Learning about Opioid Use Disorder
What is physical
dependence, tolerance and addiction?
Physical
dependence can
happen with the chronic use of many drugs—including many prescription drugs,
even if taken as instructed. Physical dependence does
not constitute addiction, but it often accompanies addiction. This difference can
be difficult to discern, particularly with prescribed pain medications, for
which the need for increasing dosages can represent tolerance or a worsening
underlying problem, as opposed to the beginning of abuse or addiction.
Drug tolerance simply means that a person’s reaction to
a drug decreases as they continue
to use it. A person with a drug tolerance has
to take larger doses in order to achieve the same effect as they did earlier in
their drug use. Drug tolerance is not addiction. It is
simply the body becoming desensitized to the drug’s effects.
Addiction is a
chronic relapsing disease that effects the brain and behavior. Initially one
has control over the use of a drug, but over time develops a powerful
compulsion to use the drug. The ability to control impulses despite negative
consequences is a hallmark of addiction.
People with an
addiction tend to show the three Cs: craving for the object of
the addiction, which can be mild to intense, loss of control over use of the
object of the addiction, continued engagement with
the object of the addiction in spite of harmful consequences.
There is no single
factor that can predict who will develop an addiction. Genetic, environmental
and developmental factors all influence the risk of developing an addiction.
Many people have wrongly believed that people who have a drug addiction lack
willpower or substance misuse is some kind of moral failing. Addiction
knows no socioeconomic or ethnic boundaries. Addictions develop for a variety
reasons that are unique to each individual. It is important to know that drug
addiction can be treated and managed, but getting treatment and
support can help make recovery possible. Addiction to opioids is called “opioid use disorder” (OUD).
Nova:
Addiction (53 min. video)
https://www.thirteen.org/programs/nova/addiction-afsxne/
Harvard Medical School Global Learning Academy (FREE)
Online course —
Identification, Counseling and Treatment of OUD (8 CME credits)
Harvard Medical School Global Learning Academy (FREE)
Online course —
Collaborative Care Approaches for Management of OUD (8 CME Credits)
Preventing Opioid Use Disorder
Program to prevent drug use -
Teen-safe.org
Teenage prevention of Prescription Drug Misuse
(NIDA) National Institute on Drug Abuse
Information on Opioid Prevention for Youth, Their Caregivers, and School Personnel
Tapering Opioids
Guidance on Opioid Taper and Discontinuation
Clinical Opioid Withdrawal Scale (COWS)
Screening for Substance Use Disorders
The CRAFFT 2.0 is a behavioral health screening tool for use with children ages 12-18 and is recommended by the American Academy of Pediatrics’ Committee on Substance Abuse with adolescents.
SBIRT Massachusetts Department of Public Health
Chart of Evidence Based Screening Tools
Screening tools for Substance Use Disorders in Adolescence
Stigma
Addiction continues to be one of the most stigmatized diseases. It comes from long held beliefs that people with addictions have some kind of “character” flaw, lack will power or the addiction is due to some kind of moral failing. Stigma impacts the lives of those with addictions, frequently preventing them from accessing appropriate treatment and receiving the support and services they need to recover.
Patients with a Substance Use Disorder Need Treatment, Not Stigma
MA – State without Stigma Campaign
Changing the Language of Addiction
Working through workplace stigma: Coming back after an addiction
Stigma and OUD – short video
Respect and Dignity Key in Treating Substance Use Disorders – short video
(PCSS) Provider’s Clinical Support System:
“Stigma in Methadone and Buprenorphine Maintenance Treatment”
(PCSS) Provider’s Clinical Support System:
“The Role of Shame in Opioid Use Disorder”
