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

Video Transcription

Video Summary

The speaker presented a program on safe opioid prescribing, framed around requirements of the MATES Act and informed by FDA and CDC guidance. The talk emphasized that opioids may be appropriate for selected patients, especially those with cancer-related pain, sickle cell disease, palliative care, end-of-life care, and some carefully monitored non-cancer pain cases. The main goal is balancing adequate pain relief with prevention of overdose, addiction, and other harms.<br /><br />A major theme was understanding pain types and matching treatment appropriately. The speaker reviewed nociceptive, neuropathic, nociplastic, inflammatory, somatic, and visceral pain, explaining that opioids can help some forms of pain but are ineffective for conditions like fibromyalgia/nociplastic pain. Non-opioid and nonpharmacologic options—such as NSAIDs, acetaminophen, anticonvulsants, antidepressants, nerve blocks, physical therapy, and complementary approaches—should be used whenever possible.<br /><br />The lecture also covered core safety practices: risk assessment tools, informed consent, patient-provider agreements, urine drug testing, PDMP checks, and monitoring for analgesia, function, adverse effects, and aberrant behaviors. It distinguished tolerance, dependence, misuse, abuse, addiction, and opioid use disorder, and explained opioid tolerance, equianalgesic dosing, opioid rotation, and incomplete cross-tolerance.<br /><br />Additional safety topics included respiratory depression risk, drug interactions, constipation prevention, safe storage and disposal, abuse-deterrent formulations, and naloxone co-prescribing. The speaker closed by highlighting buprenorphine as an important option, especially for patients with substance use disorder, and encouraged use of SAMHSA, NIDA, and addiction medicine resources for referrals.

Asset Caption

Dr. Galluzzi Safe Opioid Prescribing Recording

Keywords

safe opioid prescribing

MATES Act

FDA guidance

CDC guidance

pain management

opioid risk assessment

non-opioid therapies

opioid tolerance

naloxone co-prescribing

buprenorphine

opioid use disorder