Expert Consultations: Real-World Answers

Pharmacologic Management of Opioid Use Disorder – Interview

Published on March 1, 2025 Certification expiration date: March 1, 2028

Guest

Smita Das, M.D., Ph.D., M.P.H.

Interview by

Helen Tellegen

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Highlights

Methadone requires no withdrawal period to initiate, unlike buprenorphine. For naltrexone, patients must be opioid-free for 7-10 days.
Running out of buprenorphine early indicates insufficient dosing rather than misuse. This provides clinical data about medication effectiveness.
Don't withhold buprenorphine when patients test positive for other substances. This can be dangerous and counterproductive, potentially increasing overdose risk.

Timing of Medication Initiation for Opioid Use Disorder

Helen Tellegen, PMHNP: In the lecture, you discussed the timing of initiating medications for opioid use disorder during the withdrawal process. Could you elaborate on the specific time frames for starting different medications? Additionally, why is the timing of their initiation so critical?

Smita Das, MD: When it comes to buprenorphine especially, we want to ensure that a

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Learning Objectives:

After completing this activity, the learner will be able to:

Differentiate the timing requirements for initiating medications for opioid use disorder based on their unique pharmacological properties and withdrawal considerations.
Implement evidence-based approaches to buprenorphine management.
Apply harm reduction strategies for patients with opioid use disorder.

Original Release Date: March 1, 2025

Expiration Date: March 1, 2028

Expert: Smita Das, M.D.

Medical Editors: Helen Tellegen, M.D., Flavio Guzmán, M.D.

Relevant Financial Disclosures:

Smita Das declares the following interests:

- Lyra Health: Employee

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Participants must complete the activity online during the valid credit period that is noted above.

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Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credits.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.