1 MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Mark Fisher Program Administrator State Opioid Treatment Administrator Kentucky Division of Behavioral Health
2 OBJECTIVES Learn about types of opioids and associated withdrawal symptoms Learn what medications are available to treat opioid addiction Understand the pros and cons associated with each medication Understand the risks and benefits of utilizing these medications during pregnancy
3 Addiction A brain disease, not a social dysfunction. Green light, Red light responses.
5 Short Definition of Addiction Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is characteristic biological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one s behaviors and interpersonal relationships. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. Source: American Society of Addiction Medicine ( ASAM)
6 OPIOID ADDICTION AND TREATMENT Opioids-effects and withdrawals Methadone Buprenorphine-Suboxone and Subutex Naltrexone
7 OPIOIDS Naturally occurring from opium (opiate)- morphine, codeine, and thebaine Semi-synthetics (opiate)- Morphine-heroin, MS Contin Codeine-Vicodin, Lortab, Oxycodone, Percoset, Tylox, Oxycontin Thebaine-Not used therapeutically, but converted into Naloxone, Naltrexone, Buprenorphine Fully-synthetic (opioid)- Methadone, Fentanyl, Darvon
8 IMPACT OF OPIOIDS ON PHYSICAL HEALTH Drowsiness Constipation Depression of CNS Physical dependence and addiction Infections and collapsed veins
9 PHYSICAL IMPACT CONT. Liver or kidney disease Damage to vital organs Hyperalgesia HIV and Hepatitis C Fatal overdose
10 IMPACT OF OPIOID ADDICTION ON EMOTIONAL, SOCIAL, AND FAMILY Decrease/cease self care and ADL s Increase in criminal behavior Loss of job, school difficulties Depression, anxiety Dishonesty, lack of trust
11 EMOTIONAL/SOCIAL IMPACT CONT. Less quality time with family Lose/harm relationships Compromise personal values Engage in high risk behaviors Financial burden to community
13 WITHDRAWAL SYMPTOMS CONT. Involuntary leg movements Restlessness Runny nose Sweating Vomiting Bone and joint pain
14 OPIOID WITHDRAWAL Peak between 48 and 72 hours after last dose. Feels like terrible flu. Typically subsides after about 1-2 weeks. Can show persistent withdrawal symptoms for months. Less dangerous than alcohol, but for those in poor health can be fatal.
15 METHADONE-MYTH V. FACT Finding Normal
16 METHADONE Developed on the battlefield in WWII Germany for pain relief. Schedule II narcotic Long acting opioid analgesic (24-36 hours) Full mu opioid agonist-binds and activates creating a Blocking Effect.
17 METHADONE Long half-life (12-59 hours) Administered orally- always in liquid form National average dose is 80 milligrams
18 METHADONE TREATMENT Medication is only one component ( wrap around services) Detoxification v. Maintenance (MMT) Opiate Treatment Programs Overview of average OTP Federal and State regulations Kentucky s programs
19 Kentucky Opioid Treatment Programs Kentucky Opioid Treatment Programs 1 Narcotics Addiction Program/bluegrass.org Bus: (859) Center for Behavioral Health Kentucky Inc Bus: (502) Corbin Professional Associates Bus: (606) E-town Addiction Solutions, LLC Bus: (270) Associates, Lexington Professional Bus: (859) MORE Center/Methadone/Opiate Rehab. & Ed Bus: (502) Northern Kentucky Clinic, LLC Bus: (859) Paducah Professional Associates Bus: (270) Paintsville Professional Associates Bus: (606) Perry County Treatment Services Bus: (606) Center, Pikeville Treatment Bus: (606) Ultimate Treatment Center Bus: (606) Western Kentucky Medical Bus: (270) Center for Behavioral Health Inc. Frankfort Bus: (502) Georgetown Medical, LLC* Bus: (502) Center for Behavioral Health, Bowling Green Bus: (270) Carroll Counseling Carrollton* Bus: (502) Maysville Medical LLC* Bus: (606) Daviess Treatment Services* Bus: (270) Simpson Treatment Center* Bus: (270) * Indicates a Medication Station
20 Drug overdose rate by county
21 Kentucky Counties in Crisis
22 Substance use by county
23 METHADONE BENEFITS Right dose does not cause euphoric or tranquilizing effects.* This does not apply to opiate naïve individuals. Reduces/blocks effects of other opiates. Tolerance is slow to develop.
24 METHADONE BENEFITS Relieves cravings. Allows the individual to feel normal. Improved employment status and family relationships.
25 METHADONE BENEFITS Decrease in criminal activities. Decrease in high risk behaviors such as IVDU = decrease in HIV and Hep. C. Improved health and health care.
26 METHADONE LIMITATIONS Increased risk when combined with other drugs. (Benzodiazapines) Can only be dispensed/administered through an OTP. Private can be expensive. Heavily regulated, lots of rules, can be time consuming.
27 METHADONE LIMITATIONS Abuse liability and diversion Use by pain management programs Opiate naïve users Associated health complications torsade de pointes-qt prolongation, arrhythmia - ventricular tycachardia
28 BUPRENORPHINE (SUBOXONE) Overcoming Dependence
29 BUPRENORPHINE Drug Addiction Treatment Act of 2000 In 2002, two forms were FDA approved- Subutex and Suboxone, both made by Reckitt-Benckiser. Schedule III narcotic Opioid analgesic with effects up to 6 hours.
30 BUPRENORPHINE Partial mu opioid agonist (ceiling effect) Long half-life (24-60 hours) Administered as sublingual tablet Subutex- 2 mg or 8 mg buprenorphine Suboxone- 2 mg bup +.5 mg naloxone 8 mg bup + 2 mg naloxone
31 SUBUTEX Contains Buprenorphine only. Minimally used in U.S. today except with pregnant women. Higher rate of diversion, can be injected.
32 SUBOXONE Naloxone added as means to decrease diversion. Poor bioavailability sublingually, but if dissolved and injected, will precipitate withdrawal. High diversion potential with lack of regulatory oversight.
33 BUPRENORPHINE TREATMENT Medication is only one component Short-term v. long-term OTP v. OBOT (Office Based) Overview Federal and State guidelines Kentucky s programs
34 BUPRENORPHINE BENEFITS Virtually no euphoric or tranquilizing effects. Blocks effects of other opiates. Relieves cravings to use other opiates. Allows normal function. Lower abuse liability and diversion potential than Methadone.
35 BUPRENORPHINE BENEFITS Increased anonymity and less intrusive, vs. attending a MAT clinic daily. Increased treatment options/access to treatment. Decrease in high-risk behaviors. Good step down option for those tapering from Methadone.
36 BUPRENORPHINE LIMITATIONS Expensive. Cannot take if opiates still in your system. Counseling may not be available or affordable in the same area as doctor. Doctors limited to 30 patients the first year with a maximum of 100.
37 BUPRENORPHINE LIMITATIONS No regulations for clinics, only practice guidelines. Potential for overdose of other opiates due to ceiling effect. Abuse and diversion potential still exists.
38 NALTREXONE Long half-life (up to 72 hours) Opioid antagonist-binds, but blocks instead of activates Is NOT an opiate
39 NALTREXONE Used primarily to treat alcohol dependence due to blocking neurotransmitters believed to be involved with alcohol dependence. Oral- ReVia Injectable- Vivitrol Implant- not FDA approved
40 NALTREXONE TREATMENT Medication is only one component. Average length of treatment is 3 months. Works best with highly motivated patients.
41 NALTREXONE BENEFITS Any physician can prescribe in any setting. Relatively inexpensive when compared to Methadone or Buprenorphine. Non-addictive, does not produce dependence, and does not build tolerance.
42 BENEFITS CONT. More acceptance in abstinence-based programs. Less stigma than Methadone or Buprenorphine. In KY Medicaid covers, but only oral is 1 st - tier; injectable is a 3 rd -tier.
43 NALTREXONE LIMITATIONS Does not help with cravings. Poor compliance with oral version. Cannot have any opiates in system when starting treatment or will precipitate withdrawal.
44 LIMITATIONS CONT. Injection site reactions Risk of overdose in attempt to break through blockade. Cannot be used with pregnant clients.
45 MAT AND PREGNANCY No FDA approved medications. Cold turkey detox may trigger miscarriage, pre-term labor. Methadone is recommended and preferred mode of treatment. ( Gold Standard) Subutex shows to be promising.
46 MAT AND PREGNANCY CONT. Individualized approach, informed choice. Decreases/ceases cycles of intoxication and withdrawal Decrease in high risk behaviors
47 MAT AND PREGNANCY CONT. Prenatal care Additional services-parenting, nutrition Opportunity to address other factorsmental health, social supports, basic needs
48 KORTOS Ky Opiate Replacement Treatment Outcome Study FY 2012 Abstinence rates increased dramatically ( 6 month review) Rx opioid use decreased 91% from admission Non-Rx methadone decreased 82% Heroin use decreased 100% Alcohol intoxication down 67% Arrests down 65% Decrease in economic hardships down 34% Improved recovery supports up 40%
49 Three things to remember 900 % increase in people seeking treatment in the last decade. 25,428 Kentuckians were admitted to drug and alcohol treatment programs 90+ Kentuckians die EACH MONTH from drug overdoses. Prescription drug overdoses is #1 cause of accidental death- has overtaken MVA s
50 2013 Statistics Heroin arrests have increased 2,334 percent from 32 in 2008 to 779 in 2012 in Louisville LMPD Seizures of heroin are up 6,688 percent LMPD blames 80 percent of burglaries and thefts on heroin addicts Jadac ( Jefferson Alcohol Drug Abuse Center)- 90 percent of its calls are heroin related Kentucky State Police -heroin submissions; in 2010 were 451, in 2012 they were 1074
51 KEY POINTS TO REMEMBER No perfect medication that is one size fits all. All 3 medications work significantly better when utilized in combination with counseling, drug screens, etc. MAT may be appropriate for pregnant women but must be closely monitored and have informed consent. Individuals receiving MAT are in recovery!
52 CONTACT INFORMATION Mark Fisher DMHDID 275 East Main St. Frankfort, KY (502)
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Mark Fisher Program Administrator State Opioid Treatment Adminstrator Kentucky Division of Behavioral Health OBJECTIVES Learn about types of opioids and
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Mark Fisher, MS, SOTA Program Administrator State Opioid Treatment Administrator Kentucky Division of Behavioral Health OBJECTIVES Learn about types of
Medication Assisted Therapy and Pregnancy: An Introduction Deborah A. Orr, Ph.D. The Center For Drug Free Living Adapted from the NIDA Blending Initiative Curriculum Presentation Objectives Define opioids
Heroin Overdose Trends and Treatment Options Neil A. Capretto, D.O., F.A.S.A.M. Medical Director Type date here www.gatewayrehab.org Drug Overdose Deaths Increasing in Allegheny County Roberta Lojak holds
Medication Assisted Treatment for Opioid Addiction Tanya Hiser, MS, LPC Premier Care of Wisconsin, LLC October 21, 2015 How Did We Get Here? Civil War veterans and women 19th Century physicians cautious
OBJECTIVES Learn about types of opioids and associated withdrawal symptoms Learn what medications are available to treat opioid addiction Understand the pros and cons associated with each medication Understand
The ABCs of Medication Assisted Treatment J E F F R E Y Q U A M M E, E X E C U T I V E D I R E C T O R C O N N E C T I C U T C E R T I F I C A T I O N B O A R D The ABCs of Medication Assisted Treatment
Opioid Addiction and Methadone: Myths and Misconceptions Nicole Nakatsu WRHA Practice Development Pharmacist Learning Objectives By the end of this presentation you should be able to: Understand how opioids
Integrating Medication- Assisted Treatment (MAT) for Opioid Use Disorders into Behavioral and Physical Healthcare Settings All-Ohio Conference 3/27/2015 Christina M. Delos Reyes, MD Medical Consultant,
Frequently Asked Questions (FAQ s): Medication-Assisted Treatment for Opiate Addiction March 3, 2008 By: David Rinaldo, Ph.D., Managing Partner, The Avisa Group In this FAQ What medications are currently
Joel Millard, DSW, LCSW Dave Felt, LCSW 1. Provide an overview of the effectiveness of medication assisted treatment, to include a discussion of the different types of medications and how they are used
Heroin Heroin is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown
visited on Page 1 of 5 LEARN MORE (HTTP://WWW.NAMI.ORG/LEARN-MORE) FIND SUPPORT (HTTP://WWW.NAMI.ORG/FIND-SUPPORT) GET INVOLVED (HTTP://WWW.NAMI.ORG/GET-INVOLVED) DONATE (HTTPS://NAMI360.NAMI.ORG/EWEB/DYNAMICPAGE.ASPX?
Opioid/Opiate Dependent Pregnant Women The epidemic, safety, stigma, and how to help. Presented by Lisa Ramirez MA,LCDC & Kerby Stewart MD The prescription painkiller epidemic is killing more women than
PRESCRITPION DRUG ABUSE: AN EPIDEMIC What is Addiction? By: Lon R. Hays, M.D., M.B.A. Professor and Chairman Department of Psychiatry University of Kentucky Healthcare Addiction is a primary, chronic disease
Heroin Heroin is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown
We re glad you are here! Agenda for the Day Breaks Lunch Q&A and note cards Phones Learn about the history of opioid addiction and discuss what is happening today in Kentucky Learn about the disease of
Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently asked questions What is Naltrexone? Naltrexone is a prescription drug that completely blocks the effects of all opioid drugs
Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently Asked Questions What is Naltrexone? Naltrexone is a prescription drug that effectively blocks the effects of heroin, alcohol,
Heroin Introduction Heroin is a powerful drug that affects the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants to.
Heroin Heroin is a synthetic opiate drug that is highly addictive. It is made from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears
Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Marvin D. Seppala, MD Chief Medical Officer Hazelden Betty Ford Foundation This product is supported by
MEDICAID DRUG SPENDING ON ANTI- ADDICTION MEDICATION AND OPIOID ADDICTION REFRESHER TWO PRIMARY ACCESS POINTS Pharmacy Benefit Dispensed by a Pharmacy Billed via the PBM Process (NCPCP) Oversight by Drug
BUPRENORPHINE TREATMENT: A Training For Multidisciplinary Addiction Professionals Module II Opioids 101 Goals for Module II This module reviews the following: Opioid addiction and the brain Descriptions
Professional Intervention and Treatment Related to Opioid Misuse and Addiction Michael M. Miller, MD, FASAM, FAPA Drug Poisoning Summit: Stop the Overdose Epidemic January 30, 2012 University of Wisconsin
Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence Information for Family Members Family members of patients who have been prescribed buprenorphine/naloxone for treatment of opioid addiction
Sarah Akerman MD Assistant Professor of Psychiatry Director of Addiction Services Geisel School of Medicine/Dartmouth-Hitchcock Medical Center OVERVIEW OF MEDICATION ASSISTED TREATMENT Conflicts of Interest
Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone ) Elinore F. McCance-Katz, M.D., Ph.D. Professor and Chair, Addiction Psychiatry Virginia Commonwealth University Neurobiology of Opiate
BULLETIN INTELLIGENCE Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III drug has been made available for use
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Sidarth Wakhlu,M.D. Addiction Team Leader North Texas VA Health Care System Addiction Psychiatry Fellowship Director Associate Professor Of Psychiatry
Neurobiology and Treatment of Opioid Dependence Nebraska MAT Training September 29, 2011 Top 5 primary illegal drugs for persons age 18 29 entering treatment, % 30 25 20 15 10 Heroin or Prescription Opioids
Who We Are BHG s Medical Mission BHG Company Overview Behavioral Health Group (BHG) is a leading provider of opioid addiction treatment services. Our treatment centers provide pharmacotherapeutic maintenance
Use of Buprenorphine in the Treatment of Opioid Addiction Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Executive Summary Which of the following is an
This is a fact in the treatment of alcohol and drug abuse: Patients who do well in treatment do well in any treatment and patients who do badly in treatment do badly in any treatment. One example: Chapman
Page 43 by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. Information for Pharmacists SUBOXONE (buprenorphine HCl/naloxone HCl
Opioids Research to Practice CRIT Program May 2011 Daniel P. Alford, MD, MPH Associate Professor of Medicine Boston University School of Medicine Boston Medical Center 32 yo female brought in after heroin
A GUIDE FOR USERS UNaltrexone abstinence not using a particular drug; being drug-free. opioid antagonist a drug which blocks the effects of opioid drugs. dependence the drug has become central to a person
Considerations in Medication Assisted Treatment of Opiate Dependence Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT Disclosures Speaker Panels- None Grant recipient - SAMHSA
Treatment of opioid use disorders Gerardo Gonzalez, MD Associate Professor of Psychiatry Director, Division of Addiction Psychiatry Disclosures I have no financial conflicts to disclose I will review evidence
Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Good News: Medical treatments called opioid (oh-pee-oyd) maintenance can help you! Injecting heroin puts you
Use of Vivitrol for Alcohol and Opioid Addiction Ken Bachrach, Ph.D. Clinical Director, Tarzana Treatment Centers, Inc. email@example.com What is Vivitrol? An injectable from of naltrexone, which
Substitution Therapy for Opioid Dependence The Role of Suboxone Mandy Manak, MD, ABAM, CCSAM Methadone 101-Hospitalist Workshop, October 3, 2015 Objectives Recognize the options available in treating opioid
Medications for Alcohol and Drug Dependence Treatment Robert P. Schwartz, M.D. Medical Director Rschwartz@friendsresearch.org Friends Research Institute Medications for Alcohol Dependence Treatment Disulfiram
Presenters Erin Hall MSOT Hon. Kyle B. Haskins Closed Doors or Welcome Mat? Opening the Way for Medication-Assisted Treatment in Family Drug Courts Oklahoma Specialty Court Conference Thursday September
Beyond SBIRT: Integrating Addiction Medicine into Primary Care Community Clinic Association of Los Angeles County 14 th Annual Health Care Symposium March 6, 2015 Keith Heinzerling MD, Karen Lamp MD; Allison
MEDICATION ASSISTED TREATMENT (MAT) STATISTICS: ALCOHOL AND OPIOID USE Last year 33 Iowans died from opioid overdose deaths; an additional 19 individuals died of a heroin overdose. The number of drug overdose
Getting the best result from Opioid medicine in the management of chronic pain Your doctor has prescribed you opioid medicine to help you manage your chronic pain. This patient information leaflet gives
Opioids and Medications to Treat Opioid Dependence Colleen T. LaBelle BSN, RN-BC, CARN Program Director STATE OBOT B Boston University School of Medicine Boston Medical Center Colleen T LaBelle, RN, CARN
Opioid Addiction & Methadone Maintenance Treatment Dr. Nick Wong MD, CCFP AADAC Edmonton ODP AADAC AHMB Concurrent Disorder Series September 13, 2007 1 What is Methadone? What is methadone? Synthetic opioid.
MEDICATION GUIDE VIVITROL (viv-i-trol) (naltrexone for extended-release injectable suspension) Read this Medication Guide before you start receiving VIVITROL injections and each time you receive an injection.
Clinical Practice Approval Form Clinical Practice Title: Acute use of Buprenorphine for the Treatment of Opioid Dependence and Detoxification Type of Review: New Clinical Practice Revisions of Existing
Medication Assisted Treatment Tanya Hiser, MS, LPC State Opioid Treatment Authority Bureau Of Prevention, Treatment, & Recovery State of Wisconsin Elizabeth Collier, MSW, CSAC, ICS, LCSW TANF Best Practice
Prior Authorization Guideline Guideline: CSD - Suboxone Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Analgesics and Antipyretics (Opiate Partial Agonists) Client: County of San
Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013 Chairman Lee, members of the Senate Human Services Committee,
Using Drugs to Treat Drug Addiction How it works and why it makes sense Jeff Baxter, MD University of Massachusetts Medical School May 17, 2011 Objectives Biological basis of addiction Is addiction a chronic
Considerations in Medication Assisted Treatment of Opiate Dependence AOAAM OMED Education Program Sunday, October 7, 2012 Stephen A. Wyatt, D.O. Addiction Psychiatrist Middlesex Hospital Middletown, Connecticut
Opioids Information for Health Professionals Introduction Opioid is the generic term for any substance that binds to the opioid receptors found in the central nervous system (CNS), gastrointestinal tract,
1063 Lower Main St, Ste C212 JEFFREY H. CHESTER, DO Phone 808.249.8887-6006 www.ponohealthcare.com Board Certified by American Board of Physical Medicine & Rehabilitation Board Certified by American Society
TABLE OF CONTENT 4 5 7 8 9 11 12 13 2 HOW TO TREAT HEROIN ADDICTION Almost 1 million Americans (about 966,000 people) struggle with heroin dependency, according to statistics from the National Institute
Opioids Research to Practice CRIT/FIT 2015 May 2015 Daniel P. Alford, MD, MPH, FACP, FASAM Associate Professor of Medicine Assistant Dean, Continuing Medical Education Director, Clinical Addiction Research
Addiction Medicine for FP / GP Dr. Francisco Ward, DABPMR/PM SetonPainRehab.com firstname.lastname@example.org S Disease of Chemical Addiction Short Definition of Addiction (ASAM): Addiction is a primary, chronic disease
Medication-Assisted Addiction Treatment Molly Carney, Ph.D., M.B.A. Executive Director Evergreen Treatment Services Seattle, WA What is MAT? MAT is the use of medications, in combination with counseling
Medication is not a part of treatment. Medication can be an effective part of treatment. Medication is used in the treatment of many diseases, including addiction. Medical decisions must be made by trained
Dependence and Addiction Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania Overview Heroin and other opiates The disease of heroin addiction or dependence Effective
Drug Court EPIDEMIC In the 10 years (1997 2007) the per capita retail purchases of Methadone, Hydrocodone and Oxycodone in the United States increased 13-fold, 4-fold and 9-fold, respectively. 4.6 % OF
Medication-Assisted Treatment (MAT) & What It Means Long-Term Gary K. Byrd., M.Ed., MAC, CCS, CAMS Methadone is the Gold Standard for treatment of chronic heroin addiction Gary Byrd 2015 1 Gary Byrd 2015
MEDICATION GUIDE SUBOXONE (Sub OX own) (buprenorphine and naloxone) Sublingual Tablets (CIII) IMPORTANT: Keep SUBOXONE in a secure place away from children. Accidental use by a child is a medical emergency
Governor s Cabinet Opiate Action Team Promoting Wellness and Recovery John R. Kasich, Governor Tracy J. Plouck, Director Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio November 14,
MEDICALLY SUPERVISED OPIATE WITHDRAWAL FOR THE DEPENDENT PATIENT An Outpatient Model OBJECTIVE TO PRESENT A PROTOCOL FOR THE EVALUATION AND TREATMENT OF PATIENTS WHO ARE CHEMICALLY DEPENDENT ON OR SEVERLY
Practice Protocol Buprenorphine Guidance Protocol Developed by the Arizona Department of Health Services Division of Behavioral Health Services Effective Date: 02/23/11 Title Buprenorphine Guidance Protocol
Medication-Assisted Treatment for Opiate Addiction and the Public Financing of that Treatment Introduction March 3, 2008 By: Suzanne Gelber, MSW, Ph.D., Managing Partner, The Avisa Group Defining Characteristics
Opioid Analgesics (or Narcotic Analgesics) We are moving on to a new category of drugs whose effects, superficially, may look similar to those of the CNS depressants, but the drugs are, in fact, a completely
Buprenorphine: what is it & why use it? Dr Nicholas Lintzeris, MBBS, PhD, FAChAM Locum Consultant, Oaks Resource Centre, SLAM National Addiction Centre, Institute of Psychiatry Overview of presentation
Rationale for and approach to treating Opiate Use Disorders Gavin Bart, MD PhD FACP DFASAM Director, Division of Addiction Medicine Department of Medicine Hennepin County Medical Center Associate Professor
Objectives The Pharmacokinetics and Pharmacodynamics of methadone and buprenorphine Therapeutic implications Why we dose the way we do Dosing and Suboxone 2016 Does Not Have a Sense of Humor A long acting,
Update and Review of Medication Assisted Treatments for Opiate and Alcohol Use Disorders Richard N. Whitney, MD Medical Director Addiction Services Shepherd Hill Newark, Ohio Medication Assisted Treatment
NALTREXONE INDUCED DETOXIFICATION FROM OPIOIDS A METHOD OF ANTAGONIST INITIATED TREATMENT Opioid dependence is a devastating and frequently fatal medical condition. It is a manifestation of addictive disorder
Iowa Governor s Office of Drug Control Policy medicines or take them in a manner not prescribed, we increase the risk of negative effects. It is estimated that over 35 million Americans are ages 65 and
Treatment and Interventions for Opioid Addictions: Challenges From the Medical Director s Perspective Dale K. Adair, MD Medical Director/Chief Psychiatric Officer OMHSAS 1 Treatment and Interventions for
SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets Risk Evaluation and Mitigation Strategy (REMS) Program Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Pharmacists
MAT Counselor Education Course Exam Questions Packet Part 1 Course No: Course Title: Course Objective: MA-1901P1 Medication-Assisted Treatment (MAT) Counselor Education Course Part 1 Includes primer on