Opioid Use Disorder Case Study

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Questions and Answers

What was Patient E originally prescribed opioids for?

Back pain.

What substance did Patient E start using after prescription opioids?

Heroin.

What emergency treatment did Patient E receive after two overdoses?

Naloxone nasal spray.

What two forms of therapy are discussed with Patient E for his opioid use disorder?

<p>Methadone maintenance and buprenorphine/naloxone therapy.</p> Signup and view all the answers

What was Patient E's response to methadone maintenance?

<p>He did not want daily dosing due to work concerns.</p> Signup and view all the answers

After what timeframe did Patient E experience a relapse following detoxification?

<p>About six weeks.</p> Signup and view all the answers

What long-term treatment approach did Patient E decide on after his relapse?

<p>Buprenorphine/naloxone therapy.</p> Signup and view all the answers

What key factor did the clinician emphasize about opioid use disorder?

<p>It is a chronic disease subject to relapse.</p> Signup and view all the answers

Flashcards

Opioid Use Disorder

A chronic disease characterized by compulsive opioid use despite negative consequences.

Synthetic Fentanyl

A highly potent synthetic opioid often used in place of heroin and leading to accidental overdose.

Naloxone

A medication that reverses opioid overdose.

Methadone Maintenance

A form of medication-assisted treatment (MAT) for opioid use disorder using methadone, a long-acting opioid.

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Buprenorphine/Naloxone

Medication-assisted treatment (MAT) for opioid use disorder that includes buprenorphine, a partial opioid agonist, and naloxone, which reduces cravings.

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Relapse

A return to drug use after a period of sobriety.

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Medication-Assisted Treatment (MAT)

Treatment for substance use disorders that utilizes medications to reduce cravings and withdrawal symptoms, combined with counseling and behavioral therapies.

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Chronic Pain

Persistent pain lasting for a prolonged period, in this case linked to back pain.

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12-step meetings

Support groups based on the principles of Alcoholics Anonymous (AA) , used for recovery from substance use disorder.

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Drug Counselor

A professional trained to provide support and guidance to people struggling with substance use disorders in their recovery.

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Detoxification

The process of physically removing a substance from the body, in this case opioids.

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Biologic Basis of Substance Use Disorder

Focuses on the biological basis for substance use disorder, explaining that these disorders are treatable and not a result of moral failure.

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Study Notes

Case Study of Patient E

  • Patient E, 54, has active opioid use disorder
  • Began using prescription opioids for back pain after serving in the infantry
  • Eventually left military service and is now a construction worker
  • Used heroin for 3 years, likely synthetic fentanyl
  • Experienced two accidental overdoses requiring naloxone
  • Diagnosed with opioid use disorder, residual chronic back pain, and opioid cravings
  • Refused methadone maintenance due to daily dosing requirement and safety concerns related to machinery operation
  • Partner received education on naloxone use
  • Successfully completed 12-step meetings and detoxification within 5 days
  • Experienced relapse after 6 weeks, revived with naloxone
  • Enrolled in buprenorphine/naloxone therapy, aiming for monthly injections
  • Advised of the importance of continuous counseling and understanding of potential relapses
  • Importance of the biologic basis and lack of judgement surrounding substance use disorder was stressed
  • Patient continues with 12 step meetings, individual therapy, and physical therapy for back pain
  • Continued need of naloxone nasal spray for emergency use stressed during follow-up appointments

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