A Holistic & Practical Approach for Addressing Opioid Substance Use Disorder-Berry

Video Transcription

Video Summary

Kristen Berry, a family medicine physician and MAT prescriber, discusses opioid use disorder in primary care, focusing on stigma, diversion, adherence, and comorbidities. She explains how stigma—rooted in labeling and discrimination—creates barriers to treatment at individual, health system, and societal levels. She emphasizes that medication for opioid use disorder is highly effective, reducing death and other harms, and urges providers to use humanizing language, examine personal bias, and address racial disparities affecting Black communities.  <br /><br />The talk then covers diversion, defined as illegal or unintended use of prescribed medication. Diversion often reflects barriers to access, such as provider shortages, cost, and long wait times. Recommended safeguards include thorough assessment, urine drug screening, pill counts, frequent visits, PDMP checks, electronic prescribing, refill limits, and strict co-prescribing policies.  <br /><br />Adherence is described as a dynamic process influenced by addiction severity, mental health, stigma, cost, transportation, and the provider-patient relationship. Success includes retention, improved health, stronger relationships, and reduced shame. New tools like mobile apps and CBT-based platforms may improve adherence.  <br /><br />Finally, she reviews common comorbidities: psychiatric disorders, polysubstance use, infectious diseases like HIV and hepatitis C, and skin/soft tissue infections in people who inject drugs. She stresses integrated, team-based care, routine screening, harm reduction, and attention to social determinants of health.

Asset Caption

Dr. Berry Stigma Recording

Keywords

opioid use disorder

primary care

stigma

medication for opioid use disorder

diversion

adherence

comorbidities

harm reduction