Educational Activities Archives

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 62-80 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 as the definition of elderly or old is arbitrary, and this will be discussed. The course will look at the prevalence, screening and treatment of non-medical use of prescription drugs and illicit opioids, as well as use of tobacco, alcohol, stimulants and cocaine, marijuana, and non-opioid sedative hypnotic agents. There are interactive questions throughout the course to help digest and discuss the information presented.

Opioid use disorder (OUD) among women who become pregnant is increasing in prevalence in clinical settings. This course reviews the historical and current context of opioid use of women during pregnancy. The learner will follow the case study of Ashley during her pregnancy and the birth of her baby, and will engage in reflection and knowledge check questions.

Opioids are commonly prescribed for chronic pain, but are also associated with a risk for serious harms, including overdose and opioid use disorder. This course 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 course 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.

Patient-centered care has become a crucial approach when working with patients with substance use disorder (SUD). Unfortunately, the care continuum can be interrupted for patients with SUDs, often due to stigma and discrimination. Each interruption increases challenges in access to care and can lead to patient harm. Language can intentionally or unintentionally perpetuate stigma. As people who care for patients with SUDs, we need to learn their rights so we can advocate for them and change our language to reduce stigma. This course will discuss the importance of patient-centered care, improved language when discussing substance use, and advocacy strategies that clinicians can use when caring for people who use substances.

Opioid use disorder (OUD) has highly effective FDA-approved medications for its treatment. This course reviews and compares pharmacological treatment options for individuals with OUD, including methadone, buprenorphine (sublingual 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 are reviewed, and different treatment models are presented. The course includes case vignettes in which medication options for OUD are considered.

Lab testing in the assessment of substance use disorders may involve many different substrates, though urine drug testing (UDT) dominates clinical practice. This course is meant to provide a short guide to effective use of lab testing in the treatment of the patient with a substance use disorder, which, to a surprising degree, is often misused or misunderstood. The course 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 positives 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 substance is often just a downstream metabolite of several possible parent compounds to which the patient was exposed. The course concludes with a discussion of the difference between UDT for clinical purposes versus forensic ones.