Buprenorphine Training Program v2.0 (2012 Update)

Authors

As an ACCME accredited provider of continuing medical education, Clinical Tools, Inc. complies with the Standards for Commercial Support issued by the ACCME and requires disclosure of and resolution of any conflicts of interest for those in control of content.
Meghan Coulehan, MPH (Research Project Director, Clinical Tools, Inc.)Ms. Coulehan has contributed to nearly all of Clinical Tools' projects since she started working at the company in 1996. She has served as director of the buprenorphine education team since 2000 when the company received its first NIDA grant to develop a web-based opioid dependence training program. Since then she has overseen development, evaluation, and distribution of the DATA-2000 buprenorphine training program and clinical practice tools on BupPractice.com. She has also worked on dozens of other CME courses developed by Clinical Tools, on topics including alcohol abuse and treatment, tobacco cessation, pain and addiction, depression, and genetic counseling and testing. Ms. Coulehan also has extensive experience working on patient health education projects; she is currently the principal investigator on a project to develop an education and support website for dementia caregivers (DementiaCareCentral.com).
Disclosure: Has disclosed no relevant financial relationships.
T Bradley Tanner, MD (President, Clinical Tools, Inc.)T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on BupPractice.com. He also has a strong background in technology and oversees development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role a Clinical Associate Professor of Psychiatry at the University of North Carolina Chapel Hill.
Disclosure: Has disclosed no relevant financial relationships.
Karen Rossie, DDS PhD (Research Scientist, Clinical Tools, Inc. )Karen Rossie, DDS, PhD, directs projects at Clincal Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University. She taught and practiced oral pathology and oral medicine for 12 years at the University of Pittsburgh, doing research in autoimmune disease, transplantation, cancer, salivary gland disease, and diabetes. An interest in the psychological aspects of disease led her to obtain a PhD in psychology at the Institute of Transpersonal Psychology in Palo Alto where she now taught psychology part time in a distance learning program. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, and pain and addiction.
Disclosure: Has disclosed no relevant financial relationships.

Reviewers

Colleen T LaBelle, BSN (Nurse Program Manager at Boston Medical Center, Program Director State Technical Assistance Treatment Expansion of Buprenorphine for the Bureau of Substance Abuse Services)Ms. Labelle is the Nurse Program Manager at Boston Medical Center, and Program Director State Technical Assistance Treatment Expansion of Buprenorphine for the Bureau of Substance Abuse Services in MA. She manages the largest buprenorphine practice in the State of Massachusetts, and 14 community health center models. In addition, she has served as a faculty member, National Advisory Committee for Buprenorphine member, and Liaison to the State of Massachusetts providing trainings and technical support to community providers on buprenorphine. Ms. Labelle has been a part of the SAMHSA Summit on Buprenorphine. participated in professional editing of TAP 30 Technical Assistance Publication for Nurses with SAMHSA, 2009. Co-author): Five Year Experience with Collaborative Care of Opioid Addicted Patients using Buprenorphine in Primary Care, published Archives of Internal Medicine.
Disclosure: Has disclosed no relevant financial relationships.
Edwin Salsitz, MD (Medical Director, Office-Based Opioid Therapy Program, Beth Israel Medical Center)Dr. Salsitz is currently the Medical Director of a large office-based opioid treatment center at Beth Israel Medical Center. He also treats substance abuse patients at a private practice and is an ASAM-certified addiction medicine specialist. He has worked with opioid-dependent patients for over 20 years at a novel office-based methadone maintenance clinic. Dr. Salsitz is involved with buprenorphine education and serves as a Course Director for ASAM buprenorphine trainings and as a mentor in the Physician Clinical Support Services program.
Disclosure: Speaker for Reckitt Benckiser, Pfizer, Forest Labs, and Cephalon.
Judith Martin, MD (President of California Society of Addiction Medicine (CSAM) and Medical Director, BAART Turk Street Clinic)Dr. Martin's residency specialty is family practice and she has worked in addiction medicine since 1986, and is certified in addiction medicine by the American Society of Addiction Medicine (ASAM). She works with heroin-addicted patients and their families in East Oakland, as the Medical Director of The 14th Street Clinic. She also serves as the Medical Director for the East Bay Community Recovery Project, a multi-service agency that includes a residential program for addicted women and their children, Project Pride. Dr. Martin has published several papers related to methadone maintenance and she has taught in the Division of Family Medicine at Stanford University School of Medicine. Currently, Dr. Martin is the President of the California Society of Addiction Medicine (CSAM), has served on CSAM's executive council, and she chairs their Committee for the Treatment of Opiate Dependence. Since 2001, she has been involved in efforts to train physicians in opiate dependence and the use of buprenorphine for the treatment of opiate addiction. She is currently co-chair of the American Society of Addiction Medicine's Buprenorphine Training Subcommittee.
Disclosure: Has disclosed no relevant financial relationships.
Steve Applegate, MEd MEdMr. Applegate has experience in substance use counseling, state initiatives impacting substance use, and professional training. His prior positions include director of higher education and instructional design at the North Carolina Governor's Institute on Alcohol and Substance Abuse, project director of the North Carolina Initiative of the Mid-Atlantic Addiction Technology Transfer Center, and program director of the Addiction Sciences Center (an outpatient substance abuse treatment center at the University of Virginia Health Sciences Center). Mr. Applegate works as an on-site consultant and travels to the Clinical Tools (CTI) office on a monthly basis from his office in Richmond, VA. Mr. Applegate helped design the CTI Instructional Manual and works to continue to revise it as we expand our Instructional Design methodology. Mr. Applegate has extensive experience with online education and training, especially in the area of substance abuse. He often pushes the envelope of technology and brainstorms with Clinical Tools how we can utilize new technology within our products. He helped guide development of the curriculum plan and assessments in Phase I of the current project.
Disclosure: Has disclosed no relevant financial relationships.

Audience and Accreditation

Audience

Physicians

Type: AMA PRA Category 1 Credit(s)™Estimated Time: 9 hour(s)Release Date: 10/1/11Expiration Date: 10/23/13

Credit Statement for AMA PRA Category 1 Credit(s)™: Clinical Tools, Inc. designates this enduring material for a maximum of 9 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • A letter of completion for up to 9 hour(s) is available for non-physicians.

A score of 70% on the post-test is required to complete the program.

Overview

Goal: To provide training to physicians that meets the requirement of DATA 2000, in order to increase the number of physicians who are knowledgeable about and qualified to prescribe buprenorhpine to their opioid-dependent patients.
Professional Practice GapsRead More

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that in 2012 there were 467,000 people who abused or were dependent on heroin; the prevalence of past month non-medical use of pain relievers was 1.9% (SAMSHA, 2013). In fact, these figures probably vastly underestimate the true prevalence of opioid use disorders in the United States (SAMHSA, 2005). Further, only a small fraction of these users have received treatment for an opioid use disorder (SAMHSA, 2005).

Buprenorphine is a safe and effective treatment for opioid dependence that offers patients a more widely available, accessible, convenient treatment option as compared to traditional opioid treatment programs (OTP) (SAMHSA, 2001; Johnson et al., 2003; SAMHSA, 2004). The Drug Addiction Treatment Act (DATA) of 2000 -- an amendment to the Controlled Substances Act -- allows physicians who are not part of an OTP to prescribe buprenorphine. However, the law requires physicians to complete an 8-hour buprenorphine training conducted by an approved organization in order to prescribe it.

This buprenorphine training program prepares physicians to prescribe buprenorphine safely and effectively to address needs of the millions of Americans with opioid use problems. In addition, the program has been developed to meet the DATA 2000 training guidelines as defined in Public Law 106-310-106th Congress and is endorsed by the American Society of Addiction Medicine, one of the approved training organizations named in DATA 2000. The program content is based upon SAMHSA’s 2004 publication Treatment Improvement Protocol (TIP) #40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. The courses are regularly reviewed and updated by ASAM members who are experts in the field of addiction medicine and buprenorphine treatment.

References:

Johnson RE, Strain EC, Amass L. Buprenorphine: how to use it right. Drug Alcohol Depend. 2003; 70(suppl 2): S59-S77. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12738351.

Substance Abuse and Mental Health Services Administration (SAMHSA). Use of Buprenorphine in the Pharmacologic Management of Opioid Dependence: A Curriculum for Physicians. Substance Abuse and Mental Health Services Administration. 2001. Available at: http://www.buprenorphine.samhsa.gov/Buprenorphine_Curriculum.pdf.

Substance Abuse and Mental Health Services Administration (SAMHSA). Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Rockville, Md: Center For Substance Abuse Treatment. Treatment Improvement Protocol Series, No. 40, USDHHS Publication (SMA) 04-3939. 2004b. Available at: http://buprenorphine.samhsa.gov/Bup_Guidelines.pdf.

Substance Abuse and Mental Health Services Administration (SAMHSA). Overview of Findings From the 2004 National Survey on Drug Use and Health. Rockville, Md: Office of Applied Studies. 2005. Available at: http://oas.samhsa.gov/NSDUH/2k4NSDUH/2k4Overview/2k4Overview.pdf.

Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. Rockville, Md: Office of Applied Studies. 2013. Available at: http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#ch2


This program is designed to change: Read More Competence, Performance, Patient Outcome.

Educational Objectives

After completing this program participants will be able to:
  • Expand your practice to comply with the regulations and requirements of office based buprenorphine treatment

  • Relate buprenorphine's pharmacological properties to its drug effects and understand the physiological effects of opioids and opioid treatments on patients

  • Identify, assess, and diagnose opioid use and dependence in your patients

  • Utilize medical and substance abuse history information to assess your patients in terms of suitability of treatment with buprenorphine

  • Provide effective and successful treatment to your patients throughout the phases of buprenorphine treatment: induction, maintenance, and discontinuation, and deal with complications that arise

  • Assess and adapt treatment guidelines to best treat your patients from specific patient populations, including those with psychiatric comorbidities, adolescents, the elderly, pregnant women, methadone transfers, and patients with pain

  • Prescribe, refer, or implement appropriate psychosocial therapies for treating opioid dependence

Program Activity Syllabus

Review Dates

Content Review:
Sat, 12/15/2012
Editorial Review:
Sat, 12/15/2012

Participation Requirements

Read More Program Credit: Obtaining credit for participation in this program requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the program, you will be instructed on how to print out a certificate for your records.
Time Requirement: Keep track of the amount of time it takes you to complete this program. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.
Technical Requirements: To participate in this program, you will need a computer, an Internet connection, and a Web browser. This program requires Chrome, Firefox, and IE7 or higher.

Funding

Initial development of this program was supported by a grant from the National Institute on Drug Abuse (#R44-DA12066).