2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Treatment

▪ Pharmacological Treatment ▫ Buprenorphine, Methadone, Naltrexone

▪ Behavioral Treatment (Therapy) ▫ Motivation Interviewing – getting you motivated to do treatment ▫ Cognitive Behavioral Therapy – getting you to think differently about drug use

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Medication: BUP and mu-opioid receptors

Binding Potential (Bmax/Kd)

MRI

4 -

Bup 00 mg

Bup 02 mg

0 -

Bup 16 mg

Slide Courtesy of Laura McNicholas, MD, PhD

Bup 32 mg

December9, 2019

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Medications to treat opioid use disorder

▪ Methadone

Only in OTP Efficacious, best retention

▪ Buprenorphine

Office based Efficacious, retention less than methadone

▪ Naltrexone

Office based Efficacious Retention less than methadone & buprenorphine

Slide27of42FromRDBruce,MD,MA,MS atNewOrleans,LA,December4-7,2019,RyanWhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.