Combat opioid use disorder and the opioid epidemic as we review common clinical scenarios with addiction medicine specialists, Dr. Stefan Kertesz, University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton,Virginia. We need all hands on deck, and that means you! Learn the basics of opioid use disorder treatment as Dr. Manhapra gives us the scoop on “bup, bup, bup” (buphrenophine), and Dr. Kertesz primes us on opioid related health care policy and reminds us that “We can all do something about the opioid crisis”. Plus, Stuart and Paul express some concerns about how to approach these patients. Do not miss this episode filled with clinical pearls, policy, and joy! Special thanks to writers and producers, Dr. Carolyn Chan and Elena Gibson (MD Candidate, MS4), for their hard work on both of our addiction medicine episodes. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 01:35 Guest Bios 03:10 Picks of the week 06:22 Case from Kashlak Memorial 07:20 Controversy: Is opioid addiction a real disease? 10:16: Vietnam Heroin Study (4) 12:52 Counseling patients on treatment options for opioid use disorder 17:32 Detox and initiation of medical treatment 18:50 Psychosocial needs and treatment (5) 20:50 How effective is Narcotic Anonymous? 21:36 80/20 rule 25:50 Inpatient vs outpatient treatment, complex discharge planning 27:03 Shared decision making for treatment options 31:50 Medical treatment is strongly recommend for OUD 32:17 Viewpoint: harms reduction in residential programs with polysubstance use 32:29 Taper, abstinence, and long-term treatment with buprenorphine 34:50 How to prescribe buprenorphine - Take the leap! 39:30 Medical education and the opioid epidemic 42:02 1980 NEJM article (6) 43:00 Complex persistent dependence patients (7) 46:40 Post-op pain and risk of addiction 51:34 Approach to increasing pain medications 54:50 Health Policy Intro 54:59 Opioid thresholds for patients and policy 61:39 Medicaid expansion and opioid epidemic (10) 66:25 Take home points 69:50 Round Table 73:56 Outro Tags: opioid, use, abuse, addiction, disorder, dependence, buprenorphine, suboxone, naloxone, methadone, taper, abstinence, heroin, fentanyl, drug, substance, overdose, chronic, pain, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medicine, medical, primary, physician, policy, resident, student