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

Video Transcription

Video Summary

This lecture reviewed medications for opioid use disorder beyond buprenorphine. Methadone is a full mu-opioid agonist given only through opioid treatment programs. It is started when withdrawal begins, titrated slowly because of its long half-life, and monitored for sedation, QT prolongation, hypotension, constipation, and drug interactions. Treatment is usually long term.  <br /><br />Naltrexone is an opioid antagonist available orally or as a monthly injection. Patients must be opioid-free for 7–10 days before starting it. Oral naltrexone has weak evidence due to adherence issues, while injectable naltrexone performs better and helps prevent relapse. It can cause nausea, insomnia, liver toxicity, and mood effects.  <br /><br />The lecture also covered clonidine and lofexidine for withdrawal symptom management, especially when buprenorphine or methadone are not used. Supportive medications like hydroxyzine, loperamide, NSAIDs, antiemetics, and sleep aids can also ease withdrawal symptoms.

Asset Caption

Dr. Samuel Naloxone Methadone Recording

Keywords

methadone

naltrexone

opioid use disorder

withdrawal management

clonidine

lofexidine