Medical Approaches to Care of Patients with SUD (2025-2026 Recording)-Medical Approaches to Care of Patients with SUD Recording

Video Transcription

Video Summary

The session focused on medical care for patients with substance use disorders, using a case of a 30-year-old man with opioid use disorder who presented with fevers, back pain, and pleuritic chest pain after returning to injection opioid use. He was diagnosed with MSSA bacteremia, tricuspid valve infective endocarditis, and septic pulmonary emboli. The speakers emphasized non-stigmatizing, person-first language and the importance of understanding how drug preparation and injection practices influence infection risk.<br /><br />A major theme was how hospitals can better care for patients with injection-related endocarditis through multidisciplinary teams, addiction consult services, and hospital-based initiation of medications for opioid use disorder. The talk reviewed traditional buprenorphine induction, high-dose initiation, and low-dose initiation/microinduction, especially for patients who are on methadone, have severe pain, or cannot tolerate withdrawal. Buprenorphine’s pharmacology and the fentanyl-era drug supply were highlighted as key reasons newer induction strategies are needed.<br /><br />The second half addressed hepatitis C prevention and treatment. The patient was found to have chronic hepatitis C and was successfully treated with direct-acting antivirals after discharge. Speakers reviewed hepatitis C transmission risks, natural history, the limitations of liver enzymes for deciding treatment, and the effectiveness of modern regimens like sofosbuvir/velpatasvir and glecaprevir/pibrentasvir.<br /><br />The talk concluded with prevention strategies: universal screening, vaccination, harm reduction counseling, safer injection education, access to clean supplies, and HIV PrEP when appropriate. Overall, the session stressed that integrating addiction treatment with infectious disease care improves outcomes, reduces complications, and helps patients stay engaged in care.

Keywords

opioid use disorder

injection drug use

MSSA bacteremia

tricuspid valve endocarditis

septic pulmonary emboli

person-first language

addiction consult service

buprenorphine induction

microinduction

methadone

fentanyl era

hepatitis C treatment

direct-acting antivirals

harm reduction