Managing Opioid Use Disorder Care in the Era of Fentanyl-Presentation

Video Transcription

Video Summary

Dr. John Mariani discusses managing opioid use disorder in the era of fentanyl. He emphasizes the need for evidence-based practices in the prevention and treatment of opioid use disorders, particularly in prescribing medications. While there is a lack of scientific evidence specifically focused on fentanyl users, Dr. Mariani shares his clinical observations and experiences. He notes that fentanyl has led to a rise in overdose fatalities and a loss of confidence in traditional treatment methods. Fentanyl's high potency and lipophilic nature make it more challenging to treat compared to other opioids like heroin or oxycodone. Dr. Mariani explains the pharmacokinetic and pharmacodynamic differences between fentanyl and other opioids and how these differences may impact treatment outcomes. He also discusses some strategies for managing fentanyl use disorder, such as low-dose and high-dose buprenorphine inductions, as well as the use of extended-release injectable buprenorphine and naltrexone. While there is limited evidence and more research is needed to fully understand the most effective approaches, Dr. Mariani emphasizes the importance of tailoring treatment to individual patients' needs and adjusting strategies based on clinical circumstances. He concludes by highlighting the need for more studies and evidence-based guidelines to guide clinicians in managing fentanyl use disorder.

Keywords

Substance Use Screening

Primary Care

Screening Tools

Implementation Guidance

Dr. Jennifer McNeely

Prevalence of Substance Use

TAPS Tool

Electronic Health Records

Referral and Treatment Options

opioid use disorder

fentanyl

evidence-based practices

treatment

overdose fatalities

pharmacokinetic

pharmacodynamic

buprenorphine inductions

naltrexone

tailoring treatment