#498 Opioid Withdrawal with Dr. Ashish Thakrar

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 15 September 2025

⏱️ 77 minutes

🔗️ Recording | iTunes | RSS

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Summary

Grow your management tools for opioid withdrawal in the hospital. Investigate how to decide between methadone and buprenorphine, additional medications to manage symptoms and how and when to use short-acting opioids for management of withdrawal. We’re joined by Ashish Thakrar, MD at the University of Pennsylvania.

Claim CME for this episode at curbsiders.vcuhealth.org!
By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | iTunes | [email protected] | CME!

Show Segments

Intro, disclaimer, guest bio
Guest one-liner
Case from Kashlak; Definitions
Symptoms of opioid withdrawal
Medications for the management of opioid withdrawal
Buprenorphine precipitated withdrawal
Starting Buprenorphine: Experiences and Strategies
Titrating Methadone: Dosage and Adjuncts
Adjunctive short-acting opioids
Emerging Trends in Drug Supply: Xylazine and Medetomidine
Outro

Credits

Producer, Show Notes: Zina Huxley-Reicher
Infographics: Zina Huxley-Reicher MD and Zoya Surani
Hosts: Carolyn Chan, MD MHS, Zina Huxley-Reicher MD, Shawn Cohen, MD
Reviewer: Payel Jhoom Roy, MD, MSc
Showrunner: Carolyn Chan, MD, MHS
Technical Production: PodPaste
Guest: Ashish Thakrar, MD MHSP

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Transcript

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0:00.0	Hey, before we get to the show, I wanted to remind you to check out our Patreon at patreon.com slash curbsiders.
0:06.7	If you haven't signed up yet, sign up now to get ad-free episodes, twice-monthly bonus episodes,
0:11.8	and a whole bunch of other cool stuff at patreon.com slash curbsiders.
0:18.5	I will say this was one of my favorite episodes.
0:21.3	It will really withdraw you into it.
0:24.7	No.
0:25.8	Too bad, right?
0:27.4	Draw you in?
0:28.9	No.
0:32.3	The curbsiders podcast is for entertainment, education, and information purposes only.
0:35.5	And the topics discussed should not be used solely to diagnose, treat, cure, or prevent any diseases or conditions.
0:38.8	For the more of the views and statements expressed on this podcast are solely those of those
0:40.7	and should not be interpreted to reflect official policy or position of any entity, aside from possibly cash like more honest, and affiliate outreach programs. If indeed, there are any. In fact, there are none. Pretty much, we aren't responsible if you screw up. You should always do your own homework and let us know.
0:49.4	Welcome back to the KERB SITER's Internal Medicine Podcast, where we use expert interviews to bring you clinical pearls and practice changing knowledge.
1:04.8	Today, we are actually going to give Matt and Paul a break from recording, and we are going to bring you an episode from the Curbsiders Addiction
1:11.7	Medicine podcast, our mini series on substance use disorder. So I'm Dr. Carolyn Chan, and today
1:16.7	I have two fabulous co-hosts, Dr. Sean Cohen and Dr. Zina Huxley-Riker. And on tonight's episodes,
1:22.8	we are really going to dig in and dive in deep to the management of opioid withdrawal in the era of fentanyl with
1:29.2	Dr. Ashish Kakar. But before we get too much into our contents, Sean, will you remind everybody what we
1:34.9	do on this miniseries? I would love to, Carolyn. We are the AddictionMed podcast that uses expert
1:41.0	interviews, often with people we idolize. And in this case, in someone who I've
1:45.2	read every paper that he's ever written and use it on rounds to justify what I'm doing,
	...

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