In this episode of Going anti-Viral, Dr Michael Saag speaks with Dr Sandra Springer from the Yale School of Medicine about the substance use disorder epidemic. Dr Springer describes the history of the epidemic and the recent crisis of overdose deaths in the United States. She talks about the increase in overdose deaths since 1999 due to prescription opioids. Dr Saag and Dr Springer review how HIV practitioners can manage patients with substance abuse disorder, including a discussion of how to manage patients undergoing withdrawal. Finally, they address harm reduction strategies available to practitioners and new data showing a reduction in overdose deaths, providing long-term hope for the effectiveness of these strategies. But they note that more research, funding, and outreach is needed to meet the risks that opioid and non-opioid substances pose in the future.

0:00 – Introduction

1:22 – Magnitude of the substance use disorder epidemic

2:31 – Factors that led to the increase in deaths after 1999

3:54 – Background on widespread fentanyl use

5:22 – Impact of prescription opioids for chronic pain management on addictions

7:52 – HIV healthcare practitioners’ role in managing patients with substance use disorders

10:15 – Management of withdrawal, including long-term management options

18:33 – Harm reduction strategies and the use of naloxone to prevent overdose deaths

23:04 – Review of new data showing reduction in overdose deaths in the United States

24:19 – Closing remarks and expectations for the next 10 years

IAS–USA resources on substance use disorders:

-- MATE Act CME - https://www.iasusa.org/dea-compliant-cme-resource-center/

-- Fellow Resources: https://www.iasusa.org/fellow-student-resources/

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Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections.

Going anti-Viral’s host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences.

Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.

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