Methadone

Opioid use disorder (OUD) has highly effective FDA approved medications for its treatment. This module reviews and compares pharmacological treatment options for individuals with OUD, including methadone, buprenorphine (SL and injectable formulations), and naltrexone (oral and long-acting intramuscular formulations). Current evidence for each medication is reviewed in detail and studies comparing each are discussed. The purpose and goal of medications for OUD is reviewed and different treatment models are presented. The module includes a discussion of a case vignette in which medication options for OUD are considered.

This module discusses the importance of integrating opioid use disorder (OUD) pharmacotherapy into general medical settings, describes models in primary care, emergency rooms, and hospitals where medications for OUD treatment are successfully included as standard care, and reviews keys to OUD pharmacotherapy implementation in clinical practice. Participants are encouraged to adapt this information for use in their own clinical practices.

Utilization of evidence-based counseling to effectively manage primary care patients with Opioid Use Disorders (OUD) provides the best chance of improving motivation for change, treatment engagement and ultimate remission. Standard Medical Management (SMM) is one such option that can be used that is efficient, focused, and relatively easily integrated into primary care practice. The goal of this module is to prepare participants to deliver the assessment and treatment components of the initial and subsequent 15-minute SMM sessions. Participants will also review brief motivational strategies to manage resistance and/or lack of progress, as well as common issues when treating OUD.

Lab testing in the assessment of substance use disorders may involve many different substrates, though urine drug testing (UDT) dominates clinical practice. This module is meant to provide a short guide to effective use of lab testing in treatment of the patient with a substance use disorder, which to a surprising degree is often misused or misunderstood. The module describes the clinical role of lab testing to guide treatment and not to be punitive. To properly use and interpret UDT, it reviews common false positive and false negatives that might occur in the immunologic-based first step in UDT. To understand confirmatory gas chromatography/mass spectrometry, it goes on to describe the metabolism of common opioids and benzodiazepines, because the detected confirmed moiety often is just a downstream metabolite of several possible parent compounds to which the patient was exposed. The module concludes with a discussion of the difference between UDT for clinical purposes versus forensic ones.

This educational activity reviews other substance use disorders that often co-occur with opioid use disorder (OUD), including benzodiazepines and other tranquilizers, cocaine and stimulants, and cannabis. The presentation will also discuss principles of diagnosis and evaluation of treatment for each of these by themselves, and in the context of OUD.

Substance Use disorders in Older Adults is a growing problem not only in the United States but throughout the developed world. The Baby Boomer generation, born between 1946 and 1964 is turning 58-76 years old this year. This group is presenting with more Substance Use Disorders and need for substance use treatment now. The use of an artificial cut off age of 65 years of age as the definition of elderly or old is somewhat arbitrary and this will be discussed. The module will look at the prevalence, screening and treatment of tobacco, alcohol, opioids, non-medical use of prescription drugs and illicit opioids as well as stimulants and cocaine, marijuana and non-opioid sedative hypnotic agents. A case vignette will drive the CME portion and elucidate the tenants of the module.

This webinar will explore the intersection of substance use and veteran status, examining the impact of post-traumatic stress, moral injury, and systemic barriers to care. Participants will learn about evidence-based interventions, and resources available to veterans.

According to the Substance Abuse and Mental Health Services Administration, in 2019, only 10% of adults in the U.S with any substance use disorder (SUD) received treatment in part because effective evidence-based treatments for SUDs can be difficult to access in many communities.  CCBHCs help address this issue, delivering easily accessible and effective outpatient behavioral health care and SUD treatment through activities including expanded operating hours, same-day and walk-in appointments, outreach to sidelined populations and moving service delivery beyond clinic walls to reach people in their homes and in the community.

This Advisory provides comprehensive information for hospitals and associated healthcare facilities on best practices and recommendations for implementing and expanding treatment of opioid use disorder with methadone in these settings.

Over 2.5 million adults in the U.S. are diagnosed with OUD. In 2022, 12.7% of ED visits involved opioids. Yet only 25% of those who need treatment receive recommended MOUD. MOUDs are highly effective treatments that have been shown to decrease opioid use, cravings and transmission of infectious disease, and to increase retention in treatment. As the opioid epidemic continues to impact people across the U.S., the ED represents a critical access point to the health care system, supporting people with OUD by initiating MOUD, such as buprenorphine, and connecting them to low-threshold, easy-to-access care for continued treatment.