Precipitated Withdrawal 2.0: Outpatient Tips and Tricks

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Precipitated Withdrawal 2.0: Outpatient Tips and Tricks

Recorded: Thursday, March 31, 2022 - Sunday, April 3, 2022
On-Demand Session

Overview

This 1-hour, on-demand session from the ASAM 53rd Annual Conference addresses the management of precipitated withdrawal in the outpatient setting including use of telemedicine support and indications for referral to higher levels of care.

Despite the complexity of managing precipitated opioid withdrawal, there remains little consensus on best practices for treatment, particularly in the outpatient setting. This session offers and in-depth examinination of prediction, prevention, and management of precipitated withdrawal in the outpatient settings from the acute care setting perspective. Additionally, this session explores various clinical scenarios and current evidence on management of precipitated withdrawal and address concerns regarding the risk of precipitated withdrawal in the outpatient setting.

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.

Learning Objectives

Upon completion, learners will be able to:

  1. Identify whether precipitated withdrawal can be predicted based on patient characteristics such as frequency or type of opioid used
  2. Compare buprenorphine induction protocols (including microdosing with sublingual or transdermal patch, macrodosing and subcutaneous buprenorphine) and the likelihood of precipitating significant withdrawal.
  3. Review the existing evidence for management of precipitated opioid withdrawal in the outpatient setting

Registration Rates

Rate DescriptionRate
ASAM Member$29
Non-Member$39
Associate Member$19
Resident Member*$19
Student Member*$19

*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.

Membership Question?  Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.

Refunds & Cancellations

All ASAM e-Learning Center refund requests must be made in writing to education@asam.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or e-Learning Center credit. Automatic full refunds will be made for any course with a live-course component that has been cancelled.

Registration Deadline: 05/01/2025

Course Instructions

  1. Click on the Contents tab to watch the on-demand recording.
  2. Click Complete Post Test to answer multiple choice questions. Participants will have 10 attempts to pass and must answer 2 out of 3 questions correctly.
  3. Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
  4. Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.

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For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please check the FAQ page or e-mail Education@ASAM.org

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JoAn Leas

MD

JoAn Laes, MD is an addiction medicine physician at Hennepin Healthcare in Minneapolis, Minnesota, focusing on inpatient addiction medicine and toxicology consultation as well as outpatient treatment of opioid and other substance use disorders. She is a core medical toxicology faculty for the Minnesota Poison Center, Minneapolis, Minnesota, medical director for Missions Inc. Detox facility in Plymouth, Minnesota and 1800 Chicago detox facility in Minneapolis, MN and a nocturnist at Mercy Hospital in Coon Rapids, Minnesota. She is the chair of the medical toxicology workgroup for the American Society of Addiction Medicine and the president elect for the Minnesota chapter of ASAM. She completed internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota and is board certified in Internal Medicine, Medical Toxicology, and Addiction Medicine.

Timothy Wiegard

MD

Dr. Wiegand holds board certification in internal medicine, medical toxicology and clinical pharmacology. He completed his Postgraduate Fellowships in Medical Toxicology and Clinical Pharmacology at the University of California, San Francisco in 2006. His current position is as the Director of Toxicology at the University of Rochester Medical Center in Rochester, New York where he holds an appointment in Emergency Medicine as Associate Clinical Professor of Emergency Medicine at Strong Memorial Hospital and Highland Hospital. In addition to his positions at the University of Rochester Dr. Wiegand Directs the Toxicology Consult Service at Strong Memorial and Highland Hospitals, serves as Medical Director of Huther-Doyle Chemical Dependency treatment program in Rochester, NY, and treats acute alcohol and opioid withdrawal at the Syracuse Behavioral Health (SBH) Rochester detoxification facility. He is also faculty for the SUNY Upstate Medical Toxicology Fellowship training program and serves as on-call toxicologist for the SUNY Upstate Poison Center. Dr. Wiegand directs a clinical rotation in medical toxicology for the Strong Memorial Hospital Emergency Medicine residency program and is involved in toxicology, pharmacology and addiction medicine education for fellows, residents, and students in pharmacy and medicine. His interests include the treatment of acute intoxication and treatment of alcohol, opioid and other drug withdrawal syndromes and in the treatment and prevention of addiction and dependence. He has been treating opioid dependence since 2005 as an SAMHSA-waived OBOT provider. Dr. Wiegand has published in the areas of acute intoxication, withdrawal and treatment and prevention of drug overdose and in medical education in toxicology and emergency medicine and in the development, billing and reimbursement related to clinical toxicology practice. He is a section editor for the Encyclopedia of Toxicology, 3rd edition and has published numerous journal articles and textbook chapters on toxicology and related topics. Dr. Wiegand won the 2013 American Society of Addiction Medicine (ASAM) Annual MedSci research award for best abstract for research involving addiction medicine education during medical toxicology fellowship training. Dr. Wiegand is the Chair for the American College of Medical Toxicology (ACMT) Addiction Medicine section and he was appointed to the New York chapter of the American Society of Addiction Medicine (NYSAM) Board of Governors as Communication Committee Chair and Board Member in 2013. He has been increasingly active in ASAM and in his state chapter, NYSAM, since 2011.

Lewis S. Nelson

MD

Dr. Nelson is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is a member of the Board of Directors of the American Board of Emergency Medicine and a Past-President of the American College of Medical Toxicology. He remains actively involved with CDC, FDA, DHS, and with several professional medical organizations including ASAM. Dr. Nelson is an editor of the textbook Goldfrank’s Toxicologic Emergencies and on the editorial boards of several journals. In addition to providing direct clinical care to patient in the ED and his efforts at New Jersey Poison Information & Education System, his specific expertise include the consequences of licit and illicit opioids, emerging drugs of abuse, opioid stewardship, and alcohol withdrawal.

Dr. Jeanmarie Perrone, MD

Professor of Emergency Medicine and Medical Toxicology, Perelman School of Medicine at the University of Pennsylvania

Jeanmarie Perrone, MD is a Professor in the Department of Emergency Medicine, the Director of the Division of Medical Toxicology and the founding Director of the Center for Addiction Medicine and Policy at the University of Pennsylvania.  Dr. Perrone has led numerous investigations and initiatives in opioid stewardship and ED treatment of Opioid Use Disorder (OUD) with buprenorphine.  She serves on several regional and national task forces and advisory committees with the State of Pennsylvania, the CDC and FDA addressing judicious opioid use and MOUD treatment access. She has advocated at the state and national level for harm reduction and ED treatment for OUD and is a  co-investigator in a 30 site NIDA sponsored trial of ED buprenorphine.  Dr. Perrone has been featured in prominent news media including the New York Times, USA Today and National Public Radio and published in the New England Journal of Medicine and JAMA . She has won numerous awards for education and mentorship of students, residents and fellows and is boarded in emergency medicine, medical toxicology and addiction medicine.  

CME, CE, CEU and Other Credit Types

ACCME Accredited with Commendation

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.


Disclosure Information

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.

Key:

Complete
Failed
Available
Locked
View On-Demand Recording
Open to view video.
Open to view video. Video is approximately 1 hour long. Recorded between 03/31/22 - 04/03/22.
Complete Post Test
3 Questions  |  10 attempts  |  2/3 points to pass
3 Questions  |  10 attempts  |  2/3 points to pass This post test has 3 questions and requires 2 out of 3 to pass the quiz.
Complete Evaluation
19 Questions
19 Questions Scroll down on evaluation, there may be questions that expand past the size of the window.
Claim Credits & Certificate
Up to 1.00 medical credits available  |  Certificate available
Up to 1.00 medical credits available  |  Certificate available Attendees should claim only the credit commensurate with the extent of their participation in the activity.