Medical Considerations for Patients with Opioid Use Disorder-Presentation

Video Transcription

Video Summary

Jeanette Tetreault, a professor of medicine and public health at Yale, presents an educational module on medical considerations for patients with opioid use disorder (OUD), focusing on injection-related infections and integrated care. Injection drug use can lead to various infections, including skin and soft tissue infections, infective endocarditis, hepatitis C, and HIV, often requiring comprehensive clinical evaluation and treatment.<br /><br />Tetreault discusses a case of a 30-year-old woman with OUD who presents with infection and severe back pain, highlighting the importance of recognizing complications like bacteremia, endocarditis, and osteomyelitis. Treatment should address both infection and underlying substance use, including initiating medications for opioid use disorder during hospitalization to improve outcomes and retention.<br /><br />Screening for hepatitis C and HIV is emphasized, with hepatitis C being highly prevalent among injection drug users and treatable with modern, well-tolerated direct-acting antivirals leading to high cure rates. Prevention strategies include vaccination, screening, addiction treatment, and harm reduction. Opioid agonist therapy also lowers risk of hepatitis C and HIV transmission. For HIV, pre-exposure prophylaxis (PrEP) is an important antiviral prevention tool.<br /><br />Overall, hospitalization for injection-related complications is a critical opportunity to engage patients in addiction treatment, screening, and prevention efforts to improve health outcomes and reduce mortality associated with OUD and related infections.

Keywords

opioid use disorder

injection-related infections

infective endocarditis

hepatitis C screening

HIV prevention

opioid agonist therapy

addiction treatment