Show notes
Our first episode explores how our patient, TJ, developed an opioid use disorder, and the steps providers need to take in order to diagnose the disease. Share your reactions and questions with us at Speak Pipe . We might feature you on a future episode!=== Outline ===1. Introduction: 0:002. Chapter 1 - First experience with Opioids: 4:233. Chapter 2 - Transition to OUD/Taking a History and Physical: 10:114. Chapter 3 - Neurobiology of OUD: 22:235. Chapter 4 - Opioid Dependence and Withdrawal: 27:006. Conclusion: 35:07=== Learning Points ===Remember to use the 3 C’s: control, craving, and consequences when meeting a patient with potential OUD for the first time. Use the DSM-V criteria to quantify the severityStay away from language such as opioid abuse and instead use patient-centered language such as opioid use disorder or substance use disorder. Instead of clean urine, say negative urine drug screen. A history and physical are key parts of the evaluation for a patient with OUD, looking for signs of recent use, complications of use (such as infections) or signs of withdrawal. It is essential to the safety and well-being of our patients that we promptly treat the symptoms of opioid withdrawal, as this can lead to using a batch of opioids that could cause overdose.=== Our Expert(s) ===Dr. Carolyn Chan is an academic hospitalist at Yale New-Haven Hospital with interests in medical humanities, quality improvement, and addiction medicine. You can reach her on twitter @CarolynAChan. Dr. Lisa Sanders, MD, FACP, associate professor of medicine (general medicine) and author of the popular Diagnosis column for the New York Times Magazine offers her media expertise to the PCP team as a production consultant for the podcast. === References ===CDC Drug Overdose Prevention: https://www.cdc.gov/drugoverdose/prevention/index.htmlCDC Newsroom report on Overdose Deaths Accelerating During COVID-19: https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html === Recommended Reading ===Buresh M, Stern R, Rastegar D. Treatment of opioid use disorder in primary care. BMJ. 2021 May 19;373:n784. doi: 10.1136/bmj.n784. PMID: 34011512.Alexander GC, Stoller KB, Haffajee RL, Saloner B. An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19. Ann Intern Med. 2020 Jul 7;173(1):57-58. doi: 10.7326/M20-1141. Epub 2020 Apr 2. PMID: 32240283; PMCID: PMC7138407.Hoffman KA, Ponce Terashima J, McCarty D. Opioid use disorder and treatment: challenges and opportunities. BMC Health Serv Res. 2019 Nov 25;19(1):884. doi: 10.1186/s12913-019-4751-4. PMID: 31767011; PMCID: PMC6876068.=== About Us ===The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts on various primary care topics, allowing patients the autonomy to share their stories with our audience and for young clinicians to learn from their experiences.Hosts: Nate Wood, Maisie Orsillo, and Addy FeibelLogo and name: Eva ZimmermanTheme music and Editing: Josh OnyangoProducers: Helen Cai and Addy FeibelOther Background music: TrackTribe, Jesse Gallagher, Madirfan, The Tides, Corbyn Kites, and pATCHESInstagram: @pcpearlsTwitter: @PCarePearlsListen on most podcast platforms: linktr.ee/pcpearls
