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2021 AM Posters
Concurrent Treatment of Opioid and Alcohol Use Dis ...
Concurrent Treatment of Opioid and Alcohol Use Disorder
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Pdf Summary
This case presentation discusses the concurrent treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). Addiction is considered a chronic or relapsing condition, similar to other chronic medical illnesses. Medication-assisted treatment options for OUD include buprenorphine, methadone, or naltrexone with psychosocial support. AUD can be treated with naltrexone or acamprosate in addition to psychosocial therapy. The case focuses on the barriers to successful long-term care for patients with both alcohol and opioid use disorders.<br /><br />The patient in the case lives in a shelter with roommates who use drugs and is separated from his wife. He works as a video editor. The hospital/treatment course includes follow-up appointments with a hepatologist and a cardiologist. Recurrent episodes of alcoholic hepatitis are a result of excessive alcohol use, and the chronic nature of the patient's polysubstance use disorder complicates treatment. The patient is unable to start first-line pharmacologic treatments for AUD due to contraindications or inability to abstain from alcohol.<br /><br />The patient's social determinants of health, such as housing instability, lack of familial support, and proximity to drug users, hinder his recovery. The chief complaint is abdominal fullness and leg swelling. The patient has a history of opioid and alcohol use disorders, hypertension, hypothyroidism, and major depressive disorder. The physical exam reveals pitting edema and erythema in the lower extremities.<br /><br />This case highlights the challenges and complexities of treating patients with concurrent alcohol and opioid use disorders. It raises questions about systemic barriers to receiving necessary services and how to partner with community-based organizations to integrate care and increase access to treatment. The patient's treatment must address the social determinants of health that prevent adequate access to psychosocial care. The patient's recovery also depends on interpersonal relationships, temperament, and the effects of drugs.
Keywords
alcohol use disorder
opioid use disorder
medication-assisted treatment
psychosocial support
polysubstance use disorder
social determinants of health
housing instability
abdominal fullness
leg swelling
psychosocial care
The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.
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