Opioid Use Disorder Management in a Clinical Approach
Get insights into the clinical approach to opioid use disorder. Explore effective practices for managing and treating this condition.
Overcoming Barriers in Managing Opioid Use Disorder: Strategies for Effective Care
A lot of people have opioid use disorder (OUD) these days, which is a serious health problem. It falls under the larger group of disorders called substance use disorders (SUD). Treating OUD can be hard because everyone has their own set of problems, like pain or other health issues. Doctors and other healthcare professionals need to develop plans tailored to each patient. They also need to stay up to date on laws, ethics, and methods for protecting patient information. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 protects all patients, but those who are getting treatment for drug or alcohol abuse have to follow more rules.
In this tutorial, we discuss how to overcome problems with OUD administration. We look at stigma, team-based approaches, communication with patients, patient-centered care, and legal issues. These methods can help healthcare workers help their patients get better. Keywords like “opioid use disorder management,” “overcoming stigma in OUD,” and “patient-centered care for SUD” highlight important ideas to help people understand and find what they’re looking for.
Learning Objectives
- Explain treatment planning methods that use patient-focused choices and proven ways to talk.
- Name the three kinds of stigma and how they affect people with mental health issues, SUD, and especially OUD.
- Talk about legal, ethical, and privacy concerns in caring for people with OUD.
Effective Treatment Planning with Patient-Centered Decisions
People with complex issues, like mental health problems, SUD, and pain, need special care. Each person shows up differently, so health systems are now focusing on care that puts the patient first.
Patient-centered care means building teams with doctors, patients, and families. They work together to plan, give, and check health care. This way ensures the patient’s needs are met, and their wishes, likes, and family situations are respected. It focuses on shared choices about treatments while seeing the patient as a whole person in their daily life (Dwamena et al., 2012; Bokhour et al., 2018).
Studies show key steps for a good patient-centered plan:
- Take a full patient history and a check-up, reviewing old and new treatments.
- Find all available drug and non-drug options.
- Check the patient’s current health, recent changes, and patterns.
- Look at risks for misusing or abusing opioids.
If starting opioids or if the patient is already on them, think about opioid stewardship. This means checking harms, benefits, risks, side effects, pain control, daily function, drug tests, stop plans, and ways to spot OUD. These programs, sometimes called analgesia stewardship, help manage opioids safely (Harle et al., 2019; Coffin et al., 2022). Guides exist to set them up (American Hospital Association, n.d.; Shrestha et al., 2023).
Integrative chiropractic care can play a big role here. It uses spinal adjustments and targeted exercises to get proper spinal alignment. This helps reduce pain without relying only on drugs, making it a good fit for OUD patients with pain. For example, adjustments fix spine issues that cause pain, and exercises strengthen muscles to keep alignment right.
A Nurse Practitioner (NP) adds full management and ergonomic advice. They look at work setups to prevent pain, such as how to sit or lift. NPs coordinate care by reviewing options such as therapy, meds, and lifestyle changes, ensuring everything works together.
Dr. Alexander Jimenez, DC, APRN, FNP-BC, with over 30 years in chiropractic and as a family nurse practitioner, observes that blending these methods cuts opioid use. At his El Paso clinic, he uses functional medicine to address root causes through nutrition and non-invasive treatments. He notes that poor posture from modern life worsens pain, leading to OUD risks. His teams help patients with self-massage and VR for recovery, reducing drug needs (Jimenez, n.d.a; Jimenez, n.d.b).
The Power of Chiropractic Care in Injury Rehabilitation-Video
Evidence-Based Ways to Communicate
Good talking skills are key to building a patient-centered plan (Schaefer & Block, 2009). There are proven methods for starting conversations and getting patients involved.
One method is BATHE:
- Background: Ask, “How have things been since your last visit?”
- Affect: Ask, “How does this make you feel?”
- Trouble: Ask, “What bothers you most?”
- Handling: Ask, “How are you coping?”
- Empathy: Say, “That sounds hard.”
This uses open questions to let patients lead and feel supported (Stuart & Lieberman, 2018; Thomas et al., 2019).
Another is GREAT:
- Greetings/Goals: Start with hello and set aims.
- Rapport: Build trust.
- Evaluation/Expectation/Examination/Explanation: Check and explain.
- Ask/Answer/Acknowledge: Listen and respond.
- Tacit agreement/Thanks: Agree and thank.
This guide talks well (Brindley et al., 2014).
Motivational interviewing is also useful. It’s a team-style talk to boost a patient’s desire to change. Build a bond, focus on the issue, spark a desire for change, and plan steps (Frost et al., 2018).
These methods emphasize listening, clear communication, and a structured approach to planning. For OUD patients with pain or mental issues, mix techniques for the best results.
Dr. Jimenez shares that in his practice, these talks help patients see non-drug options, such as chiropractic adjustments. He finds that empathy reduces stigma and fear, encouraging openness about OUD (Jimenez, n.d.a).
Understanding Stigma in Mental Health and Substance Use Disorders
Stigma blocks good talk for many with mental health or SUD. It’s attitudes, beliefs, actions, and systems that lead to unfair views and bad treatment (Cheetham et al., 2022).
Studies show stigmas like linking mental illness to violence (Perry, 2011). Media on shootings with mentally ill people strengthens this (McGinty et al., 2014; McGinty et al., 2016; Schomerus et al., 2022). For SUD, people think they’re more dangerous than those with schizophrenia or depression (Schomerus et al., 2011). Society blames people with SUDs more and avoids them (McGinty et al., 2015; Corrigan et al., 2012).
Views come from knowledge, contact with affected people, and the media. Public ideas are tied to norms on causes, blame, and danger. Race, ethnicity, and culture shape attitudes too (Giacco et al., 2014).
Health workers have biases. A survey of VA mental health providers showed awareness of race issues but avoidance of talks, using codes like “urban,” and thinking training stops racism (McMaster et al., 2021).
There are three stigma types:
- Structural Stigma: The ways Society and institutions keep prejudice. In health, it’s worse care, less access to behavioral health. Less funding for mental vs. physical issues (National Academies of Sciences, Engineering, and Medicine, 2016).
- Public Stigma: General or group attitudes, like police or church norms. Laws reinforce it, like broad mental illness rules implying all are unfit (Corrigan & Shapiro, 2010).
- Self-Stigma: When people internalize stigmas, it leads to low self-worth and shame. “Why try” affects independent living (Corrigan et al., 2009; Clement et al., 2015).
Dr. Jimenez observes that stigma makes OUD patients hide symptoms, delaying care. In his integrative work, he addresses this through education on holistic options, showing that recovery is possible without judgment (Jimenez, n.d.b).
Overcoming Stigma and Addressing Social Factors
To fight stigma, use education, behavior changes, and better care. Laws like the ADA and MHPAEA help ensure equal coverage and prevent discrimination (U.S. Congress, 2009; U.S. Congress, 2008; U.S. Department of Health and Human Services, n.d.; Busch & Barry, 2008; Haffajee et al., 2019).
These address social determinants of health (SDOH), such as coverage, access, quality, education, and stability (Centers for Disease Control and Prevention, n.d.).
Community programs help too:
- West Virginia’s Jobs and Hope: Training, jobs, education, transport, skills, record clearing for SUD people (Jobs and Hope, n.d.).
- Belden’s Pathway: Rehab for failed drug tests, leading to jobs (Belden, n.d.).
Education boosts provider confidence in OUD meds, reducing barriers (Adzrago et al., 2022; Hooker et al., 2023; Campbell et al., 2021).
Overcoming stigma is key to success in mental health and SUD.
Interprofessional Team Work
Teams improve outcomes for patients with chronic pain and mental health or SUD (Joypaul et al., 2019; Gauthier et al., 2019).
Teams include doctors, nurses, NPs, pharmacists, PAs, social workers, PTs, therapists, SUD experts, and case managers.
Each helps uniquely:
- Pharmacists watch meds, spot interactions.
- Case managers link specialists, find resources, and support families (Sortedahl et al., 2018).
- Teams set goals, max non-opioid treatments (Liossi et al., 2019).
Integrative chiropractic care includes adjustments and exercises for alignment, easing pain naturally.
NPs give full care, ergonomic tips to avoid pain triggers, and coordinate options.
Dr. Jimenez’s clinic shows this. As a DC and FNP-BC, he leads teams with therapists, nutritionists, and coaches. He observes interprofessional work cuts opioid use by addressing the roots with functional medicine, VR, and nutrition. For OUD, he blends chiropractic care for pain, NP coordination for plans, and stigma-fighting through team support (Jimenez, n.d.a; Jimenez, n.d.b).
Legal and Ethical Issues in SUD Care
Providers must know laws and ethics for mental/SUD patients, like discrimination, aid, and privacy (Center for Substance Abuse Treatment, 2000).
Key Federal laws:
- Americans with Disabilities Act (ADA) of 1990.
- Rehabilitation Act of 1973.
- Workforce Investment Act of 1998.
- Drug-Free Workplace Act of 1988.
ADA and Rehabilitation ban discrimination in government and in business services like hotels, shops, and hospitals. Protect those with impairments limiting life activities (U.S. Department of Health and Human Services, n.d.).
Provisions:
- Protect “qualified” people who meet the requirements.
- Reasonable accommodations for jobs.
- No hire/retain if there is a direct threat.
- No denial of benefits, access, or jobs in funded places.
For SUD: Alcohol users are protected if qualified, no threat. Ex-drug users in rehab are the same. Current illegal drug users are protected for health/rehab, not others. Programs can deny if used during.
Workforce Act centralizes job programs; no refusal to SUD people (U.S. Congress, 1998).
Drug-Free Act requires drug-free policies for federal funds/contracts: statements, awareness, actions on violations (U.S. Code, n.d.).
States have their own laws; check the local laws.
Public Aid laws:
- Contract with America Act (1996): No SSI/DI if SUD key factor (U.S. Congress, 1996).
- Adoption Act (1997): 15-month foster reunification limit (U.S. Congress, 1997).
- Personal Responsibility Act (1996): Work after 2 years of aid, drug screens (U.S. Department of Health and Human Services, 1996).
These push work, sobriety.
Dr. Jimenez notes that legal awareness helps his practice by ensuring holistic plans comply and by reducing OUD risks through a non-drug focus (Jimenez, n.d.a).
Keeping Patient Info Private
Privacy is vital. Laws include:
- HIPAA (1996): Protects PHI, sets use/disclosure rules (U.S. Department of Health and Human Services, n.d.).
- 42 CFR Part 2: Extra for SUD records. No disclosure of name or status without consent. Fines for breaks. Applies to federal-aided programs (Substance Abuse and Mental Health Services Administration, n.d.).
Consent needs: program name, receiver, patient name, purpose, info type, revoke note, expire date, signature, and date.
This fights discrimination fears, encouraging treatment (Center for Substance Abuse Treatment, 2000).
Wrapping Up
As we deal with the recurring problems of opioid use disorder (OUD), it’s evident that the best way to handle them is via a multifaceted strategy that puts the health of the patient first instead of short-term cures. Healthcare professionals are essential to changing lives. They do this by supporting patient-centered decision-making and evidence-based communication, and by breaking down the three forms of stigma—structural, public, and self—that make it harder for people to get well. Legal and ethical frameworks, including HIPAA and 42 CFR Part 2 privacy regulations, ensure that those who need assistance receive it without fear of being treated unfairly. Interprofessional teams also help make sure that everyone gets the treatment they need.
Chiropractic therapy, which focuses on spinal adjustments and specific exercises to help with appropriate alignment, is a non-invasive technique to ease pain and cut down on the need for narcotics. Nurse Practitioners (NPs) improve this by offering comprehensive care, ergonomic advice to prevent injury, and coordination of multiple treatment options, including therapy and lifestyle adjustments. Dr. Alexander Jimenez, DC, APRN, FNP-BC, stresses in his clinical practice that these integrative strategies not only help with physical symptoms but also provide patients with the tools they need to make educated decisions and follow tailored programs. This leads to long-term recovery and less usage of opioids (Jimenez, n.d.a; Jimenez, n.d.b).
Recent developments in OUD therapy as of 2025 indicate a transition towards more individualized and accessible alternatives. For example:
- FDA-approved drugs like methadone, buprenorphine, and naltrexone are still the mainstays of therapy for OUD. They help minimize cravings and withdrawal symptoms while also assisting people to stay stable over the long term.
- Precision medicine goes beyond one-size-fits-all methods by tailoring treatments to each person’s genetic, psychological, and social characteristics. This should lead to better results.
- New Guideline: The World Health Organization’s 2025 updates stress the need of psychological support in addition to drug treatments. They also concentrate on preventing overdoses in the community and making care more widely available.
- Declining Trends: The number of fatalities involving opioids dropped for the first time in 2023 since 2018, which is a good indicator that continuing efforts in policy, education, and treatment are having an effect.
We can create a future where OUD is not a life sentence but a disease that can be managed by combining these new ideas with reducing stigma and working together to care for people. Healthcare professionals, communities, and governments must continue to push for fair access to treatment so that everyone gets the compassionate, evidence-based help they need. In the end, overcoming the obstacles to managing OUD isn’t just about therapy; it’s also about restoring hope, respect, and a better quality of life.
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The information herein on "Opioid Use Disorder Management in a Clinical Approach" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Master's in Family Practice MSN Diploma (Cum Laude)
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
My Digital Business Card
Licenses and Board Certifications:
DC: Doctor of Chiropractic
APRNP: Advanced Practice Registered Nurse
FNP-BC: Family Practice Specialization (Multi-State Board Certified)
RN: Registered Nurse (Multi-State Compact License)
CFMP: Certified Functional Medicine Provider
MSN-FNP: Master of Science in Family Practice Medicine
MSACP: Master of Science in Advanced Clinical Practice
IFMCP: Institute of Functional Medicine
CCST: Certified Chiropractic Spinal Trauma
ATN: Advanced Translational Neutrogenomics
Memberships & Associations:
TCA: Texas Chiropractic Association: Member ID: 104311
AANP: American Association of Nurse Practitioners: Member ID: 2198960
ANA: American Nurse Association: Member ID: 06458222 (District TX01)
TNA: Texas Nurse Association: Member ID: 06458222
NPI: 1205907805
| Primary Taxonomy | Selected Taxonomy | State | License Number |
|---|---|---|---|
| No | 111N00000X - Chiropractor | NM | DC2182 |
| Yes | 111N00000X - Chiropractor | TX | DC5807 |
| Yes | 363LF0000X - Nurse Practitioner - Family | TX | 1191402 |
| Yes | 363LF0000X - Nurse Practitioner - Family | FL | 11043890 |
| Yes | 363LF0000X - Nurse Practitioner - Family | CO | C-APN.0105610-C-NP |
| Yes | 363LF0000X - Nurse Practitioner - Family | NY | N25929 |
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
My Digital Business Card
Again, I Welcome You.
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