Maria Broadstreet – Patients in Crisis: Life Threatening Risks of Opioids, Medical Marijuana, Vaping

Outline

The Opioid Crisis: Dealers, Doctors and Drug Companies

• Are there really gateway drugs?
• The path from post-op pain treatment to heroin
• Saving our “children”
• Opioid use amongst healthcare providers

Risks of the Opioid Options

• Natural vs. synthetic options
• Opioids for treatment of pain
• Genetic risks coming to light
• Why fentanyl is scarier than heroin

Opioids ARE Changing the Brain

• Effect of different drugs on brain neurons
• MRI’s before and after opioid abuse
• Pleasure center in the brain – is it just willpower?
• Can the effects be reversed?
• Association with other diagnoses (depression/ADHD)

Life Threatening Challenges

• Is it reasonable to expect a patient to just stop?
• Withdrawal signs/symptoms
• Initial interventions when you don’t know what your patient has taken
• Ethics of supplying clean needles
• Interpretation of drug test results
• Safe drug disposal

Treatment Options

• Inpatient vs. outpatient benefits
• Medication assisted
  • Buprenorphine – what you MUST know
  • Methadone
  • Mitigating medications
  • Quickly recognize symptoms of precipitated withdrawal
  • Process of induction
  • Maintenance
• Lucemyra
• Therapy and group counseling
• Assessment of true pain vs. drug-seeking behavior
• Your safety in a potentially dangerous situation
• Provider requirements – X waiver

Narcan

• What can go wrong with this life-saving treatment
• Quick overdose assessment
• Why Narcan will not work on non-opiate overdoses
• Administration perils
• Critical assessment AFTER Narcan administration

Marijuana: Medical…or Otherwise

• Conditions benefited by medical marijuana
• Long-term implications of recreational use
• Ramifications of legalization
• Side effects can be life threatening

The New Hot Topic of Vaping

• What we know and what we don’t know yet
• The risks of various vaping devices
• Patient education based upon the latest injury/death statistics

Patients in Addiction Crisis

• Early intervention more effective than treating at “rock bottom”
• Expecting quitting “cold turkey” is just unrealistic
• Relapse IS predictable
• MAT is NOT trading one drug for another
• Addiction is not just “1 gene”
• Opioids change the brain