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ORN Spring 2025 - Case Reports - Diagnosis and Treatments
Description:

Understanding Complex Cases in Opioid Use Disorder Treatment

This webinar will explore two complex cases related to opioid use disorder (OUD) treatment and its complications. The first case examines the diagnosis and management of presumed naltrexone-XR (Vivitrol®)-precipitated withdrawal in a patient chronically treated with buprenorphine-XR (Sublocade®). While optimal treatment strategies remain unclear, we will review a potential approach and its rationale, along with relevant literature.

The second case highlights a 39-year-old woman with a long history of intranasal opioid and recent xylazine use, who presented with severe nasal and skull base damage, including nasal septum perforation and oral-nasal fistulae. Her case underscores the need for clinicians to recognize nasal destruction as a potential consequence of intranasal fentanyl and xylazine use and to refer patients for both OUD treatment and otolaryngologic care to prevent further harm.

Learning objectives:
At the conclusion of this seminar, attendees should be able to:
  1. Identify the causes, clinical manifestations, and treatment strategies for opioid withdrawal, including naltrexone-precipitated withdrawal.
  2. Evaluate the pharmacology and contraindications of naltrexone and buprenorphine in opioid use disorder treatment.
  3. Describe the diagnostic utility of serum and urine naltrexone levels.
  4. Explain the patterns and mechanisms of tissue damage caused by intranasal drug use, including opioids and xylazine.
CME

Continuing Medical Education (CME) Credits Available

Participants in this program may earn the following CME credits:

1 AOA Category 1-A Credit
1 AMA PRA Category 1 Credit™ (Approval Anticipated)
1 AAPA Category 1 CME Credit (Approval Anticipated)
1 Nurses CNE Credit (Approval Anticipated)

Earn valuable continuing education credits while enhancing your professional knowledge!

Instructions and Claiming CME
Need help claiming your CME certificate? Download the instructions here. 
Video content must be watched in its entirety and surveys must be complete to claim CME certificates.
What is ORN
  • Help is here! The Opioid Response Network (ORN) is your resource for no-cost education, training and consultation to enhance efforts addressing opioid and stimulant use disorders.
  • ORN has consultants in every state and territory to deploy across prevention, treatment, recovery and harm reduction.
  • Share your needs via the “Submit a Request” form at www.OpioidResponseNetwork.org. Within one business day, your regional point person will be in touch to learn more.
Speaker:
Jessica Moore, MD

Jessica Moore, MD FAAEM FASAM is an attending physician at Temple University Hospital in Philadelphia, PA. She attended medical school at Cooper Medical School at Rowan University in Camden, NJ and completed Emergency Medicine residency at Temple University Hospital. She is passionate about improving care for those with substance use disorders, and completed fellowship training in Addiction Medicine at Cooper University Health Care in Camden, NJ. She is board certified in both Emergency Medicine and Addiction Medicine. Dr. Moore currently spends her clinical time working in the Emergency Department, on the inpatient Addiction Medicine consult service, and at a low-barrier, streetside mobile buprenorphine clinic. Jessica's hobbies include traveling, baking, reading, running, and spending time with her dog, Pete.




 
Julie Kmiec, DO, FAOAAM 


Julie Kmiec, DO, FAOAAM, is an Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine.  She completed her psychiatry residency and addiction psychiatry fellowship at Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center.  Her clinical interests include withdrawal management and the treatment of opioid use disorder.  She previously served as Medical Director of the UPMC Opioid Treatment Program and Ambulatory Detox and Bridge Clinic.  She currently works in the Center for the Treatment of Addictive Disorders at the Pittsburgh VA which provides a range of services for veterans with substance use disorders.  She is a past president of the American Osteopathic Academy of Addiction Medicine.

DISCLAIMER
ACCREDITATION: 
In support of improving patient care, American Academy of Addiction Psychiatry is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

DISCLOSURE AND CONFLICT OF INTEREST RESOLUTION:
All conflicts of interest of any individual(s) in a position to control the content of this CME activity will be identified and resolved prior to this educational activity being provided. Disclosure about provider and faculty relationships, or the lack thereof, will be provided to learners.
Funding:
Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Summary
Availability: Registration Required
Access expires on Apr 01, 2028
Location: Online Meeting
Date / Time: Apr 30, 2025 5:00 PM - 6:00 PM ET
Cost: FREE
Credit Offered:
1 AAPA Category 1 CME Credit
1 AMA PRA Cat 1 Credit
1 Nurses CNE Credit
1 AOA Category 1A Credit
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