Telehealth MOUD Video Demonstrations: Meeting Between Patient in MOUD and a Nurse Care Manager

Summary

A nurse care manager checks in with a patient during a buprenorphine follow-up. The patient says treatment is going well: a new group schedule is easier to manage alongside a new part-time job, and the medication is helping without current cravings or withdrawal symptoms. She also describes setting boundaries with people connected to past opioid use. She reports one instance of opioid use about three weeks earlier, one recent instance of marijuana use, and occasional alcohol use.

The main focus is the patient’s alcohol use while taking buprenorphine. The nurse explains that both substances can slow the central nervous system and, when combined, can dangerously slow breathing and heart rate, leading to severe sedation, coma, or death. Using a nonjudgmental, harm-reduction approach, the nurse clarifies the safety concern and works with the patient on a plan rather than demanding abstinence.

Strategies and Plan

• The patient proposes limiting herself to one glass of wine and avoiding stronger drinks.
• If she drinks, she plans to eat beforehand or with the drink, stay hydrated, and switch to water afterward.
• The nurse recommends tracking drinks, sticking to a self-set limit, and being with people she trusts.
• The nurse emphasizes that there is no known safe amount of alcohol when taking buprenorphine.
• A follow-up is scheduled in about a week to review how the plan is going.
• The patient’s treatment schedule was adjusted to accommodate her work, and she plans to continue with her new group.

Presenters and Source

• Nurse Care Manager: Maureen Oscadal, RN, BSN, AMB-BC, CARN
• Patient: Cathie Murphy, SUDP
• Source: Northwest ATTC — Telehealth MOUD Video Demonstrations: Meeting Between Patient in MOUD and a Nurse Care Manager