16 Hour MAT Waiver Content

16 Hour MAT Waiver Content Dopamine release leads to subjective feelings of ______ pleasure, reward Why would addiction be considered a disease? Dz= a disorder of structure or function that produces specific signs or symptoms Addiction has defined causes (genetics, environment) and observable consequences (behavioral, biological) underlying change in brain circuits may persist beyond detoxification, particularly in individuals with severe disorders. (varies with drugs and intensity of use. Amphetamine may take a year of abstinence to regain brain dopamine functionality) Brainpower Read More Should buprenorphine be prescribed from Emergency rooms? Twice as likely to follow-up for addiction treatment vs referral alone What studies support group/social interactions in recovery? Skinner box with rats: they use more drugs when caged than when in group 65% of vietnam soldiers that were addicted in vietnam did not use opioids on return to USA. physical exam should always include looking for injection site marks -pupils -bowel sounds -neuro exam lab tests at OUD evaluation HCV, HIV, LFTs, pregnancy test, urine drug screening Most common formulation of methadone liquid concentrate or powder used in OTPs -tablets MC outside of OTPs define detox program and goal narcotic drug is dispensed in decreasing doses, not exceeding one hundred and eighty days, "to alleviate adverse physiological or psychological effects incident to withdrawal from the continuous or sustained use of a narcotic drug," with the ultimate goal of bringing a patient to a narcotic drug-free state What did CARA (Comprehensive Addiction and Recovery Act) 2016 accomplish? CARA temporarily expands the types of practitioners who may dispense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treatment or detoxification treatment without being separately registered as a narcotic treatment program. Whereas prior to the CARA, only qualified physicians were permitted to dispense narcotic drugs in this manner, the CARA now temporarily permits certain nurse practitioners and physician assistants to qualify to do so. Timing of buprenorphine induction Pt should be in mild to moderate withdrawal at time of induction. Use COWS assessment (Clinical Opiate Withdrawal Scale) -COWS ≥ 8 , 11 or 12 not unreasonable -COWS 8 ok if UDS is neg and no self-reported opioid use in past 3 days -Write Buprenorphine prescription ahead of time so pt can bring it to office and avoid prio