Treat Opioid Use Disorder Now! Save Lives in Your Community! - - PowerPoint PPT Presentation

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Treat Opioid Use Disorder Now! Save Lives in Your Community! - - PowerPoint PPT Presentation

Dec 07, 2022 156 likes •459 views

Treat Opioid Use Disorder Now! Save Lives in Your Community! References I have no financial disclosures. ADDICTION IS NOT A MORAL FAILING. It is a chronic disease that requires medical treatment. Chronic Brain Condition with Treatment

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Treat Opioid Use Disorder Now! Save Lives in Your Community!

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References

I have no financial disclosures.

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ADDICTION IS NOT A MORAL FAILING.

It is a chronic disease that requires medical treatment.

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Substance Use Disorder Chronic–Relapsing Needs Chronic Care

Chronic Brain Condition with Treatment

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Chronic use Acute use Withdrawal Euphoria

Tolerance & Physical Dependence Opioid Agonist Therapy

Normal

No Longer Chasing the High

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The Problem

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Rise in Drug Overdose Deaths

70,237 people Died from drug

  • verdoses in the

US in 2017

Drug overdose deaths, 1980 to 2017

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In 2017 overdose deaths passed fatal motor vehicle collisions

1 IN 96 DIE OF AN OVERDOSE… 1 IN 103 DIE IN CAR CRASHES

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DRUG-RELATED ED VISITS a lost opportunity…

  • 17% of patients discharged from acute care

with a Substance Use Disorder (SUD) diagnosis

  • For every 1,000 people over 15, there are

25 drug-related ED visits

  • 28% of adult ED patients screen positive for

SUD

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HOSPITAL ACQUIRED CONDITION

OVERDOSE

15 x overdose increase in month after discharge

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Number of deaths after ED treatment for nonfatal

  • verdose by number of days after discharge in the

first month (n=130)

Source: Weiner, Scott, et al.. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Annals of Emergency Medicine. April 2, 2019.

CA Bridge Delivers Addiction Treatments When it Matters Most

  • Study of patients treated in

Massachusetts EDs for opioid

  • verdose 2011-2015
  • Illustrates the short-term increase in

mortality risk post-ED discharge

  • Of patients that died, 20% died in the first

month

  • Of those that died in the first month, 22%

died within the first 2 days

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Treatment Starts Here

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  • “Detox” = 80-90% relapse rates
  • Addiction is a chronic disease requiring medication
  • With MOUD (aka MAT)

– 70% ↓ mortality – ↓ illicit opioid use – ↓ HIV and Hep C transmission – Employment, improved quality of life

  • Medication for opioid use disorder is

more successful than counseling

Pierce Addiction 2016 Clark Health Affects 2011 Kimber BMJ 2010

Medications for Opioid Use Disorder

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Respiratory depression

  • Treats cravings and physical symptoms
  • “Ceiling” effect protects against euphoria or significant respiratory

depression….very safe

  • High affinity to opioid receptors…bumps off full agonist

– Decrease in receptor activity induce withdrawal if patient just used

  • pioid (heroin or pills)

Buprenorphine.. “partial agonist”

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Dupouy et al., 2017 Evans et al., 2015 Sordo et al., 2017

Standardized Mortality Ratio

Benefits of MAT: Decreased Mortality Live Longer! Bup Saves Lives!

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37% vs 78%

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  • Brain chemistry and structure of OUD is changed.
  • Those changes require a medication to stabilize the disease.
  • Diabetes - insulin is a stabilizing medication
  • Dosage of meds used does not get them high. Restores

balance in the brain’s circuits.

  • Abuse among opioid-dependent people is low
  • “Street use” of bup is for patients dependent on opiates

without access to MOUD.

Lofwall RA. J Addic Med 2014

Replacing One Drug For Another? Buprenorphine Abuse?

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24-7 access to high quality treatment of substance use disorders in all California hospitals. Now 50+ hospitals as the access point for patients with substance use disorders.

California Bridge Program

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OUD Opioid Use Disorder MAT Medication for Addiction Treatment

2605 2273 Changing Lives, Changing Health Care: 8 months

  • f California Bridge in 52 Hospitals

patients identified with OUD

5078 3818

Patients provided with treatment

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How sick do you feel?

What is COWS?

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ASK THESE QUESTIONS:

  • 1. How sick do you feel?
  • 2. When was the last time you used?
  • 3. What did you use? (frame the question “because I don’t want to make you

sick, I want to help you get better”

  • 4. Have you used Methadone recently?
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  • If patient is admitted for a medical or surgical reason other than opioid dependency:
  • Methadone and buprenorphine can be administered to maintain or

detoxify, including new starts

  • If the patient presents to ED or urgent care in withdrawal:
  • Legal to administer 72 hours of methadone or buprenorphine to treat

withdrawal

  • On discharge, regular rules apply

DEA REGULATIONS

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Marshall 2019 ED DATA:

  • 119 patients with Opioid Use Disorder TREATED
  • 97% Follow-Up Rate, CARES and STEPS
  • 82 % in treatment at 1 month
  • 65% of all 2019 starts still in treatment as of February, 2020
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Get your X-waiver NOW!

Did som eone say 24 hours of CME? WHAT?? Sign m e up for CME and TRAINING to provide LIFE SAVING TREATMENT!! Online is FREE. WORKSHOP : 3:30 -5:30 TODAY AND TOMORROW to COMPLETE YOUR FIRST 4 HOURS!!!

PCSSNOW.ORG

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Arianna Sampso n, PA-C, APP L e ad

Marshall Me dic al Ce nte r, Plac e rville, CA Dire c to r, Co -Princ ipal I nve stigato r, CA Bridge Pro gram Co Dire c to r, CA Substanc e U se Navigato r (SU N) Pro gram Arianna@bridge to tre atme nt.o rg

(530)409-3048