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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Dec 18, 2017

Take the pain out of pain management with clinical pearls from addiction medicine specialists Dr. Stefan Kertesz at the University of Alabama at Birmingham School of Medicine and Dr. Ajay Manhapra from the VA Hampton Medical Center in Hampton,Virginia. They walk us through an approach to pain management in the recovered addict, discuss treatment options for opioid use disorders, plus hot tips on how to interpret guidelines surrounding opioids, and more! What are you waiting for? Hit the play button! Special thanks to Elena Gibson and Carolyn Chan for writing and producing this show.

Full show notes available at

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Time Stamps

  • 00:00 Intro
  • 01:58 Host picks of the week
  • 04:10: Intro to the episode
  • 04:35: Guest Bios
  • 12:32: Case from Kashlak Memorial
  • 13:40 Define substance dependence, substance abuse, hazardous use
  • 17:42 Where to go next conversation about pain control
  • 17:54: Assessing risk of relapse
  • 19:35 Screening Tools
  • 20:10 Risk factors for developing OUD when initiating opioids.
  • 25:10: CDC Guidelines length of prescription and risk of substance use disorder (7)
  • 27:00: Defining optimal length of opioid after common surgical procedures  (6)
  • 30:30: Long term receipt of opiates and addiction
  • 33:50: OUD treatment options
  • 37:30: Duration of buprenorphine/naloxone treatment, tapering risks (8)
  • 38:50: POATs: Prescription opioids (9)
  • 40:05 Social support and mental health services for addiction management
  • 41:10 Risk of abstinence and adverse outcomes
  • 42:35 Protracted withdrawal
  • 43:35: Editorial BMJ Golden Month of Opioid use disorder (10)
  • 44:00 Overdose risk in patients on long term opioids
  • 44:40 Op-Ed on the Hill (11)
  • 45:40 Example of protracted withdrawal syndrome
  • 47:40 Reducing Harms: Naloxone, who to prescribe to?
  • 50:30 Take home points
  • 53:40 Outro

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