Cracking Down: E-Cigarettes for Smoking Cessation and Medication for Opioid Use Disorders after Nonfatal Opioid Overdose

Paxton Bach, general internist in Vancouver, is hosting this week’s episode of The Rounds Table alongside Kate Colizza generalist internist in Calgary.  This week they are covering studies related to addiction medicine that are relevant to all areas of practice – the use of e-cigarettes for smoking cessation and initiation of medication for opioid use disorders after nonfatal opioid overdose.

One in five of all deaths in the country were related to cigarettes, according to a study by the Conference Board of Canada in 2017. E-cigarettes have been viewed as having fewer chemicals; however, limited data exists to suggest a benefit in using e-cigarettes for smoking cessation compared to nicotine replacement therapy.  Kate discusses a randomized trial of e-cigarettes versus nicotine replacement therapy on abstinence rates.

Last year in Canada there were over 4000 deaths related to opioid use.  A nonfatal overdose is a predictor of a future overdose event.  What are the outcomes if an intervention, such as a medication for opioid use disorder, is put in place after a nonfatal overdose?  Paxton covers a retrospective cohort study on the initiation of medications on mortality outcomes for opioid use disorders after a nonfatal overdose.

Finally, The Good Stuff segment.  Kate shares a recently-launched podcast called ‘Crackdown’ that includes the first-hand experiences of patients who use drugs during the drug war and overdose crisis. Paxton reviews an article about a community in northern Wisconsin and their experience recruiting a physician for their community to treat patients with opioid use disorders.

Like what you hear?  Rate us on iTunes!  Chat with us on Twitter at @roundstable and tweet at Paxton Bach @paxbach and Kate Colizza @KateColizza.

Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.

The Papers

1. E-cigarettes: https://www.nejm.org/doi/full/10.1056/NEJMoa1808779

2. Non-fatal opioid overdose: https://annals.org/aim/fullarticle/2684924/medication-opioid-use-disorder-after-nonfatal-opioid-overdose-association-mortality

Good Stuff

1. Crackdown podcast: https://itunes.apple.com/ca/podcast/crackdown/id1450566001?mt=2 and https://www.cbc.ca/news/canada/british-columbia/crackdown-podcast-garth-mullins-1.4998251

2. Recruiting the right doctor: https://www.npr.org/sections/health-shots/2018/12/09/674329075/for-one-rural-community-fighting-addiction-started-with-recruiting-the-right-doc

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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