Buprenorphine Dose Limits - What Is The Evidence?
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Buprenorphine Dose Limits - What Is The Evidence?
Recorded: Thursday, March 31, 2022 - Sunday, April 3, 2022
This 1-hour, on-demand session from the ASAM 53rd Annual Conference reviews literature on a range of issues surrounding buprenorphine dosing and dose limits so clinicians can make better decisions for their patients.
This session provides a review of evidence for the initial recommendations of dosing limits for buprenorphine and the safety and advisability ofhigher doses in select patients given the current overdose crisis of synthetic opioids, such as fentanyl. Additionally, this session examines the needs of special populations, such as patients with co-existing pain, poly-substance use, pregnant patients, and diversion.
The target audience for this Intermediate level session includes physicians, nurse practitioners, physician assistants, other clinicians, researchers, residents, fellows, students, and counselors.
This session addresses the following ACGME Competencies: Patient Care and Procedural Skills, Medical Knowledge, Practice-based Learning and Improvement, System Based Practice.
Upon completion, learners will be able to:
- Discuss the evidence on buprenorphine dose and clinical outcomes, including special situations such as pregnancy and polysubstance use.
- Screen, identify, evaluate, and counsel patients who may benefit from higher doses of buprenorphine.
- Identify strategies to navigate constraints such as prior authorizations and administrative limits.
*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.
Refunds & Cancellations
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Registration Deadline: 05/01/2025
- Click on the Contents tab to watch the on-demand recording.
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DNP, EdD, PMHNP-BC, FNP-BC, CARN-AP
Dr. MaryAnne Christine Murray, DNP, EdD, MSN, MN, MS, MA, MBA, PMHNP-BC, FNP-BC, CARN-AP is in private practice of psychiatric, mental health, and addiction care in Long Beach, Washington. She trained in Addiction Studies at Seattle University from 1987-1991 and then taught in that program while working as a Chemical Dependency Counselor and earning a Master of Science in Counseling Psychology. During nursing school, she worked as a social worker in the HIV/AIDS clinic at Harborview Medical Center, Seattle, providing mental health and substance use disorder (SUD) care. As a nurse she managed a large hospital-based withdrawal management unit and a 26-day treatment program for pregnant women with addictions. After working in outpatient methadone settings, she served for eight years at a rural, remote community mental health center where she created a Medications for Addiction Treatment (MAT) program. With her husband, Dave Cundiff, MD, MPH, she is currently developing an integrated health care clinic to offer primary care, mental health care, pain management, and MAT/SUD treatment, in the small city of Ilwaco on the Pacific coast of Washington State. Dr. Murray also precepts Psychiatric/Mental Health Nurse Practitioner students for multiple Universities in Washington State and beyond.
Through her addiction treatment prescribing and with mentoring by buprenorphine expert Dr. Cindy Grande, MD, Dr. Murray learned and teaches the importance of therapeutic targets in Opioid Use Disorder care.
Lucinda Grande, MD is a partner at Pioneer Family Practice in Lacey, Washington, where she practices primary care with a special interest in treatment of addiction and chronic pain. She co-founded and served as Medical Director of the Olympia Bupe Clinic, a low-barrier buprenorphine clinic in Olympia, Washington, and currently serves as Medical Advisor there. Her medical degree is from the University of Washington School of Medicine in Seattle. She completed her family medicine residency at St. Peter Family Medicine in Olympia, Washington. She advocates to improve access to opioid treatment medication and other services in high needs populations including those in correctional institutions and hospitals, and also for patients who depend on prescribed opioid medications to manage chronic pain. Dr. Grande is a Clinical Assistant Professor in the University of Washington Department of Family Medicine. Her clinical research addresses the low-barrier model of buprenorphine access and the use of buprenorphine and sublingual ketamine for treatment of chronic pain. The Olympia Bupe Clinic is a recipient of a State Opioid Response grant from the Washington State Health Care Authority and is a Medicaid Transformation Demonstration partner of the Cascade Pacific Action Alliance.
MD, MS, FACOG, FASAM
Tricia Wright, MD MS is a Professor of Clinical Medicine in the Department of Obstetrics, Gynecology and Reproductive Health at the University of California, San Francisco. Previously she was at the University of Hawaii and founded the Path Clinic, a perinatal clinic specializing in the care of pregnant and parenting women with Substance Use Disorders. She is board certified in both Obstetrics and Gynecology and Addiction Medicine and a Fellow of the American College of Obstetrics and Gynecology and a Distinguished Fellow of the American Society of Addiction Medicine. She has published multiple papers on pregnancy and addiction as well as a textbook Opioid Use Disorders in Pregnancy published in 2018 by Cambridge University Press.Dr. Wright completed her undergraduate degree in Biological Sciences from Stanford University, her MD from the University of Michigan. She completed her residency in Obstetrics and Gynecology from the University of New Mexico and obtained a Master’s Degree in Clinical Research from the University of Hawai‘i.
Does Disclose - McKesson - Consultant
Dave Cundiff, MD, MPH is a long-time Public Health physician, Board Certified in Addiction Medicine in 2022, who is co-founder of Smart Moves Integrated Health Services in Ilwaco, Washington. He is passionate about organized medicine and has been an AMA member since 1988. Dr. Cundiff is a past president of the American Association of Public Health Physicians (AAPHP). He currently serves as AAPHP's Delegate in the AMA House of Delegates; as Medical Director of Bayview Recovery in Tacoma, Washington; and as lead physician at Discover Recovery in Long Beach, Washington.
CME, CE, CEU and Other Credit Types
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NAADAC, the Association for Addiction Professionals
This activity has been approved by the American Society of Addiction Medicine, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #295, ASAM is responsible for all aspects of the programming.
California Association for Drug/Alcohol Educators (CAADE)
This educational program is approved by CAADE: #CP40 999 1222.
California Association of DUI Treatment Centers (CADTP)
This educational program is approved by CADTP: #205.
California Consortium of Addiction Programs and Professionals (CCAPP)
This educational program is approved by CCAPP: #OS-20-330-1222.
Continuing Education Credits (CEUs)
Non-physician participants will receive a certificate of attendance upon completion of the activity and an online evaluation confirming their participation. Participants should submit his/her certificate of attendance to their professional organization/institute.
Maintenance of Certification (MOC) or Continuing Certification Programs (CCP)
American Board of Medical Specialties (ABMS)
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, The ASAM 53rd Annual Conference has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards: Allergy and Immunology, Anesthesiology, Colon and Rectal Surgery, Family Medicine, Medical Genetics and Genomics, Nuclear Medicine, Physical Medicine and Rehabilitation, Plastic Surgery, Preventive Medicine, Psychiatry and Neurology, Radiology, Thoracic Surgery, Urology
American Board of Preventive Medicine (ABPM)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1 credit towards ABPM MOC Part II requirements.
American Board of Anesthesiology (ABA)
This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in Anesthesiology TM (MOCA®) program, known as MOCA 2.0®.
American Board of Pediatrics (ABP)
Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn a maximum of 1 MOC point in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.
American Board of Internal Medicine (ABIM)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 Medical Knowledge MOC point 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 credits.
American Board of Surgery (ABS)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and/or Self-Assessment requirements of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
American Board of Psychiatry and Neurology (ABPN)
Successful completion of this CME activity can be used to satisfy the American Board of Psychiatry and Neurology’s (ABPN) CME requirement for Maintenance of Certification program.
American Board of Addiction Medicine (ABAM)
Successful completion of this activity can be used to satisfy the American Board of Addiction Medicine (ABAM) Tmoc credit requirements.
Royal College of Physicians and Surgeons of Canada (RCPSC)
Royal College Fellows can use participation in Accredited Continuing Medical Education to earn Section 3 Credits.
In accordance with disclosure policies of ASAM and the ACCME, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all CME activities. These policies include mitigating all possible relevant financial relationships with ineligible companies for the Planning Committees and Presenters. All activity Planning Committee members and Faculty have disclosed relevant financial relationship information. The ASAM CME Committee has reviewed these disclosures and determined that the relationships are not inappropriate in the context of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.
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