Literature

Curbside Consults Podcast

By Clement Lee, MD, MSc

Published December 9, 2022

In this episode of Curbside Consults, we examine an update on management of opiate use disorder in hospitalized adults by the SHM (Society of Hospital Medicine). We are joined by Dr. Susan Calcaterra, Associate Professor of Medicine, Director of the Addiction Medicine Consult Liaison Service, and Associate Program Director of the Addiction Medicine Fellowship at the University of Colorado School of Medicine. She is the lead author of the SHM’s 2022 consensus statement on the management of opiate use disorder in hospitalized adults.

00:05 – Intro
00:40 – SHM consensus statement process
03:17 – Appropriate terminology for persons who use drugs
05:11 – DSM criteria for substance use disorder
07:29 – Laboratory screening and imaging
10:20 – Management of opiate withdrawal
12:29 – Empiric methadone dosing
13:39 – Pain management with underlying opiate use disorder
15:15 – Pharmacology of buprenorphine
18:00 – The role of psychiatric consultation
19:16 – Discharge considerations
22:12 – Candidacy for oral antibiotics
23:45 – Concluding remarks
26:22 – Outro

Articles discussed in this episode:

1. Calcaterra SL et al. Management of opioid use disorder and associated conditions among hospitalized adults: A Consensus Statement from the Society of Hospital Medicine. J Hosp Med 2022.
2. Wyse JJ et al. Perioperative Management of Buprenorphine/Naloxone in a Large, National Health Care System: A Retrospective Cohort Study.  J Gen Intern Med 2022.
3. Baddour LM et al. Management of Infective Endocarditis in People Who Inject Drugs: A Scientific Statement from the American Heart Association. Circulation 2022.
4. Buprenorphine Waiver Notification

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

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Susan Calcaterra, MD, MPH/MSPH, MS, is Associate Professor of Medicine, Director of the Addiction Medicine Consult Liaison Service, and Associate Program Director of the Addiction Medicine Fellowship at the University of Colorado School of Medicine. She is the lead author of the SHM’s 2022 consensus statement on the management of opiate use disorder in hospitalized adults.
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Clement Lee, MD, MSc, was a 2021–2022 NEJM Editorial Fellow and is a 2022-2023 Senior Editorial Fellow. He is currently an internal medicine hospitalist at Newton-Wellesley Hospital and a pediatric hospitalist at Boston Children's Hospital. He completed his internal medicine-pediatrics residency at Penn-CHOP.