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Course 3. Buprenorphine
This course on buprenorphine prescribing in the primary care setting will cover buprenorphine’s safety profile and its different formulations; prescribing buprenorphine for pain; how a clinician gets a buprenorphine waiver, and how a buprenorphine waiver can augment clinical care; contraindications to buprenorphine use; considerations for special populations; prescribing buprenorphine when a patient is also using benzodiazepines and alcohol; opioids and stimulants; misuse and diversion of buprenorphine; planning for buprenorphine initiation, including understanding the risk of precipitated opioid withdrawal; starting buprenorphine for problematic fentanyl use; and buprenorphine as maintenance therapy.
  


Management of Opioids and Chronic
Pain in the Primary Care Setting
 




Module 3: BUPRENORPHINE


Description

The Center for Innovation in Academic Detailing on Opioids (CIAO), at the San Francisco Department of Public Health, has prepared online coursework modules with the aim of educating learners on topics related to the management of opioids and chronic pain in the primary care setting as well as how to communicate relevant information to patients and providers.

Opioids have legitimate medical uses, but many people also use opioids recreationally. Problematic use, whether medical or recreational, can lead to addiction, overdose, and death. Buprenorphine has emerged as a critical tool in the treatment of problematic opioid use.

This course on buprenorphine prescribing in the primary care setting will cover buprenorphine’s safety profile and its different formulations; prescribing buprenorphine for pain; how a clinician gets a buprenorphine waiver, and how a buprenorphine waiver can augment clinical care; contraindications to buprenorphine use; considerations for special populations; prescribing buprenorphine when a patient is also using benzodiazepines and alcohol; opioids and stimulants; misuse and diversion of buprenorphine; planning for buprenorphine initiation, including understanding the risk of precipitated opioid withdrawal; starting buprenorphine for problematic fentanyl use; and buprenorphine as maintenance therapy. Additionally, a clinical expert on buprenorphine will review selected journal publications on comparing buprenorphine induction strategies, cognitive behavioral therapy in primary care-based buprenorphine, conversion from high-dose full-opioid agonists to sublingual buprenorphine on pain scores and quality of life for chronic pain patients, and low barrier treatment for persons experiencing homelessness and injecting heroin in San Francisco. Case studies will be used to help illustrate course concepts, and interactive dialogue simulations will help hone buprenorphine-related messaging between patient, provider, and provider educator.


Learning Objectives

At the end of this activity, the participant should be able to:

  1. Describe indications, contraindications, and general tenets of starting buprenorphine.

  2. Explain safety profile of buprenorphine as treatment for opioid use disorder (OUD) when used concurrently with benzodiazepines and stimulants.

  3. Explain modeling non-stigmatizing, patient-centered clinical care for a patient with opioid use disorder who’s starting on buprenorphine.



Method of Participation/Instructions for Obtaining Credit

Participants should read and listen to the coursework content, answer the multiple-choice test questions within each module, and complete the evaluation form online to receive a certificate. You must receive a score of 80% or better to complete the course. You will have unlimited attempts to successfully complete the post-test.  Your certificate will be available immediately for print or download upon completion of the entire module.

This course was released November 1, 2022 and expires May 31, 2025.


Accreditation

Please see the overall curriculum overview for accreditations and credit designations. This module will take 60 minutes to complete, which is equivalent to 1.0 credit (or 0.1 CEUs), including 1 credit for Pain Management, Schedule II Drugs, and Pharmacotherapeutics.

The ACPE Universal Activity Number for this knowledge-based module is 0005-9999-22-013-H01-P for pharmacists.

ABIM Maintenance of Certification Points: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.


Disclosure

This UCSF CME activity was planned and developed to uphold academic standards to ensure balance, independence, objectivity, and scientific rigor; adhere to requirements to protect health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA); and include a mechanism to inform learners when unapproved or unlabeled uses of therapeutic products or agents are discussed or referenced.

The following individuals have no financial relationships with ineligible companies whose primary business purpose is the manufacturing, marketing, selling, re-selling or distributing health care goods used on or by patients.

Course Directors
Phillip Coffin, MD
Brian Wylie, OTD, MPH
Rebecca Martinez, FNP-C

Additional Speakers
Jessica Ristau, MD
Assistant Professor of Medicine
Division of General Internal Medicine
University of California, San Francisco
San Francisco, California

The following individuals have disclosed a relevant financial relationship with one or more ineligible companies. Financial relationships have been mitigated in accordance with the Standards for Integrity and Independence of Accredited Continuing Education Activities.

NONE.


Special Needs or Other Concerns
If you require any special accommodations for a disability which creates a hardship to participating in this activity, or you have questions or concerns about this course, please contact the Office of CME. (Additional contact information is below.)

Supplemental Material
Cultural and Linguistic Competency Resources  
CLC Info and Resources

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UCSF School of Medicine
Office of Continuing Medical Education
Box 0742
490 Illinois Street, Floor 8
San Francisco, CA  94143

info@ocme.ucsf.edu
Phone: (415) 476-4251 • Fax: (415) 476-0318



Type:     Internet Activity (Enduring Material)
101 Registered Users