Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-CME Paid Option-Module-4

Video Transcription

Video Summary

This micro-learning on opioid stewardship uses a case of Tom, a 65-year-old man on chronic opioids, clonazepam, and weekend alcohol use to show how to reduce overdose risk without necessarily stopping opioids. The key message is to recognize “stacked” overdose risks: older age, opioid therapy, benzodiazepines, alcohol, and a dose above 50 MME/day. Recommended strategies include routinely co-prescribing naloxone, providing clear overdose education, using nonjudgmental counseling and motivational interviewing, checking the PDMP, considering urine drug testing, involving trusted contacts, and encouraging safer use behaviors. The session also warns against abrupt opioid tapering, which can raise overdose and mortality risk. Practical options for Tom include discussing tapering clonazepam or opioids, rotating to buprenorphine, limiting alcohol, and carrying naloxone. Overall, the training emphasizes harm reduction, shared decision-making, and ongoing risk reassessment at every visit.

Keywords

opioid stewardship

overdose risk

naloxone

benzodiazepines

harm reduction