Medications for Opioid Use Disorder > Interduction

Medications for Opioid Use Disorder

Presented by
Lance J. Parks, LCSW

Approvals

This program meets the requirements of continuing education for the California Board of Behavioral Sciences
This program is accepted by the Texas State Board of Examiners of Professional Counselors.
This program is approved for 6 continuing education hours by:
The California Board of Registered Nursing # CEP 14462
Texas State Board of Social Worker Examiners # 5547
The National Board for Certified Counselors # 6412
The Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling #50-14000
Texas Board of Examiners of Marriage and Family Therapists # 628
The California Association for Alcohol and Drug Educators # CP40 725 H 0419
The California Consortium of Addiction Programs and Professionals: CCAPP-IE Provider # 1N-16-256-0822

Objectives

At the end of the course, the participant will be able to:

1)  Define the key terms commonly used and associated with Opioid Use Disorder.
2)  Explain what Opioid Use Disorder is.
3)  Discuss the benefits, effectiveness cost-effectiveness and cost benefits of Medication for OUD.
4)  Identify the challenges to expanding Access to OUD Medication
5)  Explain and apply the Opioid Use Disorder in General Medical Settings
6)  Recognize the Need for and Extent of Assessment in OUD.
7)  Assess and provide treatment planning or Referral to patients.
8)  Discuss Medical Management of Patients Taking OUD Medications in Hospital Settings
9)  Summarize the different types Addiction Treatment.

Course Outline:

  • Chapter 1: Introduction to Medications for Opioid Use Disorder Treatment


    • The Approach to OUD Care

      • A noticeable theme in chronic disease management is patient-centered care.

      • Key Terms


    • Overview of Medications for OUD

      • Benefits

      • Effectiveness

      • Methadone

      • Naltrexone

      • Buprenorphine

      • Cost Effectiveness and Cost Benefits

      • Requirements and Regulations


    • Duration of Treatment With OUD Medication

      • Maintenance Treatment

      • Medication Taper

      • Medically Supervised Withdrawal

    • Treatment Settings

      • Challenges to Expanding Access to OUD Medication

      • Resources (4565 words)

      • Notes

  • Chapter 2: Addressing Opioid Use Disorder in General Medical Settings


    • Scope of the Problem

      • Screening

        • Alcohol Screening

        • Tobacco Screening

        • Drug Screening

    • Assessment

      • Determine the Need for and Extent of Assessment

      • Set the Stage for Successful Assessment

      • Take a Complete History

        • Medical history

        • Mental health history

        • Substance use history

        • SUD treatment history

        • Social history

        • Family history

        • Conduct a Physical Examination

        • Opioid withdrawal

        • Other laboratory tests

    • Treatment Planning or Referral

      • Understanding Treatment Settings and Services

      • Outpatient OUD Treatment Settings

      • Outpatient medical settings

      • Residential drug treatment settings

      • Determining OUD Service Intensity and Ensuring Follow-Through

      • Referring patients to behavioral health and support services

      • Helping patients who are not ready to engage in OUD treatment

    • Resources

    • Appendix

    • Notes

  • Chapter 3: Pharmacotherapy for Opioid Use Disorder


    • Scope of the Problem

    • Overview of Pharmacotherapy for Opioid Use Disorder

      • Introduction to Medications That Address OUD

        • Methadone

        • Naltrexone

        • Buprenorphine

        • Choosing an OUD Medication

        • Comparative Effectiveness

        • Duration of Medication

      • Principles of OUD Pharmacotherapy

        • Basic Function

        • Intrinsic Activity

      • Overview of Medication Indications and Dosing

    • Methadone

      • Formulations

      • Pharmacology

        • Bioavailability

        • Dosing Considerations

        • Contraindications

        • Precautions and Warnings

          • Respiratory Depression

          • Concurrent substance use disorders (SUDs) involving benzodiazepines or alcohol

          • QTc prolongation and cardiac arrhythmia

          • Accidental Ingestion

          • Neonatal abstinence syndrome (NAS)

          • Misuse and diversion

          • Physical dependence

          • Sedation

          • Adrenal insufficiency

          • Drug Interactions

          • Side Effects

          • Assessment

          • Patient Selection

          • Informed Consent


      • Initiating Methadone Treatment

        • Day 1

          • First dose for patients with opioid tolerance

          • First dose for patients without current opioid dependence

        • Dose Titration (Weeks 1 to 2)

        • Dose Titration (Weeks 3 to 4)

          • Serum Levels

        • Dose Stabilization (Week 5 and Beyond)

          • Take-Home Medication

          • Assessing responsible handling of take-home doses

      • Duration of Methadone Treatment

      • Dose Tapering and Methadone Discontinuation

      • Methadone Dosing Summary

        • Enhancing Access to OUD Medication in OTPs

        • Appendix

    • Naltrexone

      • Formulations

      • Pharmacology

        • Bioavailability

        • Dosing Considerations

        • Contraindications

        • Precautions and Warnings

          • Side Effects

          • Assessment

          • Patient Selection

          • Informed Consent

      • Initiating XR-NTX treatment

        • Storage and preparation

        • Administration

          • Follow-up care after first dose

        • Duration of treatment

          • Treatment discontinuation

          • Rapid naltrexone induction

      • Oral Naltrexone

        • All are similar to those for XR-NTX, save issues specific to suspension/diluent contents and the injection itself.

        • Patient Selection

        • Dosing

        • Duration of treatment

      • Naltrexone Dosing Summary

      • Appendix

    • Buprenorphine

      • Formulations
        • History of Approvals

        • Implants

        • Injectables


      • Pharmacology

        • Bioavailability

        • Metabolism and Excretion

        • Dosing Considerations

        • Contraindications

        • Precautions and Warnings

          • Drug Interactions

          • Side Effects

          • Assessment

          • Patient Selection

          • Informed Consent

      • Initiating Buprenorphine Treatment

        • Office-Based Induction

        • Home Induction

        • Induction

          • Patients who are currently physically dependent on opioids

          • Patients with a history of OUD who are not currently physically dependent on opioids

          • Patients who are currently taking methadone

        • Dose Stabilization

      • Risk Evaluation and Mitigation Strategy

      • Transmucosal Buprenorphine Dosing Summary

        • Induction and stabilization

        • Maintenance

        • Duration of treatment

      • Initiation of Buprenorphine Implants

        • Implant procedure

        • Wound care

        • Stabilization

        • Removal

      • Initiation of Buprenorphine Extended Release Injection

        • Storage

        • Administration

        • Medical management

        • Duration of Buprenorphine Treatment

      • Dose Tapering and Buprenorphine Discontinuation

      • Appendix

    • Medical Management Strategies for Patients Taking OUD Medications in Office-Based Settings

      • Patient Selection

      • Patient Management and Treatment Monitoring

      • Course of Treatment

      • Role of the Treatment Plan and Treatment Agreement in Medical Management

        • Medical Management Strategies

        • Referral to counseling and other psychosocial supports

        • Frequency of medical management visits

        • Drug testing in ongoing medical management

          • Opioids and opiates in point-of-service tests

          • Assessing buprenorphine adherence

          • Discontinuing medication for OUD

          • Forced tapers or abrupt discontinuation

        • Patient follow-up

      • Administrative Considerations

      • Storage of Buprenorphine

      • Records for Dispensers

        • Recordkeeping for ordering, storing, and dispensing buprenorphine in the office

        • Recordkeeping for prescribing buprenorphine

      • DEA Inspections

      • Emergency Protocols and Patient Safety Measures

      • Recommendations for Staff & Member Training

      • Appendix

    • Medical Management of Patients Taking OUD Medications in Hospital Settings

      • Hospitalized or ED Patients Taking Medication for OUD

        • Pain Management

        • Buprenorphine

        • Methadone

        • Naltrexone

      • Hospitalized or ED Patients Not Taking Medication for OUD

        • Buprenorphine Induction in the Hospital Setting

        • Methadone Induction in the Hospital Setting

        • Naltrexone Induction in the Hospital Setting

      • Medical Management Plan

      • Notes


  • Chapter 4: Partnering Addiction Treatment Counselors with Clients and Healthcare Professionals

    • Overview and Context

      • Scope of the Problem

      • Setting the Stage

      • Distinguishing OUD From Physical Dependence on Opioid Medications

      • Understanding the Benefits of Medication for OUD

      • Reviewing the Evidence on Counseling in Support of Medication To Treat OUD

      • Using a Recovery-Oriented Approach to Treating Patients With OUD

        • Acknowledge many pathways to recovery

        • Promote recovery for clients with OUD

        • Provide person-centered care

        • Promote family and social support

        • Provide trauma-informed care


      >
    • Quick Guide to Medications

      • Understanding the Neurobiology of OUD

        • Buprenorphine

        • Methadone

        • Naltrexone

      • Knowing What Prescribers Do

        • Administer buprenorphine

        • Administer methadone

        • Administer naltrexone

        • Set expectations

    • Counselor-Prescriber Communications

      • Obtaining Consent

      • Structuring Communications With Prescribers

      • Helping Clients Overcome Challenges in Accessing Resources

    • Creating of a Supportive Counseling Experience

      • Maintaining the Therapeutic Alliance

      • Educating Patients About OUD and a Chronic Care Approach to Its Treatment

      • Counseling Patients on Overdose Prevention and Treatment

      • Helping Patients Cope With Bias and Discrimination

      • Helping Patients Advocate for Themselves

      • Addressing Discrimination Against Clients Who Take OUD Medication

        • Help clients address employment related issues

        • Understand potential legal issues

        • Address issues in dealing with healthcare providers

        • Demonstrate awareness of pregnancy and parenting issues

      • Helping Clients Find Accepting Mutual Help Groups

        • Prepare clients who take medication for OUD to attend mutual-help meetings

        • Facilitate positive mutual-help group experiences

        • Online mutual-help groups

        • Mutual-help groups specific to OTPs

      • Facilitating Groups That Include Patients Taking OUD Medication

    • Other Common Counseling Concerns

    • Notes


  • Chapter 5: Resources Related to Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families


    • General Resources

      • Facts and Figures

      • Groups and Organizations

      • General Information

      • Practice Guidelines and Decision Support tools

      • Assessment Scales and Screening Tools

    • Resources for Counselors and Peer Provides

      • Organizations

      • Publications and Other Resources

    • Resources for Clients and Families

      • Organizations

      • Publications and Other Resources

      • Treatment Locators

      • Patient Success Stories

      • Online Boards and Chat Rooms

    • Provider Tools and Sample Forms

      • Provider Screening and Assessment Tools and Aids

      • Drug Abuse Screening Test (DAST-10)

      • DSM-5 Opioid Use Disorder Checklist

      • TAPS Tool Part I

      • TAPS Tool Part 2

      • Two-Item Drug Use Disorder Screener for Primary Care Clinics Serving U.S. Veterans

      • Urine Drug Testing Window of Detection

      • Provider Informational, Educational, and Decision-Making Tools

      • Key Points of Patient Education for Buprenorphine

      • Key Points of Patient Education for Methadone

      • Key Points of Patient Education for Naltrexone

      • Monitoring Recovery Activities

      • Strategies for Managing Benzodiazepine Use by Patients in OUD Treatment

      • Buprenorphine Forms

      • Naltrexone forms

    • Glossary of TIP Terminology


    • Notes
 
Medications for Opioid Use Disorder > Interduction
Page Last Modified On: September 5, 2020, 08:21 PM