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Results sorted by posted date (oldest first)
Posted 11/19/2019 (updated 3/25/2024)
The intersection of opioid abuse, particularly injection drug use (IDU), and HIV is well documented; in fact, IDU is the second most frequent route of HIV transmission. Injection drug use, either directly or via sexual contact with an IDU partner, accounts for one-third of the estimated AIDS cases since the beginning of the epidemic, and 18 percent of new infections in the United States.
Posted 5/26/2021 (updated 4/10/2024)
Opioid dependence is a chronic relapsing disorder with considerable individual and global public health burden. The current standard of care for opioid dependence includes treatment with methadone or sublingual (SL) buprenorphine or buprenorphine-naloxone (hereafter, buprenorphine), combined with psychosocial and behavioral support. Both medications are associated with reductions in mortality, illicit opioid use, bloodborne viral infections, and criminal behavior as well as better cost-effectiveness than no treatment or psychosocial treatment alone. Buprenorphine is a partial μ-opioid receptor agonist, enabling office-based treatment for nonsupervised or take-home use of the medication. However, SL formulations of buprenorphine are prone to nonmedical use (eg, injecting, diversion), prompting models of care, particularly in the early phases of treatment, requiring regular attendance at clinics or pharmacies for administration of doses.
Posted 10/5/2021 (updated 4/3/2024)
This webinar focused on the crucial role of the emergency department (ED) in recognizing and treating opioid use disorder (OUD) patients with evidence-based medications for addiction treatment. Gail D’Onofrio, MD, discussed her pioneering work in creating the evidence for initiating ED buprenorphine treatment with ED patients presenting with opioid use disorder. Overall, the opioid epidemic intertwined with the COVID-19 pandemic has greatly escalated the need to mitigate the morbidity and mortality associated with the rising rate of fentanyl use. Data supporting the use of buprenorphine in the ED setting as well as the consequences of not initiating treatment will be discussed. While the use of ED prescribed buprenorphine has increased, universal adoption has lagged. Barriers to implementation of ED buprenorphine were discussed as well as strategies to overcome these challenges. Components of successful integration of an ED program with community partnerships was outlined. Current research by emergency physicians regarding innovative strategies such as high-dose buprenorphine inductions and use of extended release 7-day formulation of buprenorphine will be discussed. Initiation buprenorphine effectively, reduces withdrawal symptoms, improves adherence to treatment, and saves lives.