4-hour Live MOUD Training - 11/1/2025-Presentation Slides - 4-hour Live MOUD Training with Dr. Wyatt-

Presentation Slides - 4-hour Live MOUD Training with Dr. Wyatt-
Pdf Summary
This comprehensive document presents a detailed 4-hour live training on Medications for Opioid Use Disorder (MOUD), led by addiction psychiatrist Dr. Stephen A. Wyatt, D.O., affiliated with UNC and Chair of COPE. Funded by SAMHSA via PCSS-MOUD, the training aims to equip healthcare providers with evidence-based knowledge and skills to treat substance use disorders (SUD), especially opioid use disorder (OUD).

<strong>Key Components:</strong>

1. <strong>Addiction Overview:</strong> Addiction is defined as a chronic brain disease characterized by compulsive drug use despite adverse consequences. It involves interactions of neurobiology, genetics, environment, and behavioral factors. SUD prevalence is 8-10% in the general population but higher in healthcare settings, with significant morbidity, mortality, and financial costs—estimated at $3.73 trillion annually in the U.S.

2. <strong>Treatment Goals & Medications:</strong> Harm reduction includes naloxone access, safe syringe programs, and MOUD to sustain long-term recovery with or without abstinence. FDA-approved MOUDs include methadone (full opioid agonist), buprenorphine (partial agonist), and naltrexone (antagonist). Buprenorphine has a high receptor affinity, long half-life, and safety advantages, especially in overdose risk. Combining buprenorphine with naloxone reduces diversion potential. Maintenance dosing is individualized, typically 8-24 mg daily.

3. <strong>Legislation & Access:</strong> The DATA 2000 waiver was repealed in 2023, requiring an eight-hour training for DEA-registered providers to prescribe buprenorphine without patient limits, aiming to improve access.

4. <strong>Clinical Application:</strong> Initial evaluation includes building therapeutic alliances, comprehensive history (medical, psychiatric, social), screening (e.g., COWS for withdrawal), and laboratory testing. Initiation strategies cover traditional low-dose, high-dose induction, and micro-dosing protocols, considering complexities such as fentanyl persistence and precipitated withdrawal management. Maintenance should continue as long as benefit is observed, with caution against early discontinuation.

5. <strong>Special Populations & Considerations:</strong> 
   - Co-occurring psychiatric disorders are common (~44%) and require integrated treatment.
   - Pregnant women benefit from methadone or buprenorphine with attention to neonatal opioid withdrawal syndrome (NOWS); breastfeeding is encouraged.
   - Adolescents benefit from MOUD with psychosocial supports.
   - Pain management in MOUD patients involves continuing MOUD while managing acute and chronic pain carefully.
   - Patients with HIV, renal failure, and hepatic dysfunction can safely receive MOUD with monitoring.

6. <strong>Barriers & Solutions:</strong> Stigma, training gaps, insurance hurdles, and concerns about diversion limit MOUD access; education and policy changes aim to improve uptake.

7. <strong>Case Studies:</strong> Practical scenarios illustrate diagnosis, treatment planning, and management challenges.

The program emphasizes evidence-based practice, safety, harm reduction, and individualized patient care to improve OUD outcomes and reduce overdose deaths. Resources include mentoring and discussion forums to support clinicians.
Keywords
Medications for Opioid Use Disorder
MOUD
opioid use disorder
addiction psychiatry
buprenorphine
methadone
naloxone
substance use disorder treatment
DATA 2000 waiver repeal
harm reduction