En español
NIDA

Empowering Family Medicine Residencies to Address Prescription Opioid Abuse

Revised November 2015

2014 Meeting Overview

The Empowering Family Medicine Residencies to Address Prescription Opioid Abuse workshop was held on May 3, 2014. This Blending Meeting provided physicians, clinicians, healthcare providers, researchers, policy makers, and others with the opportunity to learn from top experts who play roles in the design of science-based treatment programs and from the practitioners who implement these programs across the country.

The workshop was divided into two parts, a morning and afternoon session. Each session provided participants a different focus: the morning focused on essentials for patient care and the afternoon focused on resident education.

Goals:

The goals of the day-long workshop were to:

  • Review important and timely topics in the use of buprenorphine for office-based treatment.
  • Provide buprenorphine waiver training for outpatient practice.
  • Create a forum to discuss emerging research findings and their implications in clinical practice.
  • Provide updates and practical applications for addressing prescription opioid abuse in family medicine settings.

Attendance:

Over 100 individuals registered for this conference, and each participant was provided with a program booklet and a flash-drive containing all presentation materials.

Morning Session

Description:

Utilizing case-based presentations and small group case discussions, the Managing Opioid Dependence with Buprenorphine: Essentials for Patient Care session reviewed office-based buprenorphine treatment fundamentals. Procedures for obtaining prescribing waivers were also reviewed. The session satisfied the face-to-face portion of the waiver certification process, and the remainder of the prescribing certification process was available online.

Objectives:

At the conclusion of the workshop, participants were able to:

  • Describe the epidemiology of the current opioid abuse epidemic.
  • Explain how buprenorphine is an effective medication for the management of opioid dependence in a variety of populations including youth, pregnancy, and patients with co-occurring disorders such as chronic pain.
  • Appropriately select patients for buprenorphine induction, detoxification, stabilization, and maintenance, and address issues of safety and diversion.
  • Use mentoring resources for office-based buprenorphine practice.

Morning Agenda:

Begin Session Faculty
8:00 a.m. Welcome and Introductions

Workshop Overview and Organization
Geetha Subramaniam, M.D., DFAPA

Kenneth Saffier, M.D.
8:15 a.m. Opioid Misuse: An Overview of Epidemiology, Treatment Gaps, and D.A.T.A. 2000
A review of buprenorphine pharmacology, efficacy, and safety including practice guidelines from the Prescription Opioid Addiction Treatment Study.
L. Paul Gianutsos, M.D., M.P.H.
8:45 a.m. Office-Based Treatment of Opioid Addiction with Buprenorphine: Patient Assessment and Selection, Induction, Maintenance, and Detoxification
A review of other medically assisted treatment approaches (methadone, naltrexone).
Jeffrey Baxter, M.D.
9:15 a.m. Small Group Case Discussions
Assessment of Patients Requesting Buprenorphine, Induction Techniques, and Monitoring Guidelines
 
9:35 a.m. Opioid Addiction in Pregnancy:
Antepartum and Postpartum Management and Care of Neonates
Jim Walsh, M.D.
9:50 a.m. Small Group Case Discussions
Induction of Pregnant Patients, Dose Requirements, Neonatal Detox, and Breastfeeding Issues
 
10:05 a.m. Break
10:15 a.m. Improving Treatment for Youth Opioid Addiction:
Lessons from the Adolescent and Young Adult Buprenorphine Treatment Study
Marc Fishman, M.D.
10:30 a.m. Small Group Case Discussions
Assessing Adolescents in Withdrawal, Weighing Treatment Options, and Structuring Care
 
10:50 a.m. The Management of Acute and Chronic Pain in the Context of Addiction Richard Blondell, M.D.
11:05 a.m. Small Group Case Discussions
Assessing Chronic Pain Patients, Identifying Risk Level, and Ongoing Monitoring
 
11:25 a.m. Additional Important Issues:
Responding to Relapses, Other Drug Use, Tapering, and Discontinuation of Therapy
Jeffrey Baxter, M.D.
11:45 a.m. Questions and Answers Panel with Presenters
12:10 p.m. Preparing Your Office for Office-Based Opioid Addiction Treatment:
Clinical Tools for Implementation
Jeffery Baxter, M.D.
12:20 p.m. Question and Answers: Wavier Process  
12:30 p.m. Adjourn

Afternoon Session

Description:

The Managing Opioid Dependence with Buprenorphine: Integration into Resident Education session included brief presentations by practitioners of family medicine, highlighting four model programs for successful integration of buprenorphine prescription in practice. Small group facilitated discussions were held for reviewing strategies for developing buprenorphine education and integrating them in residency programs. Discussion focused on current status of buprenorphine practice and training; overcoming barriers; engaging administration, staff, faculty, and residents; competencies and milestones; using mentoring resources and involving residents.

Objectives:

At the conclusion of the workshop, participants were able to:

  • Develop strategies for strengthening buprenorphine education in family medicine residency curricula, including integrating certification courses for residents and faculty into family medicine programs.
  • Create their own individual and residency actions plan to develop and promote buprenorphine education in their residency program.
  • Develop and integrate buprenorphine curricula as part of a comprehensive approach to sub- stance use disorders education.

Afternoon Agenda:

Begin Session Faculty
1:30 p.m. Welcome and Workshop Overview  
1:35 p.m. Introductions, Buprenorphine Training: Why Teach? Why Now? Panelists:
L. Paul Gianutsos, M.D., M.P.H.; Valerie Carrejo, M.D.;
James J. Ledwith, Jr., M.D., FAAFP; Kenneth Saffier, M.D.

Residents: Stephen Merjavy, M.D.; Christy Martinez M.D. 
Overview of Buprenorphine Programs J. Paul Seale, M.D.
1:45 p.m. Small Group Discussions and Debriefing
Current Status of Buprenorphine Practice and Training at Each Institution
 
2:15 p.m. Using Supporting Factors to Overcome Barriers: Case Examples
Assessment of Patients Requesting Buprenorphine, Induction Techniques, and Monitoring Guidelines
Valerie Carrejo, M.D., and Sally Bachofer, M.D.
2:25 p.m. Small Group Brainstorming and Debriefing
Identifying Local Supporting Factors and Barriers
 
2:50 p.m. Partners in Curriculum Development:
Engaging Administration, Staff, Faculty, and Residents
James J. Ledwith, Jr., M.D., FAAFP, and Peter C. McConarty, M.D.
3:00 p.m. Small Group Discussions
 Identifying/Cultivating Partners at My Residency: Who? How?
 
3:15 p.m. Break
3:30 p.m. Buprenorphine, ACGME Competencies and Milestones:
Grabbing Attention and Getting Buy-In
Julie Nyquist, Ph.D.
3:45 p.m. Using Mentoring Resources and Involving Residents Kenneth Saffier, M.D.
3:55 p.m. Resident Perspectives Stephen Merjavy, M.D., and Christy Martinez, M.D.
4:05 p.m. Small Group Discussions
Create Individual Action Plans for Each Program
 
4:20 p.m. Workshop Summary and Debriefing Facilitator Presentations  
4:35 p.m. Commitment to Act (Individual Specific First Steps) and Session Evaluation  
5:00 p.m. Adjourn

This page was last updated November 2015