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Activity Dates: 10/07/2022 - 10/07/2025

Session Time and Location

The live session is complete.

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric patients, we invite you to participate in this online course.

Session Summary

Any co-occurring substance use increases the difficulty in determining the best treatment approach, however, AUD and OUD were listed as one of the most common co-occurring SUD that many pharmacists encounter in clinical practice. The target audience for this topic would be those familiar with individual treatment of AUD and OUD who may want to further explore the complications and intricacies of treating these disorders when they are co-occurring.

Both AUD and OUD have FDA approved medications and clear guidelines which guide treatment of these disorders individually. However, when these disorders are co-occurring, treatment can become more complicated. The medical community has largely focused on OUD during the epidemic even though most patients with substance use disorder use multiple substances, and the presence of multiple substance use disorders is associated with worse treatment outcomes. Because problematic alcohol and opioid use are traditionally studied as independent conditions, limited evidence-based strategies exist for mitigation of alcohol-related risk among patients with OUD. Comorbid OUD and AUD are known to interfere with medication adherence and to be associated with increased morbidity and mortality.

The presence of chronic pain is also known to complicate both AUD and OUD and to be associated with poorer outcomes. Recent studies have started to consider the effect of pain on alcohol treatment outcomes. Jakubczyk and colleagues (2016) found reductions in physical pain during alcohol treatment predicted lower risk of alcohol relapse during the 4 weeks following treatment. Similarly, Witkiewitz and colleagues (2015) found pain interference and pain intensity at the end of treatment significantly predicted heavy drinking and time to first heavy drinking day during and following treatment.

Naltrexone is the only medication currently indicated to treat AUD and OUD. In a patient who is not able or not willing to take naltrexone, there may be a need to consider other medications for OUD and AUD as monotherapy or in combination. It can be difficult to determine if one  treatment should take precedence or to manage concurrently.

One significant concern is that treatment of OUD with an opioid agonist medication (buprenorphine or methadone) may be dangerous in combination with alcohol. A case-control cohort study found that treatment of OUD with opioid agonists is associated with fewer admissions for alcohol-related acute events in patients with OUD with co-occurring AUD.

Course Requirements

To receive ACPE credit for this session, you must:

  • Sign in (or create a FREE account).
  • Register for this course.
  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date.
  • Complete the evaluation at the end of the activity.
  • If necessary, complete the post-test retest no later than the closing activity date.
  • Receive a passing grade (70%).
  • Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.

Upon successful completion, ACPE credit is reported within 24 hours to CPE Monitor although transcripts can be retrieved by participants online in their ACPE Transcript.

Faculty Information and Disclosures

Michelle Colvard, PharmD, BCPP

View biographical information and disclosures

Learning Objectives

  1. Describe the clinical considerations for co-occurring opioid and alcohol use disorders.
  2. Evaluate the evidence for treatment of co-occurring opioid and alcohol use disorders.
  3. Develop a treatment plan for a patient scenario with co-occurring opioid and alcohol use disorders.

Continuing Education Credit and Disclosures

Activity Dates: 10/07/2022 - 10/07/2025
ACPE Contact Hours: 1.25
ACPE Number: 0284-0000-22-075-H08-P (Application)
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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