Library and Academic Services: Substance Use Disorders and Nursing Care: Opioids

Introduction

Substance Use Disorders - Opioids

Opioid use disorder (OUD) is a substance use disorder relating to the use of an opioid. Signs of the disorder include a strong desire to use opioids, increased tolerance to opioids, difficulty fulfilling obligations, trouble reducing use, and withdrawal symptoms with discontinuation. Opioid withdrawal symptoms may include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are components of a substance use disorder. Complications may include opioid overdose, suicide, HIV/AIDS, hepatitis C, and problems at school, work, or home.

This module includes informative books, ebooks, journals, databases, videos, and more to assist you with learning and understanding more about the prevalence and harms associated with its use, and treatment modalities for those living with an opioid use disorder.

Image source: Pixabay.com

Definitions

Methadone (CAMH)
An overview of Methadone from the Canadian Centre for Addiction and Mental Health (CAMH)
Buprenorphine (CAMH)
An overview of Buprenorphine from the Canadian Centre for Addiction and Mental Health (CAMH)
Fentanyl (CAMH)
An overview of Fentanyl from the Canadian Centre for Addiction and Mental Health (CAMH)
Naloxone (CAMH)
An overview of Naloxone from the Canadian Centre for Addiction and Mental Health (CAMH)
Opioid Addiction (CAMH)
An overview of Opioid Addiction from the Canadian Centre for Addiction and Mental Health (CAMH)
Prescription Opioids (CAMH)
An overview of Prescription Opioids from the Canadian Centre for Addiction and Mental Health (CAMH)
Heroin (CAMH)
An overview of Heroin from the Canadian Centre for Addiction and Mental Health (CAMH)

Websites, Reports and Papers

Day 1 Starting Suboxone® (buprenorphine/naloxone)
Are you in withdrawal? Before starting Suboxone® (buprenorphine/naloxone) you need to be in withdrawal (dope-sick). Use the ‘SOWS’ withdrawal scale on the back page to determine how bad your withdrawal is. Wait until your withdrawal score is 17 or more to beg
A Guideline for the Clinical Management of Opioid Use Disorder (BCCSU)
The new guideline, based on provincial guidelines developed by the BC Centre on Substance Use (BCCSU) and implemented in British Columbia last year, will support health care providers to help address overdoses and save lives. The new guideline provides evidence-based recommendations a range of therapeutic options for the optimal treatment of opioid use disorder.
A Health care provider’s guide to Carfentanil
Carfentanil is a synthetic opioid approximately one hundred times more potent than Fentanyl. It is used in veterinary medicine as a sedative or anesthetic agent for large animals. Opioids can come in many forms including powder, blotter paper, tablets, patch, and even sprays. Carfentanil can resemble powdered cocaine or heroin.
Opioid- and Stimulant-related Harms in Canada (Statistics Canada)
A table of Types of opioids and stimulants as part of a report by Statistics Canada
Overdose Prevention and Response Recommendations for Service Providers
Many service providers and organizations that serve the public are concerned about an overdose occurring in workplace spaces (e.g. washrooms), at venues, or events. Establishing organizational policies and practices regarding overdose prevention and response is important for the safety of staff and clients. This document provides guidance for service providers to develop overdose prevention and response policies and protocols.
Surveillance of Opioid Misuse and Overdose in Manitoba
These surveillance reports describe opioid misuse and overdose in Manitoba. Aggregate data is collected from a wide range of provincial stakeholders and is used to develop programs and policy around the opioid situation. A baseline report provides data up until the end of 2016. Quarterly reports follow.
Training Manual: Overdose Prevention, Recognition and Response (Manitoba)
This manual is intended to prepare educators/trainers in provincial Take-Home Naloxone distribution sites to prepare lay-persons to prevent, recognize and respond to overdose in a voluntary capacity. Overdose Prevention, Recognition and Response training includes the key knowledge and competencies required to administer naloxone. Lay-responder training is designed to be brief and low-threshold, and is designed specifically for the preparation of people at risk of opioid overdose.

Video

Carfentanil: A public health emergency
Carfentanil is a potent opiod that is contaminating already dangerous street drugs like heroin and cocaine. It has caused a drastic rise in overdose deaths. We are now in a public health emergency. Harm reduction initiatives like free naloxone kits and opiate alternatives like methadone and suboxone programs are trying to limit the damage caused by carfentanil.
How Naloxone Saves Lives in Opioid Overdose (MedLinePlus video)
TOC: What is an opioid? Naloxone introduction; Signs of opioid overdose; How is naloxone given? How does naloxone work? How do opioids affect the body? Opioid withdrawal symptoms Tolerance; How opioid overdose can lead to death; NIH HEAL Initiative and NIDA research
Mechanism of Action of a Partial Opioid Agonist
Video from the online course “Provincial Opioid Addiction Treatment Support Program”. The course is provided by UBC CPD and BC Centre for Substance Use
NEW VIDEO: Brief intervention: "Miguel" (SBIRT Oregon)
This video demonstrates a telehealth visit where a primary care provider delivers a brief intervention to a patient who injects heroin and completed the DAST screening tool. This video and other tools are available at http://www.sbirtoregon.org
Opioid Crisis: A look at how opioid overdoses have risen in Canada
Nearly 4,000 Canadians died from opioids in 2017, according to Health Canada. Here’s a look at how lethal the powerful opioid has been in Canada.
Opioids: Abstinence vs. Harm Reduction
SBIRT for drug use
SBIRT = Screening, Brief Intervention, and Referral to Treatment
This case example demonstrates an ideal SBIRT Brief Negotiated Interview (BNI) between an emergency department (ED) doctor and a patient actively using heroin. These skills are based in motivational interviewing techniques.
Fatal overdoses in Manitoba rise (CBC)
Overdose deaths have skyrocketed across the country since the pandemic began. And new numbers obtained by CBC News show the crisis in Manitoba, is following the same trend.

Library Resources

The American Opioid Epidemic: From Patient Care to Public Health by Michael T. Compton (Editor); Marc W. Manseau (Editor)
Publication Date: 2019
The American Opioid Epidemic: From Patient Care to Public Health provides practicing psychiatrists, trainees, and other mental health professionals with the latest information on opioid addiction, including misuse of heroin and other illicit opioids, the role of prescription analgesic opioids, and recent overdose trends. Although highly effective in relieving acute pain, opioids can cause untold damage to people's lives, health, and social structures...

Questionnaires & Evaluation Tools

Opiod Risk Tool (ORT) (NIH)
The Opioid Risk Tool (ORT) is a brief, self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. Patients categorized as high-risk are at increased likelihood of future abusive drug-related behavior. The ORT can be administered and scored in less than 1 minute and has been validated in both male and female patients, but not in non-pain populations.
Clinical Opiate Withdrawal Scale (BCCSU)

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