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McMaster Textbook of Internal Medicine

The concerning trajectory of opioid use disorder

2021-12-28
Brittany B. Dennis, Catherine Anne Lovatt, Elahn Pogue, Mohamed Panju

Dr Brittany B. Dennis, Dr Catherine Anne Lovatt, and Dr Elahn Pogue—internal medicine residents at McMaster University—review current evidence for opioid substitution therapies, highlight methodologic limitations and the implications for risk mitigation and treatment for opioid use disorder (OUD), summarize important risk factors affecting treatment outcomes (evidence from the McMaster's GENOA study), and describe clinical and demographic trends observed in high-risk patients admitted to hospital with OUD. The webinar chaired by Dr Mohamed Panju was recorded at the Chair's Medical Grand Rounds on December 16, 2021.

See also
  • Management of cancer pain: Challenging the evidence of the recent guidelines for opioid use in palliative care This narrative review outlines the role of guidelines on opioid use and summarizes recent knowledge regarding the consequences of long-term opioid therapy (L-TOT), in particular opioid addiction and deficiencies of the immune and endocrine systems. It also addresses new strategies to strengthen the L-TOT in the management of cancer-related pain among patients receiving palliative care.
  • The 3 most important recent advances in treating cancer pain with opioids Dr Per Sjøgren from University of Copenhagen, Denmark, shares his views on the 3 most important recent advances in treating cancer pain with opioids.
  • Depression: Explaining CBT Dr Zainab Samaan, associate professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University, talks about cognitive behavioral therapy (CBT) and the role of therapist-delivered and self-help programs to deal with mood disorders.
  • Depression in the era of COVID-19 Dr Zainab Samaan, associate professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University, talks about distinctive features of depression and available treatments.
  • Chronic pain, opioids, and CBT Dr William Goldberg, clinical professor of medicine at McMaster University and Chief of Medicine at St Joseph’s Hospital from 1962-1982, comments on the issue of chronic opioid use.
  • Medical opioid controversy. Part 2: Key CPG messages Dr Gordon Guyatt, Distinguished Professor at McMaster University's Department of Health Research Methods, Evidence, and Impact and one of the founders of EBM, discusses key messages from the new Canadian guidelines on opioid use in chronic noncancer pain.
  • Medical opioid controversy. Part 1 Dr Gordon Guyatt, Distinguished Professor at McMaster University Department of Health Research Methods, Evidence, and Impact and one of the founders of evidence-based medicine, discusses new Canadian guidelines on opioid use in chronic noncancer pain.

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