Opioid use disorder is commonly known to be dangerous. The media has effectively spread the message of the danger and fatal consequences of overdose from misused prescription opioids and illicit drugs such as heroin. What many people, including medical professionals, do not commonly know is that opioid use disorder is the psychiatric condition with the highest mortality. Each year opioid use disorder kills roughly 1% of the people with this condition. Expressed another way, the risk of death from this condition at ten years is 10%.
And when you factor in the estimates that more than two million Americans have opioid use disorder, then it makes sense that this condition has attained the status of public health crisis. Every day, more than one-hundred people die from opioid overdose. The vast majority of overdose deaths are from prescription opioids rather than "street drugs" such as heroin. Dr. Adam Bisaga will discuss opioid use disorder with us today. Learn about the clinical criteria for determining opioid use and how it is treated.
Dr. Bisaga is an academic psychiatrist, educator and clinician. He is a Professor of Psychiatry at the Columbia University Medical Center, and a Research Scientist at the New York State Psychiatric Institute. He was a recipient of a Career Development Award and a Principal Investigator on grants funded by the National Institute of Drug Abuse. His research interests include development of human laboratory and clinical trial models for testing medications to treat substance use disorders, including trials to improve effectiveness of antagonist-based treatment of opioid use disorder. Dr. Bisaga publishes and lectures in the area of addiction research and he is a member of the editorial board of the journal Addiction.
Buprenorphine is the most frequently used medication to treat opioid use disorder in this country. It is also under-utilized due to the dearth of physicians trained and familiar with how to start it. On this episode Dr. Edwin Salsitz will discuss how to initiate buprenorphine in the office setting, called induction. Dr. Salsitz is an attending physician in the Beth Israel Medical Center, Division of Chemical Dependency in New York City since 1983, and is an Assistant Professor of Medicine at the Mount Sinai School of Medicine. Dr. Salsitz is a course director for the American Society of Addiction Medicine sponsored buprenorphine trainings and is a mentor in the Providers Clinical Support System for Medication Assisted Treatment mentoring program.
Medication-assisted treatment is an important approach for some people with substance use disorders. It is also frequently misunderstood--isn't treating someone with methadone for a heroin problem simply "trading one addiction for another?" Our guest, Dr. Frances Levin, will discuss this and other misconceptions regarding medication-assisted treatment.
Dr. Levin is the Kennedy-Leavy Professor of Psychiatry at Columbia University and the Chief of the Division on Substance Abuse at New York State Psychiatric Institute at Columbia University. For the past 17 years she has been the Director of the Addiction Psychiatry Fellowship Program at New York Presbyterian Hospital and for the past 12 years, she has been the principle investigator of a T32 National Institute on Drug Abuse funded Substance Abuse Research Fellowship.
Her research interests include pharmacologic and psychotherapeutic treatment interventions for cocaine and marijuana abuse, and treatment approaches for substance abusers with attention-deficit hyperactivity disorder and other psychiatric illnesses.
She is also Medical Director of the Providers’ Clinical Support System- Medication Assisted Treatments (PCSS-MAT), a national training and mentoring initiative focused on addressing prescription opioid misuse.