Opioid Abuse Questions & Answers

Updated: Jun 21, 2018
  • Author: David W Dixon, DO; Chief Editor: Glen L Xiong, MD  more...
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Questions & Answers

Overview

What is the prevalence of opioid abuse in the US?

How are symptoms of opioid abuse categorized and what are the signs of an intoxication state?

What are the symptoms of opioid withdrawal?

What are the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for opioid abuse?

How is opioid abuse treated?

What are the American Psychiatric Association (APA) recommended interventions for managing opioid dependence and withdrawal?

What are APA recommendations for psychosocial treatment of opioid use disorder?

What are the classes of opioids in opioid abuse?

What is the pathophysiology of opioids relative to opioid abuse?

What is the constellation of effects associated with mu receptor opioid subtypes in the pathophysiology of opioid abuse?

How long do structural brain changes persist following short-term opioid use?

What is the destructive behavioral pattern associated with opioid abuse?

What is the mechanism of action of methadone in the treatment of opioid abuse?

What steps have the FDA and CDC taken to combat opioid abuse?

What is the mechanism of action of buprenorphine in the treatment of opioid abuse?

What are the mechanisms of tolerance and withdrawal in opioid abuse?

Which factors increase the risk of relapse of opioid abuse?

What is the prevalence of opioid abuse in the US?

How frequently are opioids prescribed for pain in the US?

What is the prevalence of illicit opioid use in the US?

What are the CDC recommendations for prescribing opioids for chronic pain?

What are sources of opioid abuse?

What are the mortality rates of opioid abuse?

What are the death rates from overdoses related to opioid abuse?

What has increased the risk for opioid overdose?

What comorbidities are associated with opioid abuse?

Which factors have been found to reduce opioid-related deaths?

How does the incidence of opioid abuse vary by sex?

What are the age-related predilections of opioid abuse?

Presentation

What are the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for opioid use disorder?

How is tolerance defined in opioid abuse?

What is the clinical history characteristic of withdrawal in opioid abuse?

How is addiction defined in opioid abuse?

Which opioid medications are less likely to lead to opioid abuse?

What are the mental status and physiological effects of dependence in opioid abuse?

What are the mental status and physiological effects of withdrawal in opioid abuse?

What are the mental status and physiological effects of intoxication in opioid abuse?

What are the signs and symptoms of addiction in opioid abuse?

Which factors play a role in the etiology of opioid abuse?

What is the role of pharmacological factors in the etiology of opioid abuse?

What is kratom (Mitragyna speciose?

What is the role of social factors in the etiology of opioid abuse?

What is the role of psychological factors in the etiology of opioid abuse?

What is the role of genetic factors in the etiology of opioid abuse?

DDX

What conditions should be included in the differential diagnoses of opioid abuse?

What is the prevalence of comorbid psychiatric disorders in opioid abuse?

What are the differential diagnoses for Opioid Abuse?

Workup

Which lab studies are performed for the evaluation of opioid abuse and dependence?

Which lab studies are performed for evaluation of withdrawal in opioid abuse?

Which lab studies are performed for evaluation of opioid intoxication?

Which lab studies are performed for evaluation of opioid addiction?

What is the role of imaging studies in the workup of opioid abuse?

What is the role of naloxone challenge testing in the workup of opioid abuse?

Treatment

What are the issues requiring medical management of opioid abuse?

What is included in supportive care for opioid intoxication?

What is the role of naloxone in the management of opioid overdose?

What is the efficacy of at-home naloxone programs for treatment of opioid overdose?

What is the focus of pharmacologic therapy for heroin addiction?

What is the role of methadone in the maintenance therapy for opioid abuse?

What is the role of buprenorphine in maintenance therapy for opioid abuse?

What is the efficacy of buprenorphine therapy for opioid abuse?

What is the role of buprenorphine/naloxone (Zubsolv) in the maintenance treatment of opioid abuse?

What is the role of clonidine in the maintenance treatment of opioid abuse?

What are the requirements for physicians prescribing buprenorphine for maintenance therapy of opioid abuse?

What is the role of buprenorphine implant (Probuphine) in maintenance therapy for opioid abuse?

What is the role of SC injection (Sublocade) in the treatment of opioid use disorder (OUD)?

What is the role of l-alpha-acetylmethadol (LAAM) in the maintenance therapy for opioid abuse?

What is the efficacy of opioid agonist therapy for opioid abuse?

What is the role of injectable, sustained-release naltrexone (Depotrex) for opioid abuse relapse prevention?

What is the efficacy of extended-release naltrexone in the prevention of opioid abuse relapse?

What is the role of long-acting buprenorphine subdermal implant (Probuphine) in prevention of opioid abuse relapse?

What may improve adherence to buprenorphine maintenance treatment for opioid addiction?

What is the role of stress in opioid abuse relapse?

When is residential treatment indicated for the treatment of opioid abuse?

What are the options for management of opiate withdrawal?

What is the role of lofexidine (Lucemyra) in the treatment of opioid withdrawal?

What is the role of the NSS-2 Bridge device in the treatment of opioid withdrawal?

What is the role of the auricular neurostimulator device in the treatment of opioid withdrawal?

Which pharmacologic methods of detoxification are commonly used for opiate withdrawal?

What is the efficacy of alpha-2 adrenergic agonists for management of opioid withdrawal?

What is the role of a naltrexone implant for management of opioid withdrawal?

What is the role of psychotherapies and support groups in the management of opioid abuse?

What are cognitive behavior therapies for opioid abuse?

What is dynamic psychotherapy for the treatment of opioid abuse?

What is the efficacy of group therapy for the treatment of opioid abuse?

What is aversion therapy for opioid abuse?

How is Narcotics Anonymous (NA) used in the treatment of opioid abuse?

What are benefits of psychosocial therapy in the treatment of opioid abuse?

Which patients with chronic pain are at highest risk for opioid abuse?

What are common misconceptions of opioid agonist therapy (OAT) is patients who need pain management?

What are the recommendations for pain management in patients with a history of opioid abuse?

What are the pain management options for patients with a history of opioid abuse?

Medications

What are the goals of drug treatment for opioid abuse?

Which medications in the drug class Alpha 2 adrenergic agonists are used in the treatment of Opioid Abuse?

Which medications in the drug class Opioid Antagonists are used in the treatment of Opioid Abuse?

Which medications in the drug class Opioid Partial Agonist/Opioid Antagonist are used in the treatment of Opioid Abuse?

Which medications in the drug class Analgesics, Opioid Partial Agonist are used in the treatment of Opioid Abuse?

Which medications in the drug class Opioid analgesics are used in the treatment of Opioid Abuse?

Follow-up

What is involved in outpatient care of patients suffering from opioid abuse?

What are possible complications of opioid abuse?

What is the prognosis of opioid abuse?

What should be included in patient education about opioid abuse?

What education should be given to families of patients with opioid abuse?