DEA Addiction Medicine Essentials-263576

Video Transcription

Video Summary

In this lecture, Julie Kmik, an addiction psychiatrist from the University of Pittsburgh, explores the prescribing of naloxone for opioid overdose reversal. She provides a comprehensive overview of the opioid epidemic, tracing its rise from 1999 to 2008, highlighting the increased emphasis on pain management and the aggressive marketing of drugs like OxyContin. Julie details how opioid prescribing practices have contributed to a significant increase in overdose deaths, peaking at over 70,000 in 2017. <br /><br />The pharmacology of naloxone, its role as an opioid antagonist, and its high affinity for mu opioid receptors are discussed, alongside different naloxone formulations used for bystander overdose reversal. Julie elaborates on studies that exhibit naloxone's efficacy, indicating that both intramuscular and intranasal applications are effective in reversing opioid overdoses.<br /><br />The lecture addresses overdose risk factors, including high opioid dosages, recent release from a controlled environment, and mixing opioids with other substances. The effect of fentanyl's strong binding affinity complicates the naloxone response, sometimes requiring multiple doses for overdose reversal.<br /><br />Julie also discusses how naloxone distribution does not encourage more risky drug use and stresses the importance of overdose prevention programs. She concludes with a guide on prescribing naloxone, covering considerations such as risk factors, insurance coverage, and state laws supporting naloxone distribution through standing orders and collaborative pharmacy agreements.

Keywords

naloxone

opioid overdose

addiction psychiatry

opioid epidemic

overdose reversal

opioid prescribing

mu opioid receptors

fentanyl

overdose prevention

pharmacy agreements