We discuss in detail some of the psychiatric comorbidities associated with substance use disorders and what to screen for, be aware of and some management techniques.

We discuss how to manage some of the special circumstances in opioid substation therapy including OST in renal and hepatic impairment, managing polypharmacy complications with OST and managing acute pain whilst a patient is on OST.

We discuss how to manage some of the special circumstances in opioid substation therapy including vomiting of doses of OST, dealing with intoxicated patients, overdoses of OST and transitioning between Methadone and Suboxone and vice versa.

We discuss the harm reduction intervention of Naloxone and when to consider prescribing this medication, the benefits of take home naloxone and how it saves lives!

We discuss the harm reduction interventions that we can implement for people who inject drugs to decrease the risks of morbidity and mortality.

We discuss the different opioid receptors buprenorphine acts upon and the nature of these effects, the difference between agonists and antagonists, how to start a patient on Suboxone and how to monitor patients on Suboxone and adjust doses.

In episode 29 of Cracking Addiction we discuss Suboxone and talk about the components of Suboxone as well as the pharmacology and pharmacokinetics of Suboxone.

In episode 28 of Cracking Addiction we discuss our practical tips, advice and experience in managing patients on LAIB and share what we have learned.

Episode 27 of Cracking Addiction discusses the patient journey on LAIB and how to adequately deal with and manage adjusting doses of LAIB, commencing and ceasing LAIB and ensuring that patients are maintained on LAIB therapy

Episode 26 of Cracking Addiction discusses Sublocade one of the LAIB preparations available and how to commence, maintain and manage any dose changes or complications associated with Sublocade.

Episode 25 of Cracking Addiction discusses Buvidal one of the LAIB preparations available and how to commence, maintain and manage any dose changes or complications associated with Buvidal.

Episode 23 of Cracking Addiction discusses some of the special or difficult circumstances of prescribing LAIBs including intoxicated patients, pregnant patients, patients with chronic disease, patients with acute pain and our management strategies in these situations.

Cracking Addiction explores long acting injectable buprenorphine (LAIB), the different products available to utilise and different strategies and approaches to commence LAIBs

Cracking Addiction explores long acting injectable buprenorphine (LAIB), the different products available to utilise and different strategies and approaches to commence LAIBs

Cracking Addiction explores methadone pharmacokinetics, breakdown and interactions within the body and interactions with other drugs.

Cracking Addiction explores methadone, its origins, the pharmacology behind methadone and how to commence a patient on Methadone

Post birth the patient's usual oral methadone dose can be continued in the peripartum and post partum period.

Most women presenting with opioid dependence are of child-bearing age with chaotic drug use predisposes to amenorrhoea. The initiation of opioid substitution therapy (OST) facilitates stability and reinstatement of regular menstrual cycles and thus OST is a risk factor for unplanned pregnancy.

There are a whole range of drugs of concern that one can become dependent upon or become addicted to and this list can seem daunting. The list of drugs that a ‘use disorder’ can be appended to under the DSM 5 criteria is similarly long. Dr Ferghal Armstrong though provides us with a useful mnemonic to remember these drugs ‘COCA SHITS’.

Taking an accurate substance use history is of great importance in the management of addiction. There are a number of strategies that one could use but the most important part of history taking is that of demeanour and empathy.