A Primer on Antagonist-Based Treatment of Opioid Use Disorder in the Office Setting

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Direct providership by American Academy of Addiction Psychiatry

Adam Bisaga, MD | Professor of Psychiatry, Columbia University Medical Center, New York, NY

Module Description
Naltrexone, an opioid receptor antagonist, is one of only three medications approved by the FDA to treat opioid use disorder (OUD). Use of naltrexone is presently limited to specialized addiction treatment settings, in part because of the few training opportunities for medical providers on the use of naltrexone. This module presents a summary of a 4-modules training program on the use of naltrexone developed by PCSS. It reviews background information on the use of opioid antagonists in treatment of OUD, describes differences between agonist and antagonist based treatment, and provides a summary of the evidence for its efficacy. Clinical issues are also discussed including the selection of patients, protocols for treatment initiation, and the management of common clinical challenges that emerge during maintenance treatment with naltrexone.

Educational Objectives

  • Describe the evolution of antagonist-based treatment for opioid  dependence
  • State the guidelines to select the most appropriate patients for treatment with naltrexone
  • Determine pharmacological strategies to initiate treatment with naltrexone
  • Identify clinical challenges encountered during treatment with naltrexone
  • Implement naltrexone in addiction practice competently

Accreditation and Designation
American Academy of Addiction Psychiatry (AAAP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

American Academy of Addiction Psychiatry (AAAP)  designates this enduring material for a maximum of 1 (one) AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

PA Accreditation
PAs may claim a maximum of 1 Category 1 credit for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

Method of participation in the learning process
In order to receive a maximum of 1 AMA PRA Category 1 Credit™, participants must participate in the entire module, answer post-test questions, pass with a 70% pass rate and complete an evaluation at the end of the activity.