Opioid Use Disorder
Course #56964 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
Morphine and heroin were first synthesized and used medicinally in the nineteenth century, and recreational and illicit use followed. Historically, heroin dependence has been difficult to treat successfully, with poor outcome being attributed to patient characteristics, environmental factors, and the powerful reinforcing effects of the drug. Agonist-replacement therapy was introduced 40 years ago and represented a breakthrough in the management of heroin addiction. Advances in treatment have included newer pharmacotherapies, psychosocial therapy, and the growth and accessibility of 12-step programs such as Narcotics Anonymous. This course will provide the most pertinent, up-to-date information regarding the characteristics of the patients with opioid use disorder; the mechanism of opioid action and the neurobiology of opioid addiction; the epidemiology, diagnosis and risk factors of opioid abuse and dependence; and pharmacologic, psychosocial, 12-step/self-help, and alternative therapies that are effective in treating opioid use disorders. Additionally, the demographics, characteristics, comorbidity and treatment of synthetic and prescription opioid use disorder will be addressed.
- INTRODUCTION
- DEFINITIONS
- BACKGROUND
- EPIDEMIOLOGY OF OPIOID USE DISORDER
- CLASSIFICATION
- OPIOID SYNTHESIS
- PHARMACOLOGY
- CLINICAL EFFECTS
- SPECIFIC OPIOID DRUGS
- NATURAL HISTORY OF OPIOID DEPENDENCE
- PATHOPHYSIOLOGY
- EFFECTS OF OPIOID USE DISORDER
- OPIOID OVERDOSE
- OPIOID WITHDRAWAL
- LIABILITY OF MISUSE OF LEGITIMATELY PRESCRIBED OPIOID DRUGS
- MANAGEMENT OF OPIOID USE DISORDER
- MANAGEMENT OF COMORBID PSYCHOPATHOLOGY
- OPIOID USE DURING PREGNANCY
- PROGNOSIS OF TREATMENT FOR OPIOID USE DISORDER
- CONCLUSION
- Works Cited
- Evidence-Based Practice Recommendations Citations
This course is designed for dental professionals who may be involved in identifying or treating opioid use disorder.
Practice guidance for opioid use disorder in primary care has not kept pace with rapid, profound changes in this area, leaving healthcare professionals with outdated and incomplete information to guide the clinical management of opioid use disorder and related morbidity. The purpose of this course is to close this gap to allow dental professionals to provide the best, evidence-based care to patients with opioid use disorder.
Upon completion of this course, you should be able to:
- Define key terms associated with opioid abuse and dependence.
- Outline the background and epidemiology of opioid use and abuse, including risk factors for misuse and dependence.
- Describe the pharmacology and clinical effects of opioids.
- Discuss characteristics of specific opioid drugs and opioid antagonists.
- Review the natural history, pathophysiology, and effects of opioid abuse and dependence.
- Identify signs and symptoms of opioid overdose and withdrawal.
- List the issues associated with the abuse of or dependence on legitimately prescribed opioids.
- Discuss the role of crisis intervention and harm reduction in the management of opioid abuse and dependence.
- Identify methods of managing the detoxification and withdrawal associated with cessation of opioid abuse or dependence.
- Discuss therapies used to maintain extended abstinence from opioids, including agonist replacement and abstinence therapies.
- Identify common psychologic comorbidities present in opioid-dependent patients and implications for treatment.
- Outline the effects of opioid use on fetuses and neonates and appropriate interventions for opioid-dependent pregnant women.
- Identify factors associated with favorable/unfavorable treatment outcome.
Mark Rose, BS, MA, LP, is a licensed psychologist in the State of Minnesota with a private consulting practice and a medical research analyst with a biomedical communications firm. Earlier healthcare technology assessment work led to medical device and pharmaceutical sector experience in new product development involving cancer ablative devices and pain therapeutics. Along with substantial experience in addiction research, Mr. Rose has contributed to the authorship of numerous papers on CNS, oncology, and other medical disorders. He is the lead author of papers published in peer-reviewed addiction, psychiatry, and pain medicine journals and has written books on prescription opioids and alcoholism published by the Hazelden Foundation. He also serves as an Expert Advisor and Expert Witness to law firms that represent disability claimants or criminal defendants on cases related to chronic pain, psychiatric/substance use disorders, and acute pharmacologic/toxicologic effects. Mr. Rose is on the Board of Directors of the Minneapolis-based International Institute of Anti-Aging Medicine and is a member of several professional organizations.
Contributing faculty, Mark Rose, BS, MA, LP, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Mark J. Szarejko, DDS, FAGD
The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.