Naltrexone

Psychiatric pharmacists are advanced practice clinical pharmacists committed to being part of an interdisciplinary team treating substance use disorders, often in combination with serious mental illness. The following SUD toolkits were developed to further the knowledge of pharmacists and other healthcare professionals.

The purpose of this guide is to provide practical clinical practice-based guidance, based on available research combined with emerging clinical experience, on the use of buprenorphine in the treatment of individuals using fentanyl and other highly potent synthetic opioids. 

Opioid use disorder (OUD) can be a fatal addiction with complex implications for new and/or expecting mothers. OUD challenges can lead to many complications for mother and child, including low birth weight, clinical challenges with medical dosing and increased risk of accidental death. In the U.S. alone, a baby is born passively dependent every 15 minutes. To ensure best health outcomes for both mother and child, policies must allow engagement in evidence-based treatment and protect clients from legal ramifications. Hear from a physician, clinic director and an individual with lived experience to broaden understandings about the treatment and policy landscape for pregnant and postpartum women with OUD.

Research indicates a lack of training and programming specific to treating and managing co-occurring opioid and stimulant use disorders, despite the increased risk of overdose bolstered by the ever-changing and adulterated drug supply. While MOUD is the gold standard of care for treating OUD, there are no FDA-approved medications for treating stimulant use disorder, though behavioral therapies like contingency management have been well-studied. These challenges highlight the need to identify promising treatment strategies to ensure individuals with co-occurring opioid and stimulant use disorders are effectively engaged in care to prevent overdose. This session will equip BH providers and organizations in this space, including Community Behavioral Health Clinics (CCBHCs), with the tools necessary to effectively engage and provide quality, team-based care and services to individuals with co-occurring opioid and stimulant use disorders in order to improve health outcomes, reduce overdose risk, and support long-term recovery.

The number of older adults is projected to exceed 72.1 million people by 2030 and members of the baby boomer generation have the highest rates of early life substance use which increases likelihood of substance use in later life. With rates of SUDs growing in older individuals, this population is experiencing mood and anxiety disorders, sleep disorders, cognitive impairments, sleep disruption, hepatic complications, and greater physical disability as co-morbid symptoms of substance use and aging. This webinar aims to improve awareness of the occurrence and impact of SUD as well as teach geriatric SUD screening tools. Finally, the webinar will offer recommendations for pharmacologic and psychosocial treatments for SUD in older adults.

Alcohol use disorder (AUD) is commonly encountered in clinical settings, and FDA approved medications are available. This module reviews and compares pharmacological treatments for individuals with AUD, including acamprosate, disulfiram, and naltrexone (oral and long-acting intramuscular formulations), as well as non-approved (off-label) options including topiramate and gabapentin. Diagnosis of AUD and definitions of binge drinking and “at risk” drinking levels (per US Dietary Guidelines) are discussed. Effects of alcohol use on the brain, including neurotransmitter effects and withdrawal symptoms, are also reviewed. The module concludes with discussion of a case vignette in which medication options for AUD are considered.

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.

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.

Opioids are commonly prescribed for chronic pain, but are also associated with a risk for serious harms including overdose and opioid use disorder. This module reviews risk factors for opioid misuse, opioid use disorder, and overdose in patients with chronic pain, explains methods for screening and assessing for problematic opioid use, reviews methods for mitigating risks associated with prescribed opioids, and details non-opioid treatment approaches for pain. The module is based on principles in the Center for Disease Control and Prevention’s guideline on opioids for chronic pain and reviews recent evidence on benefits and harms of opioids.

At the conclusion of this activity participants should be able to describe the historical evolution and current state of the policies regulating office based prescribing of medications for opioid use disorder, and distinguish these from the federal regulations applicable to opioid treatment programs (OTPs). Participants will also be able to which identify which prescribing clinicians are eligible for the DATA-2000 waiver, the applicable waiver limits including the relevant practice settings impacting waiver limits, and the specific medications for opioid use disorder and clinic settings where the DATA-2000 does not apply. Participants will also be able to explain applicable privacy regulations and the regulations governing managing medications for opioid use disorder via telehealth.