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Extracting Data on CBD: Effects on Opioid Use and Quality of Life

Sales of cannabinoid-containing products continue to rise. In 2020 it became a billion-dollar industry. With the increased use and popularity of CBD products, every clinician needs to critically appraise the evidence to determine if CBD should play a role in pain management and help educate patients about the potential risks.

Guest Author:  Alex R. Mills, PharmD, BCACP, AAHIVP

Music by Good Talk

I Screen, You Screen, We Should All Screen for Unhealthy Drug Use

Nearly 1 in 8 Americans older than 12 used illicit substances in 2018, including misuse of prescription medications. In addition, more than 80% of those who would benefit from substance use treatment in the past year did not receive it. Thus, the importance of identifying and offering treatment should be a priority — particularly in primary care settings. However, there are many barriers to implementing unhealthy substance use screening including pervasive stigma, lack of clinician comfort, logistics, and limited knowledge of or avenues for treatment when unhealthy drug use is uncovered. The US Preventative Services Task Force (USPSTF) recently published updated recommendations on drug use screening.

Guest Authors: Melissa C. Palmer, PharmD, BCPS, BCPP; Jordan Cooler, PharmD, BCPP; and Amanda Stahnke, PharmD, BCACP

Music by Good Talk

Improving Access to Naloxone - Yes, Pharmacists (Nar)CAN!

The opioid overdose epidemic, primarily driven by potent synthetic opioids, has rapidly intensified in recent years.  Overdose education and naloxone distribution (OEND) efforts appear to have a positive impact on opioid-overdose mortality. As many states continue to expand naloxone access through various legislation efforts, it’s important to identify which laws have the greatest impact on reducing fatal opioid overdoses. 

Guest Authors:  Scott Coon, PharmD, BCPS, BCACP and Matthew Thomas, PharmD

Music by Good Talk

Treating Opioid Use Disorder - X:BOT Offers a Pragmatic Approach

Opioid-use disorder (OUD), a risk factor and major contributor to opioid-related deaths, is often underdiagnosed and undertreated.  Currently there are three FDA-approved pharmacologic treatments for OUD maintenance therapy: methadone, buprenorphine (with or without naloxone), and naltrexone.  Despite definitive evidence that methadone and buprenorphine products are effective in the treatment of OUD, there are still considerable accessibility and availability barriers that patients face when seeking Medication Assisted Treatment (MAT). The EXtended-release naltrexone vs Buprenorphine/naloxone for Opioid Treatment (X:BOT) trial compared the efficacy and safety of XR-NTX and BUP-NX to induce and maintain a patient with OUD on MAT as well as reducing opioid overdoses, relapses, and cravings.

Guest Author:  Jordan L. Wulz, PharmD, MPH, BC-ADM, CHC

Music by Good Talk

Painstaking Efforts to Improve Opioid Stewardship

Drug overdose is now the leading cause of death among Americans under the age of 50.  In 2016, the United States (U.S.) Centers for Disease Control and Prevention (CDC) released a seminal guideline for primary care clinicians regarding opioid prescribing. These guidelines are now being implemented by clinicians, insurers, and healthcare institutions. The Transforming Opioid Prescribing in Primary Care (TOPCARE) study sought to assess the impact of a multicomponent care management intervention on opioid stewardship in four primary care centers.

Guest Authors:  Lucas Hill and Jennifer Shin

Music by Good Talk 

Opioid Safety and Overdose Prevention

While narcotic analgesics remain a mainstay for the treatment of acute and chronic pain, urgent care visits and deaths from opioid overdoses have skyrocketed.   Our panelists are Dr. Lucas Hill from the University of Texas at Austin and Jeffrey Bratberg from the University of Rhode Island. Dr. Hill practices in a primary care setting and maintains the iForumRx  Opioid Safety and Overdose Prevention Resource Page.  Dr. Bratberg helped develop, implement, and expand the Collaborative Pharmacy Practice for Naloxone Partnership in Rhode Island. Drs. Hill and Bratberg describe how healthprofessionals - particularly ambulatory care pharmacists - can take action to improve the safe use of opioids and prevent overdoses.  

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