Addressing Nicotine Use in Patients with Opioid Use Disorder (On-demand)-Presentation

Video Transcription

Video Summary

The webinar focused on the high co-occurrence of nicotine use and opioid use disorder (OUD) and made the case for treating both together. Dr. Chad Morris reviewed the dramatic decline in cigarette use in the general population, while emphasizing that smoking rates remain extremely high among people with OUD, people in substance use treatment, and justice-involved populations. He also discussed the evolving nicotine landscape, including cigarettes, vaping, oral nicotine pouches, and nicotine replacement therapies.<br /><br />The presentation highlighted the severe health harms of nicotine, especially when combined with opioid use, including increased addiction, respiratory and cardiovascular risks, pain complications, and likely cancer risks from vaping. Dr. Morris stressed that nicotine addiction follows the same biopsychosocial cycle as other substance use disorders and that co-treatment improves long-term abstinence outcomes.<br /><br />Practical guidance included the Five A’s framework, motivational interviewing, assessing dependence, and using evidence-based medications such as varenicline, nicotine replacement therapy, bupropion, and potentially cytisine in the future. Behavioral treatments like CBT, contingency management, peer support, and digital/telehealth tools were also recommended. The talk concluded with case-based strategies for rural care, integrated team workflows, and use of free PCSS MOUD resources and mentoring support.

Keywords

suicide prevention

substance misuse

opioid use disorder

Zero Suicide framework

safety planning

lethal means counseling

co-occurring disorders

trauma-informed care

medications for opioid use disorder

nicotine use

co-treatment

smoking cessation

varenicline

nicotine replacement therapy

motivational interviewing

behavioral treatment