Psych CASC / OSCE · Addiction psychiatry — substance use disorders
Explain opioid agonist treatment and naloxone — CASC communication station
MRCPsych/FRANZCP-style communication station: explain OUD as a medical disorder, OAT rationale and induction, precipitated withdrawal, take-home naloxone, and negotiate against unsafe ultra-rapid detox pressure.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry/addiction registrar. The examiner may play the patient and/or mother. [3]
Candidate instructions. Explain opioid use disorder and why medication treatment is recommended after overdose. Compare methadone and buprenorphine in plain language. Explain how buprenorphine is started (waiting for withdrawal), side-effects, take-home naloxone, and why a 5-day forced detox is risky. Check understanding and agree a collaborative plan. [1][3]
References4ShowHide
- [1]Volkow ND, Frieden TR, Hyde PS, Cha SS Medication-assisted therapies--tackling the opioid-overdose epidemic N Engl J Med, 2014.PMID 24758595
- [2]Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies BMJ, 2017.PMID 28446428
- [3]American Society of Addiction Medicine The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update J Addict Med, 2020.PMID 32511106
- [4]D'Onofrio G, O'Connor PG, Pantalon MV, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial JAMA, 2015.PMID 25919527