What is Different About Opioid Dependent Patients Who Smoke?-Slides

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The document "What is Different About Opioid Dependent Patients Who Smoke?" by Maher Karam Hage, MD, outlines strategies to help individuals with opioid use disorder (OUD) who also struggle with smoking. The text highlights the role of the SAMHSA-funded Opioid Response Network (ORN) in offering local resources and expertise for handling the opioid crisis and stimulant use disorders. The ORN provides education and technical assistance to states and organizations, facilitating evidence-based prevention and treatment efforts for substance use disorders (SUDs).<br /><br />The document underscores the high rates of smoking among individuals with SUDs, which is 70-80%, and the negative health impacts and increased risk of SUD relapse linked with tobacco use. Integrating smoking cessation into SUD treatment is discussed, with references to studies demonstrating the benefits of quitting smoking on substance use outcomes without harming recovery efforts. It also emphasizes the neurobiological link between nicotine addiction and other mental health issues, contributing to increased smoking prevalence among those with SUDs.<br /><br />The discussion features a wide range of smoking cessation interventions relevant to patients with SUDs, including Nicotine Replacement Therapies (NRTs), Bupropion, and Varenicline. The document stresses the importance of employing combined pharmacotherapy approaches and tailoring treatment to patient needs and smoking habits. Suggestions are made regarding the correct usage of various cessation aids and considerations such as potential adverse effects and interactions with other medications.<br /><br />Moreover, it addresses challenges in implementing smoking cessation in SUD treatment due to low priority, lack of training among providers, and limited insurance coverage, while emphasizing the necessity of tackling these barriers. Finally, the document encourages simultaneous or sequential cessation depending on patient readiness and comfort, without delaying smoking cessation unnecessarily in the recovery journey.

Keywords

opioid use disorder

smoking cessation

substance use disorders

Opioid Response Network

nicotine addiction

pharmacotherapy

treatment integration

SAMHSA

neurobiological link

smoking prevalence