SUD 101 Module 6 - Integrating Opioid Use Disorder Treatment in Clinical Care-Presentation

Video Transcription

Video Summary

Dr. Laura Fanucchi presents an overview of integrating opioid use disorder (OUD) treatment into clinical care, emphasizing its necessity as a chronic medical disease akin to diabetes. Addiction involves genetic and environmental factors, affecting brain circuits tied to reward and control. OUD treatment in general medical settings—including primary care, emergency departments, and hospitals—is crucial due to high mortality rates and increasing overdose deaths driven by synthetic opioids like fentanyl.<br /><br />Three FDA-approved medications for OUD are methadone (a full opioid agonist), buprenorphine (a partial agonist with a ceiling effect reducing overdose risk), and naltrexone (an opioid antagonist). Methadone and buprenorphine significantly reduce mortality and improve social outcomes, but remain underutilized due to systemic barriers, especially for rural and minority populations.<br /><br />Effective treatment models include office-based opioid treatment (OBOT), the hub-and-spoke system, and hospital addiction consult services, which integrate pharmacotherapy and psychosocial support. Screening tools like the NIDA Modified ASSIST aid diagnosis based on DSM-5 criteria.<br /><br />Buprenorphine initiation requires patients to be in mild to moderate withdrawal to avoid precipitated withdrawal, and can be done in-office or at home with appropriate education.<br /><br />Emergency departments and hospitals are key intervention points, but treatment gaps persist. Managing pain in hospitalized patients with OUD involves maintaining tolerance and using multimodal analgesia.<br /><br />Overdose prevention, naloxone distribution, stigma reduction through person-centered language, and community education are vital. Future goals focus on universal acceptance of OUD treatment as essential chronic disease care integrated across healthcare and social systems.

Keywords

Opioid Use Disorder

OUD Treatment

Methadone

Buprenorphine

Naltrexone

Addiction Genetics

FDA-approved Medications

Overdose Prevention

Healthcare Integration