Treating Opiate Use Disorder in Primary Care - Interview with Shelby Pope, NP

chronic care clinical topics interviews psych Jul 25, 2024

We all know what it’s like when a patient needs care and has to go on a 6+ month waitlist to get the care they need. I’m NOT an advocate for overstretching ourselves, or trying to practice as a specialist when we’re clearly primary care providers.

We have more than enough to focus on in the day-to-day of primary care to add more, more, more. AND… sometimes the thing that feels super overwhelming and scary that you cannot imagine managing in-house (i.e. treating opiate use disorder), isn’t actually as difficult or scary as it seems.

Sometimes when we pull back the curtain on those scary things… it actually gets to be super easy and, dare I say, fun?

As a new grad, I was SO overwhelmed by caring for patients with substance use disorders. The clinic had an especially high number of patients with substance use disorders needing care, without access to an addiction medicine specialist or even psychiatrist for a bit there.

I wish I had this interview to help me feel more comfortable back then. I love SO many things about the interview on the podcast/YouTube channel this week, and I think you’ll love it, too.

My guest is Shelby Pope, an original Real World NP student and community member. She reached out to me to talk about opiate use disorder and treatment, and I’m SO THRILLED.

She made me feel SO much more comfortable about approaching opiate use disorder treatment— it feels accessible, so much easier than it seems, and incredibly rewarding.

In this episode, we talked about:

The journey from primary care provider into addiction medicine, and what she absolutely loves about it
What it looks like when a patient is either already taking treatment for opiate use disorder, or is interested in starting treatment
What to assess, treatment options for opiate use disorder, how to know if someone is ready
What “induction” looks like, a.k.a the initial starting of treatment, how to do it, what to watch out for
Medication-assisted treatment (MAT) for opioid use disorder options, including methadone and buprenorphine (yes you can prescribe in primary care safely!)
How to manage patients ongoing, including addressing cravings and harm reduction strategies
What resources can support you stepping into bringing this into primary care

Primary care providers have a HUGE opportunity to make a significant impact on morbidity and mortality in opiate use disorder - I hope you feel as inspired as I do.