Recognition and Management of Patients with Opioid Use Disorder (OUD)-CME Paid Option-Recognition and Management of Patients with Opioid Use Disorder (OUD)

Video Transcription

Video Summary

Dr. Joshua Bloom’s presentation explains how primary care clinicians can recognize and manage opioid use disorder (OUD). He reviews how opioid prescribing for acute pain can unintentionally lead to long-term use, dependence, misuse, overdose, and OUD, especially with higher doses and longer durations. Key risk factors include young age, psychiatric illness, other substance use, sleep-disordered breathing, and especially benzodiazepine co-prescribing.  <br /><br />He emphasizes screening before starting chronic opioid therapy using tools like the SOAP-R, Opioid Risk Tool, and Current Opioid Misuse Measure, along with urine drug testing and pill counts. He also explains that urine tests have important limitations and do not diagnose OUD. OUD is diagnosed using DSM-5 criteria, with severity based on the number of symptoms.  <br /><br />Treatment focuses on medication for opioid use disorder (MOUD), especially buprenorphine, methadone, and injectable naltrexone. He challenges common myths that these medications are “trading one addiction for another” and stresses they reduce mortality and improve functioning. Harm reduction is also central, especially naloxone access for anyone with OUD or high overdose risk.  <br /><br />Overall, he urges clinicians to treat OUD as a medical condition, maintain a supportive relationship, and connect patients to evidence-based care.

Keywords

opioid use disorder

primary care

buprenorphine

methadone

naltrexone

naloxone

risk assessment