Talk Amongst Yourselves: Case-based Discussions on Buprenorphine Treatment Challenges (1.5 CME)

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(1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:

Of the 70,237 drug overdoses in 2017, the majority were related to opioids. In response to the worsening opioid epidemic, the Department of Health and Human Services expanded buprenorphine prescribing privileges to include Nurse Practitioners and Physician Assistants and increased prescribing limits for physicians in 2016. However, even among physicians who already have DATA 2000 waivers, up to 40 percent have never prescribed buprenorphine. In order to increase access to this essential treatment for patients across the country, we must motivate waivered providers from all specialties to prescribe. Research with physician prescribers has identified numerous barriers to buprenorphine prescribing including provider attitudes, payment issues, lack of education and lack of structural support. These barriers occur at patient, provider and systems levels. Case-based experiential learning can address these barriers and empower interdisciplinary clinicians to effectively provide buprenorphine. In a 90 minute workshop, a multidisciplinary panel from the Substance Use Warmline will lead brief didactics and facilitate case reviews for three challenging scenarios in opioid use disorder management. Attendees will participate in small group case reviews of the following cases: 1) chronic pain and mental health 2) pregnancy and postpartum 3) polysubstance use. Groups will be guided to address patient, provider and systems level approaches to management for each case. Peer support resources and clinical tools will be discussed and shared as part of each case. Finally, the panel will review lessons learned in how to build a successful buprenorphine practice.

Learning Objectives:

1.) Utilize evidence-based practice and clinical tools to overcome common barriers to prescribing buprenorphine in a variety of healthcare settings
2.) Analyze real cases to identify opportunities for skills-building in patient, provider and system domains 
3.) Build confidence among buprenorphine prescribers and inspire non-prescribers to consider applying for their DATA 2000 waiver 

Rebecca L S Martinez


Rebecca Martinez is a family nurse practitioner who works at the intersection of HIV prevention, primary care and substance use disorder management. She's jazzed to be part of an interdisciplinary team of providers on the Substance Use Warmline at the UCSF Clinician Consultation Center, where she provides clinical support to the inspiring healthcare workers across the country who are doing their best to manage patients with substance use.

Hannah Snyder


Assistant Clinical Professor at University of California San Francisco

Erin R. Lutes


Erin R Lutes is a Clinical Nurse Specialist and Public Health Nurse specializing in HIV/AIDS. She provides expert consultation on HIV prevention and substance use disorders to clinicians across the United States with the Clinician Consultation Center based at the University of California, San Francisco. She also works for the San Francisco Department of Public Health as a Registered Nurse in primary and urgent care, serving populations impacted by substance use disorders, mental health, homelessness and HIV. In addition, she is adjunct faculty at Samuel Merritt University for students placed at an outpatient treatment facility for Native Americans. She is a US Albert Schweitzer Fellow for Life.

Elizabeth Gatewood


Elizabeth Gatewood is an Associate Clinical Professor. She has been teaching for the past five years in the Family Nurse Practitioner program at UCSF. She has maintained a practice where she precepts students. Her clinical practice is at Family Health Center at Zuckerberg San Francisco General Hospital, the catchment hospital for uninsured or underinsured in the public health department. There she integrates treatment of substance use disorder into her primary care practice. 

Jacqueline P. Tuisky


Jacqueline Peterson Tulsky, MD is a Professor of Medicine, Emeritus at UCSF in the HIV, Infectious Disease and Global Medicine Division at Zuckerberg San Francisco General Hospital (ZSFGH), the SF County safety net hospital.  She is faculty on the Clincians Consultation Center, Substance Use Warmline, a  program of  the UCSF Dept of  Family and Community Medicine at ZSFGH.  Dr. Tulsky is Boarded in Intermal Medicine and  Board hopeful  in  Addiction Medicine.   

Triveni Defries


Triveni DeFries, MD, MPH,  is an internist and current Primary Care Addiction Medicine fellow at University of California, San Francisco/San Francisco General Hospital. Prior to fellowship, she was practicing with the Indian Health Service in the Navajo Nation. Her interests include addiction medicine, primary care transformation, trauma informed care, immigrant health and native health.

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 1.5 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.

ABIM Maintenance of Certification (MOC)

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge 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.


Session Recording
Open to view video.
Open to view video. This session was recorded on 4/5/19 in Orlando, FL
CME Quiz
3 Questions  |  10 attempts  |  2/3 points to pass
3 Questions  |  10 attempts  |  2/3 points to pass Complete the quiz to claim CME.
CME Evaluation
15 Questions
15 Questions Please complete the evaluation to claim CME.
CME Credit and Certificate
Up to 1.50 medical credits available  |  Certificate available
Up to 1.50 medical credits available  |  Certificate available 1.5 AMA PRA Category 1 Credits