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Motivation and emotion/Book/2020/Opioid use disorder

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Opioid use disorder:
What is opioid use disorder and how can it be treated?
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Overview

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  1. What are Opioids?
  2. What is Opioid Use Disorder?
  3. What current treatment plans exist to treat Opioid Use Disorder?
  4. What challenges are faced before, during and after treatment?

Focus questions:

  • What is the Opioid Use Disorder?
  • How can it be treated?
  • What challenges are there in treating Opioid Use Disorder?

What is Opioid Use Disorder?

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Opioids

  • react to receptors in the brain to reduce pain. Other side effects can include drowsiness, feelings of euphoria, confusion.
    • Primary use in post operative care, palliative care, acute pain recovery and end of life respite
    • Can be natural or synthetic
    • Types of Opioids include:
      • Fentanyl,
      • oxycodone (OxyContin®)
      • hydrocodone (Vicodin®),
      • codeine
      • morphine
  • High dosages can be fatal as opioids cause respiratory issues
  • Synthetic Opioids accounted for the deaths of 30,000 Americans in 2017

Definition of Opioid Use Disorder, its prevalence, history and effect - https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder

  • Opioids are highly addictive, with dependence occurring within 4-8 weeks
  • DSM-V defines Opioid Use disorder by the following symptoms
    • Taking larger amounts or taking drugs over a longer period than intended
    • Persistent desire or unsuccessful efforts to cut down or control opioid use
    • Spending a great deal of time obtaining or using the opioid or recovering from its effects
    • Craving, or a strong desire or urge to use opioids
    • Problems fulfilling obligations at work, school or home.
    • Continued opioid use despite having recurring social or interpersonal problems.
    • Giving up or reducing activities because of opioid use.
    • Using opioids in physically hazardous situations.
    • Continued opioid use despite ongoing physical or psychological problem likely to have been caused or worsened by opioids.
    • Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
    • Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

How can it be treated?

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Current methods of treatment and areas of future study - Motivation

  • MAT - Medication-assisted Treatment
    • Combines behavioral therapy with medication - medication can assist in both the relieving withdrawals and assisting healthy brain chemistry
  • Cognitive Behavioral Therapies
  • Contingency management
  • Motivational Interviewing
 
Morphin[spelling?] - Morphine, an opioid

What Challenges are there in treating Opioid Use Disorder?

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Challenges in treatment -

  • 1 in 4 have access to MAT
    • recovery requires long term support
    • access to medication and treatment
    • access to support services

Conclusion

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  1. What is Opioid Use Disorder?
  2. How is it effectively treated (based on psychological theory and research)?
  3. What more can be done?

See also

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References

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Bhatia, G., & Sarkar, S. (2020). Sublingual buprenorphine-naloxone precipitated withdrawal–A case report with review of literature and clinical considerations. Asian Journal of Psychiatry, 53 doi:10.1016/j.ajp.2020.102121

Pius, A. K., Jones, E., Bonnell, L. N., Fujii, M. H., & MacLean, C. D. (2020). Patients' experience with opioid pain medication after discharge from surgery: A mixed-methods study. Journal of Surgical Research, 256, 328-337. doi:10.1016/j.jss.2020.06.026

Varisco, T., Shen, C., & Thornton, D. (2020). Chronic prescription opioid use predicts stabilization on buprenorphine for the treatment of opioid use disorder. Journal of Substance Abuse Treatment, 117 doi:10.1016/j.jsat.2020.108073

American Psychiatric Association. (2018). Opioid Use Disorder. Retrieved from American Psychiatric Association: https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder

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American Psychiatric Association

Mike Davis: What causes Opioid Addiction, and why is it so tough to combat? (TED ideas worth spreading)

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