Relapse Prevention for Opioid Use Disorder

Needs

Preventing relapse from opioid use is much more than merely saying ‘no’ in the face of temptation. Understanding relapse is critical in physician training. Designing a solid relapse prevention plan needs to start early before temptation presents itself. A comprehensive, relapse prevention treatment plan accounts for social interactions, emotional and physical triggers and the development of positive coping mechanisms.

Objectives

Identify causes of relapse and how to reduce stigma to enhance the quality of care in patients with addiction
Describe how anxiety and chronic pain increase relapse risks
Develop treatment planning for patients with anxiety and chronic pain to reduce the risk for relapse

Resources

This content was peer reviewed in the fall of 2016.

Stacey C. Conroy, LICSW, M.P.H.

Relapse Sensitive Care: Changing Systems of Addiction Treatment

This is an education module that describes a process for developing a Relapse Sensitive Care (RSC) model of addiction treatment. This module consists of a slide presentation of 53 slides and a post test.

Slips and Slip Ups: Managing Buprenorphine in Patients with Co-Occurring Pain and Addiction

This module contains vignette with multiple choice questions throughout. This vignette describes a patient with co-occurring pain having a difficult time finding pain management provider. It is crucial that psychiatrists and other physicians develop an understanding of co-occurring pain, so that these patients can be treated in other types of clinics or in conjunction with standard pain management clinics. This resource is free with log in.

Daniel Alford, M.D.

Managing Acute & Chronic Pain with Opioid Analgesics in Patients on Medication Assisted Treatment (MAT)

This is a 60 slide module that details the epidemiology of pain and approaches to treatment of patients with acute pain and opioid use disorder. Successfully treating the pain leads to less likelihood of relapse.

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John Renner, M.D. and John F. Kelly, Ph.D.

Addiction, Stigma and Discrimination: Implications for treatment and recovery

This resource is a webinar that includes 121 slides and includes a quiz and CME credits. The webinar highlights the background and significance of stigma and how stigma influences treatment access and treatment recovery outcomes. This resource is freely accessible via the link provided for both educators and learners, but requires registration.

Stephen A. Wyatt, D.O.

Treating Anxiety in the Substance Use Disordered Patient

This resource is a webinar which includes a post test and evaluation and 1 CME credit. Anxiety disorder is a precursor to substance use disorder. This learning activity will assist in the understanding of the social problems, adverse childhood events, and neurobiology of drug use that can result in anxiety.

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Using existing substance use disorder curriculum from across the internet, the APA has curated high-yield teaching toolkits for medical educators.

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About

In a joint effort, the APA Council on Medical Education and Lifelong Learning and the Council on Addiction Psychiatry created a curriculum workgroup to assist in the education of general psychiatric residents on topics pertaining to substance use disorders. As an educator or learner, one of the primary challenges surrounding SUD topics is identification of up to date, evidence based resources. This document includes existing, peer reviewed materials that can be used directly or in parts to educate residents.

This toolkit is intended to assist educators teaching general psychiatry residents in the specific area of opioid intoxication and withdrawal. It provides resources which align with ACGME requirements for general psychiatric residents and is not intended for subspecialty addiction psychiatry training.

Authors

This content was curated and reviewed by the following individuals:

Lisa Fore-Arcand, Ed.D.
Jonathan Buchholz, M.D.
Elie G. Aoun, M.D.
Tristan Gorrindo, M.D.