment of OUD. It describes the clinical pharmacology of naltrexone and its mechanism of therapeutic effect, the differences between agonist and antagonist based treatment, the development of various preparations of naltrexone and highlights the available evidence for its efficacy. Read more
Prescribing Naloxone to Patients for Overdose Reversal
Julie Kmiec, DO | Assistant Professor of Psychiatry, University of Pittsburgh School of Medicine Addiction Psychiatry,
Western Psychiatric Institute & Clinic, Pittsburgh, PA
This module discusses the opioid epidemic in the United States and the subsequent opioid overdose epidemic. There are several static and dynamic risk factors for overdose which will be discussed for overdose prevention. The use of naloxone for overdose reversal by bystanders will be discussed, as well as how to prescribe naloxone to those at risk of experiencing or witnessing an accidental overdose. Read more
