Harm Reduction for Patients Prescribed Buprenorphine: Is it Possible? (1.5 CME)
(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that the hallmark of addiction is loss of control and ongoing compulsive substance use despite negative consequences, and is underscored by significant difficulty in executive functioning and organization. As such, especially early on in care or at a time of relapse, highly structured treatment modalities and scheduling are unrealistic for many at best, and potentially lethal for others at worst. If late or missed appointments result in longer waits or missed opportunities for care, or substance use results in discharge from care or referral to a higher level of care when the patient is either not able or ready to make such a change, the result can be no level of care. Despite the prescription drug monitoring program, misuse deterrent opioid formulations, expanded education efforts for safe pain prescribing and SUD screening and management, increased buprenorphine trainings and expanded waivers, the substance use disorder treatment gap remains and the opioid overdose epidemic continues to soar. The landscape of the opioid epidemic has changed even more dramatically with fentanyl and carfentanyl, requiring more readily available care, and flexible care models to help keep people engaged in care, while we work with them through the natural history of substance use disorder. By partnering with them in this manner, we help keep patients alive, lower their risk of ongoing serious health complications or overdose, and increase their chances of continuing to engage in meaningful treatment; we collaborate with them in the practice of harm reduction.
MD, MPH, FASAM
Laura Kehoe, MD, MPH, FASAM, is a medical director at the Bridge Clinic, Substance Use Disorder Initiative, for the Massachusetts General Hospital. Dr. Kehoe is also Assistant Professor of Medicine at Harvard Medical School and is board certified in both Internal Medicine and Addiction Medicine. She attended Tufts University School of Medicine and Boston University School of Public Health and completed her residency in Internal Medicine at Massachusetts General Hospital. At Massachusetts General Hospital, she is the Medical Director of the Substance Use Disorder Bridge Clinic, an innovative, “on demand,” urgent care addiction program, and an attending physician on the inpatient Addiction Consult Team (ACT). In addition, she is the co-chair of the hospital-wide Substance Use Disorder Education Committee, where she works with other team members to expand evidence-based treatment of patients with addiction, and is actively involved in resident physician training.
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 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.