Supervised Drug Consumption

Topics: Harm reduction | Opioid epidemic | Safe Consumption Site

The recent opening of the first US supervised consumption site (SCS) in New York City was big news (Mays JC, Newman A. Nation’s first supervised drug-injection sites open in New York. The New York Times. November 30, 2021.). But what exactly is an SCS, and can it help patients? In this article, we’ll review the purpose of these sites, the evidence b

Drug Overdoses in the US: Trends and Prevention Strategies

Topics: fentanyl | Harm reduction | Naloxone | Opioid epidemic | Opioids

CATR: Welcome, Dr. Sharfstein. Tell us about your background. Dr. Sharfstein: I am professor of the Practice of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. I’m a pediatrician by training and have worked in the public sector. I was a health policy advisor for Congressman Henry Waxman and the health commissioner

Naloxone Prescribing

Topics: Harm reduction | Naloxone | Opioid epidemic | Opioid Use Disorder

CATR: Welcome, Dr. Coffin. Tell us what you do. Dr. Coffin: I’m a physician boarded in addiction medicine, infectious disease, and internal medicine. I am the director of substance use research at the San Francisco Department of Public Health, and on faculty at UCSF. My research is mainly in substance use, and I have various projects dealing with tre

A New High-Dose Naloxone: Life Saver or Punishment?

Topics: Harm reduction | Naloxone | Opioid Use Disorder

The FDA approved a new intranasal formulation of naloxone on April 30, 2021. Called KLOXXADO, this formulation distinguishes itself from other delivery systems by its higher dose, with each nasal spray containing 8 mg of naloxone. In comparison, the most widely used naloxone product, Narcan Nasal Spray, contains 4 mg of naloxone. What’s the rationa

Diagnosing and Treating Stimulant Use Disorders

Topics: contingency management | Diagnosis | Harm reduction | online therapy | Pharmacotherapy | Psychotherapy | Stimulants

CATR: Welcome, Dr. dela Cruz. Tell us what you do. Dr. dela Cruz: I’m an assistant professor at UT Southwestern Medical School where I’m the adult psychiatry residency associate program director, and I teach medical students, residents, and fellows. Clinically, I’m an outpatient addiction psychiatrist where I treat a variety of patients with subs

Management of Opioid Withdrawal in the Emergency Setting

Topics: Collaborative care | Detoxification | Harm reduction | Opioid Use Disorder | Opioids | Withdrawal

Opioid withdrawal is being seen more frequently in emergency settings. From 2005 to 2014, it is estimated that the rate of US emergency department (ED) visits due to opioids doubled from 89.1 per 100,000 people to 177.7 per 100,000 (Agency for Healthcare Research and Quality, www.tinyurl.com/2xr8hp8h). For many patients, the ED is their only contact wit

Medical Marijuana for Chronic Pain: The Cart Before the Horse?

Topics: Clinical practice | Harm reduction | Marijuana | Pain

In 2019, 17.5% of the American population used cannabis in the past year—up from 11.0% in 2002 (www.samhsa.gov/data/release/2019-national-survey-drug-use-and-health-nsduh-releases). As more states legalize cannabis for medical or recreational use, it’s becoming more common for our patients to add medical marijuana to their medication regimen for var

A Possible Option in Opioid-Related Harm Reduction

Topics: Harm reduction | Heroin | Opioid epidemic | Opioid Use Disorder | Pharmacology

REVIEW OF: Oviedo-Joekes E et al, JAMA Psychiatry 2016;73(5):447–455 We have effective FDA-approved medications for opioid use disorder (OUD): buprenorphine, methadone, and injectable naltrexone. Yet some patients with severe OUD decline these options. Many other countries offer a more controversial treatment—medically supervised IV administratio