AOD Health
AOD Health
Season 2 Episode 3: An interview with Ayesha Appa, MD on stimulant use and opioid-related harm
Season 2 Episode 3: An interview with Ayesha Appa, MD on stimulant use and opioid-related harm
Season 2 Episode 3: An interview with Ayesha Appa, MD on stimulant use and opioid-related harm
Monday 28th October 2024
Dr. Ayesha Appa discusses the challenges of managing chronic pain in patients using opioids and stimulants. Insights on tailored care and policy implications.
26 minutes
Informative
Supportive
Educational
Non-judgmental
Engaging
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Innovative Treatments & Recovery Paths
Sobriety Toolkit
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Get the buttons here!Balancing Act: Chronic Pain Management Amid Stimulant Use
Episode Overview
- Stimulant-positive urine drug tests were not linked to increased opioid-related ED visits or deaths within 90 days.
- Policies requiring opioid tapering for stimulant-positive tests may need reconsideration.
- Individualized care plans are crucial for managing patients with co-occurring substance use disorders.
- Patients with HIV showed different risk profiles and outcomes compared to those without HIV.
- Shared decision-making and maintaining patient engagement are key strategies in addiction medicine.
A stimulant-positive urine drug test does not have to imply opioid-related harm.
In this episode of Behind the Evidence, Dr. Anora Englander sits down with Dr. Ayesha Appa to discuss her recent study on stimulant use and opioid-related harm among patients on long-term opioids for chronic pain. Dr. Appa, an assistant professor at UCSF General Hospital, shares the motivations behind her research, which aims to address the complexities of providing high-quality care to individuals who use both opioids and stimulants.
The conversation highlights the challenges and nuances of managing chronic pain in patients with concurrent substance use, particularly in light of the 2016 CDC guidelines that recommended caution in prescribing opioids amid ongoing substance use. The study's findings reveal some surprising trends, such as the lack of a statistically significant association between stimulant-positive urine drug tests and opioid-related emergency department visits or deaths within 90 days.
This insight challenges existing policies that mandate opioid tapering or discontinuation for patients testing positive for stimulants. Additionally, the episode delves into the specific risks and outcomes for patients living with HIV, underscoring the importance of an individualized approach to care. Dr. Appa's work suggests that a one-size-fits-all policy may not be appropriate and that healthcare providers should consider the unique circumstances of each patient.
By focusing on shared decision-making and maintaining engagement, clinicians can better navigate the complexities of treating patients with co-occurring substance use disorders. This episode is a must-listen for anyone interested in the intersection of chronic pain management and substance use, offering valuable insights and practical advice for healthcare professionals.