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It is an unfortunate reality that some clinicians experience an unsettled feeling towards patients suspected to be struggling with opioid use. Many of us haven’t received much in the way of formal training in managing any addictions. We may be afraid of the complexity involved in managing patients with substance use issues. If we’re honest, we might also acknowledge biases towards people with substance use issues, and what little we know about methadone.
Caring for people with opioid use disorder does not have to be daunting. Current guidelines recommend treatment with buprenorphine, a long-acting opioid that treats withdrawal and helps to reduce cravings and substance use. Not only is buprenorphine safer than methadone, but it is also safer than most other opioids that we routinely prescribe in any clinical setting.
With proper training, any clinician can prescribe buprenorphine – it does not require special certification, a focussed practice or to be situated within an addiction clinic. The need for accessible education on buprenorphine and opioid use disorder inspired the development of the Opioids Clinical Primer program. It’s a free and certified[1] online program that also addresses typical challenges faced by clinicians in the management of chronic pain, and strategies to reduce the harms of opioids when they are needed.
The program is presented as two streams; ‘Managing Opioid Use Disorder’ and ‘Managing Chronic Pain’. I encourage you to explore both, as they both offer valuable evidence-based information that has been extensively reviewed by medical experts from all of Ontario’s medical schools, as well as community practitioners “on the ground”.
As more and more patients are on buprenorphine, understanding how to adjust doses and manage acute pain is becoming increasingly important. Even if you aren’t quite prepared to start buprenorphine treatment, being able to discuss options, offer support, and assist patients with accessing resources is a huge step towards decreasing stigma and barriers to care.
I am excited by what this program has to offer. I think it provides real-life scenarios, grounded in the realities of community practice. I hope it stimulates clinicians to reflect on their practices, recognize what they are doing well, and consider implementing new strategies and resources to assist their patients.
[1] The Opioids Clinical Primer is comprised of six courses, all of which offer a combination of Mainpro+ credits and MOC section 1 hours.
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