Motivation and emotion/Book/2020/Opioid use disorder

Overview

 * 1) What are Opioids?
 * 2) What is Opioid Use Disorder?
 * 3) What current treatment plans exist to treat Opioid Use Disorder?
 * 4) What challenges are faced before, during and after treatment?

Focus questions:
 * What is the Opioid Use Disorder?
 * How can it be treated?
 * What challenges are there in treating Opioid Use Disorder?

What is Opioid Use Disorder?
Opioids


 * react to receptors in the brain to reduce pain. Other side effects can include drowsiness, feelings of euphoria, confusion.
 * Primary use in post operative care, palliative care, acute pain recovery and end of life respite
 * Can be natural or synthetic
 * Types of Opioids include:
 * Fentanyl,
 * oxycodone (OxyContin®)
 * hydrocodone (Vicodin®),
 * codeine
 * morphine


 * High dosages can be fatal as opioids cause respiratory issues
 * Synthetic Opioids accounted for the deaths of 30,000 Americans in 2017

Definition of Opioid Use Disorder, its prevalence, history and effect - https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder


 * Opioids are highly addictive, with dependence occurring within 4-8 weeks
 * DSM-V defines Opioid Use disorder by the following symptoms
 * Taking larger amounts or taking drugs over a longer period than intended
 * Persistent desire or unsuccessful efforts to cut down or control opioid use
 * Spending a great deal of time obtaining or using the opioid or recovering from its effects
 * Craving, or a strong desire or urge to use opioids
 * Problems fulfilling obligations at work, school or home.
 * Continued opioid use despite having recurring social or interpersonal problems.
 * Giving up or reducing activities because of opioid use.
 * Using opioids in physically hazardous situations.
 * Continued opioid use despite ongoing physical or psychological problem likely to have been caused or worsened by opioids.
 * Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
 * Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

How can it be treated?
Current methods of treatment and areas of future study - Motivation


 * MAT - Medication-assisted Treatment
 * Combines behavioral therapy with medication - medication can assist in both the relieving withdrawals and assisting healthy brain chemistry


 * Cognitive Behavioral Therapies
 * Contingency management
 * Motivational Interviewing



What Challenges are there in treating Opioid Use Disorder?
Challenges in treatment -


 * 1 in 4 have access to MAT
 * recovery requires long term support
 * access to medication and treatment
 * access to support services

Conclusion

 * 1) What is Opioid Use Disorder?
 * 2) How is it effectively treated (based on psychological theory and research)?
 * 3) What more can be done?