Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton, Virginia. They walk us through an approach to pain management in persons with a history of opioid use disorder (OUD), discuss treatment options for OUD, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson, MD and Carolyn Chan, MD

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Credits

Time Stamps

00:00 Intro

01:58 Host picks of the week

04:10: Intro to the episode

04:35: Guest Bios

12:32: Case from Kashlak Memorial

13:40 Define substance dependence, substance use, unhealthy use

17:42 Where to go next conversation about pain control

17:54: Assessing risk of relapse

19:35 Screening Tools

20:10 Risk factors for developing OUD when initiating opioids.

25:10: CDC Guidelines length of prescription and risk of substance use disorder (7)

27:00: Defining optimal length of opioid after common surgical procedures (6)

30:30: Long term use of opioids

33:50: OUD treatment options

37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8)

38:50: POATs: Prescription opioids (9)

40:05 Social support and mental health services for SUD treatment

41:10 Risk of abstinence and adverse outcomes

42:35 Protracted withdrawal

43:35: Editorial BMJ Golden Month of Opioid use disorder (10)

44:00 Overdose risk in patients on long term opioids

44:40 Op-Ed on the Hill (11)

45:40 Example of protracted withdrawal syndrome

47:40 Reducing Harms: Naloxone, who to prescribe to?

50:30 Take home points

53:40 Outro