Patients in Crisis: Life Threatening Risks of Opioids, Medical Marijuana, Vaping – Maria Broadstreet

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We have an opioid crisis in America like we have never seen before! Every day in her practice, Maria Broadstreet, R.N., MSN, APN, treats clients who have families, good jobs and amazing futures if they can take control of the “disease.”

Learn your way through emotional case studies – post-surgical pain management, the phenomenon of vaping, what we are beginning to learn from legalized marijuana… You have been challenged in the past, asked to provide insight and recommendations on something that has been so misunderstood. With the vastly changing addiction field, new research is emerging. We now can “see” the brain chemistry changes from opioids on actual MRIs. With these valuable clinical insights, you truly can help people recover and lead the meaningful, happy lives they desire!

Think about Jack…a 36-year-old attorney, married, 2 kids, helps coach his son’s track team on the weekends. To most who are looking from the outside, he has it all…a big house, beautiful family, they go on amazing vacations…no one sees how he struggles in the morning until he is able to take his Vicodin, how he has to hide in the bathroom at the office so no one asks any questions, how he is consumed with making sure he has enough pills and hopes his wife doesn’t notice how much money he took out of their checking account this week…

No longer does “addiction” mean a specific stereotype. It crosses ages, socioeconomic groups, races, cultures. Withdrawal is scary, overdose is scary, we didn’t sign up for this…but we are called on as the experts to navigate the largest epidemic we will probably know in our lifetime. If it hasn’t professional or personally affected you, it will…it’s unavoidable.

1. Evaluate how opioids are affecting the brain and mental health.
2. Differentiate between substance use disorder and common co-occurring disorders.
3. Analyze the benefits of inpatient versus outpatient treatment, medication and behavioral treatment options.
4. Catalog the conditions benefited by medical marijuana use and ramifications of legalization.
5. Determine pain treatment options for a patient with an opioid addiction.
6. Choose patient teaching based upon what we know and what we don’t know regarding vaping.

The Opioid Crisis: Dealers, Doctors and Drug Companies

• Are there really gateway drugs?
• The path from post-op pain treatment to heroin
• Saving our “children”
• Opioid use amongst healthcare providers

Risks of the Opioid Options

• Natural vs. synthetic options
• Opioids for treatment of pain
• Genetic risks coming to light
• Why fentanyl is scarier than heroin

Opioids ARE Changing the Brain

• Effect of different drugs on brain neurons
• MRI’s before and after opioid abuse
• Pleasure center in the brain – is it just willpower?
• Can the effects be reversed?
• Association with other diagnoses (depression/ADHD)

Life Threatening Challenges

• Is it reasonable to expect a patient to just stop?
• Withdrawal signs/symptoms
• Initial interventions when you don’t know what your patient has taken
• Ethics of supplying clean needles
• Interpretation of drug test results
• Safe drug disposal

Treatment Options

• Inpatient vs. outpatient benefits
• Medication assisted
  • Buprenorphine – what you MUST know
  • Methadone
  • Mitigating medications
  • Quickly recognize symptoms of precipitated withdrawal
  • Process of induction
  • Maintenance
• Lucemyra
• Therapy and group counseling
• Assessment of true pain vs. drug-seeking behavior
• Your safety in a potentially dangerous situation
• Provider requirements – X waiver

Narcan

• What can go wrong with this life-saving treatment
• Quick overdose assessment
• Why Narcan will not work on non-opiate overdoses
• Administration perils
• Critical assessment AFTER Narcan administration

Marijuana: Medical…or Otherwise

• Conditions benefited by medical marijuana
• Long-term implications of recreational use
• Ramifications of legalization
• Side effects can be life threatening

The New Hot Topic of Vaping

• What we know and what we don’t know yet
• The risks of various vaping devices
• Patient education based upon the latest injury/death statistics

Patients in Addiction Crisis

• Early intervention more effective than treating at “rock bottom”
• Expecting quitting “cold turkey” is just unrealistic
• Relapse IS predictable
• MAT is NOT trading one drug for another
• Addiction is not just “1 gene”
• Opioids change the brain