Treatment of Opioid Use Disorder: Waiver Qualifying - Colorado Springs, CO - Friday, September 14, 2018

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Friday, September 14, 2018 | 8:30 am - 1:00 pm

University of Colorado
Kettle Creek Room 108
1420 Austin Bluffs Pkwy
Colorado Springs, CO 80918

Hosted by IT MATTTRs 2

Online portion: Thursday, September 13, 2018

Welcome to the ASAM Treatment of Opioid Use Disorder Course online access. This course covers all medications and treatments for opioid use disorder, and provides the required education needed to obtain the waiver to prescribe buprenorphine. ASAM is an approved provider by CSAT/SAMHSA of DATA 2000 training.

This is an 8-hour blended course combining 4 hours of online learning followed by 4 hours of live learning. The live portion of the course builds off the content delivered in the online portion. Course faculty are expecting you to come to the live course with the online portion completed. 

Getting started: To begin the online portion of the course, please log in to your right and locate the box that says Module 1. If you do not know your password, or you have forgotten it, select Forgot Password and you will be emailed a link to reset your password. Detailed instructions for completing the online portion of the course can be found under the tab titled Course Instructions.

Once you have completed the 4-hour online portion and the 4-hour live portion of the course, return here to claim CME for the course. If you have any questions, please contact education@ASAM.org.


Overview of Legislation

Physicians

The Drug Abuse Treatment Act of 2000 (DATA 2000) specifies training is necessary for physicians to obtain a waiver to engage in office‐based treatment of opioid use disorders using drugs approved by the FDA on Schedules III, IV, and V. This course addresses those requirements using a curriculum approved by CSAT/SAMHSA and ASAM, who is one of the national organizations named in the DATA 2000 legislation as eligible to prepare and administer these courses.

Nurse Practitioners & Physician Assistants

Kentucky state code does not allow physician assistants to prescribe Schedule III Controlled Substances, so they can not become waivered to prescribe buprenorphine for addiction treatment.

On July 22, 2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA) into law. CARA authorizes qualified NPs and PAs to become waivered to prescribe buprenorphine in office-based settings for patients with Opioid Use Disorder (OUD) for a five-year period expiring in October 2021.    

To qualify, NPs and PAs must: 

  • Be licensed under state law to prescribe schedule III, IV, or V medications for pain  
  • Complete not less than 24 hours of appropriate education through a qualified provider
  • Through other training or experience, demonstrate the ability to treat and manage OUD  
  • If required by state law, be supervised or work in collaboration with a qualifying physician to prescribe medications for the treatment of OUD

HHS' announcement on November 16, 2016, enables NPs and PAs to immediately begin taking the 24 hours of required training. For the full HHS announcement, click here.

NPs and PAs can begin the training immediately by taking the 8-hour buprenorphine course ASAM currently offers or that other stakeholders offer (see below for more information). The remaining 16 hours will have to be completed with one training provider. ASAM is developing multiple 16-hour training course options and formats, including collaborations with:

CME Information and Disclosure Listing

Date of Release: July 2015 

Approved Through: December 2019

The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. ASAM has been awarded the highest level of Accreditation with Commendation by the ACCME as a provider of continuing medical education.

The American Society of Addiction Medicine designates this enduring material for a maximum of 4 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Society of Addiction Medicine designates this live activity for a maximum of 4 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In accordance with the disclosure policies of ASAM and the ACCME, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. These policies include resolving all conflicts of interest between the CME Committee, Planning Committee and faculty, and commercial interests that might otherwise compromise the goal and educational integrity of this activity. All CME Committee, Planning Committee and faculty participating in the activity have disclosed all relevant financial relationships with commercial interests. The CME Committee has reviewed these disclosures and determined that the planning committee and faculty relationships are not inappropriate in the content of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.

ASAM Treatment of Opioid Use Disorder Course Program Planning Committee

Name

Nature of Relevant Financial Relationship

Commercial Interest

What was received?

For what role?

Dan Alford, MD, MPH, DFASAM, Chair

None

Paula J. Lum, MD, MPH, FASAM, Vice Chair

None

Edwin Salsitz, MD, DFASAM, Curriculum Director

None

Soraya Azari, MD

None 

Jill Mattingly, DHSc, MMSc, PA-C

None

Debra Newman, PA-C, MPAS, MPH

None

Mary McMasters, MD, DFASAMNone

Yngvild K. Olsen, MD, MPH, DFASAM

None
Shawn Ryan, MD, MBA, FASAMAdapt Pharma OrexoConsulting Fee HonorariumContent Expert Speaker
Kristin Smith, DNP, FNP-C, AAHIVSNone
Tricia E. Wright, MD, MS, FACOG, FASAMNone

ASAM CME Committee

Name

Nature of Relevant Financial Relationship

Commercial Interest

What was received?

For what role?

Catherine Friedman, MD, FAPA, DFASAM, Chair

None

R. Jeffrey Goldsmith, MD, DLFAPA, DFASAMNone
Adam J. Gordon, MD, MPH, FACP, DFASAMNone
Zwaantje Hamming, FNP-C, CARN-APNone

Herbert L. Malinoff, MD, FACP, DFASAM

None

Noel Ilogu, MD, MRCP, DFASAM

None

Edwin A. Salsitz, MD, DFASAM

None

ASAM Staff and Consultants

Arlene C. Deverman, MA, CAE, CFRENone

Marcia Jackson, PhD

None
Sandy MetcalfeNone

ASAM Medical Education Council

Name

Nature of Relevant Financial Relationship

Commercial Interest

What was received?

For what role?

Peter Selby, MBBS, CCFP, FCFP, MHSc, DFASAM, Chair

Pfizer  Johnson & Johnson Pfizer CanadaGrant funding Consulting Fees Consulting FeesPrincipal  Investigator Consulting Consulting
Daniel P. Alford, MD, MPH, DFASAMNone
Michael Fingerhood, MD, FACP, FASAMNone
Catherine R. Friedman, MD, FAPA, DFASAMNone
Adam J. Gordon, MD, MPH, FACP, DFASAMNone
Miriam S. Komaromy, MD, FACP, DFASAMNone
Edwin A. Salsitz, MD, DFASAMNone
Mark P. Schwartz, MD, DFASAMNone
Mark A. Weiner, MD, FASAMNone
ASAM Staff and Consultants
Penny S. Mills, MBANone
Arlene C. Deverman, MA, CAE, CFRENone
Marcia Jackson, PhDNone
Dawn C. HowellNone
Molly S. MazukNone
Alexandra (Alli) UngerNone
Jennifer L. ButchartNone


Learners will be able to:

  1. Apply for a waiver to prescribe buprenorphine to their patients with opioid use disorders
  2. Identify and assess patients who are appropriate for treatment with medications
  3. Have specific knowledge concerning the use of medications to manage patients with addiction involving opioid use
  4. Discuss the psychiatric and medical co-morbidities associated with opioid addiction


  1. Locate the box on the right that says “Module 1" and click “View Web Content On-Demand"
  2. Locate the box on the right that says “Certificate code" and enter the code given upon completion of Module 1 Part 1
  3. Continue to Module 1 Part 2 and Module 1 Part 3
  4. Once you have completed the entire module, locate the box called “Module 1 Quiz" and choose “Take Quiz"
  5. After you have completed Module 1 Quiz, continue to modules 2 and 3
  6. You will be required to pass all 3 Module Quizzes with a grade of 70% or higher
  7. Upon completion of both the 4 online hours and 4 live hours of the course, you will be able to claim CME Credit through the ASAM e-Learning Center
  1. Physicians, Nurse Practitioners, and Physician Assistants who wish to obtain a waiver to prescribe buprenorphine in office based treatment of opioid use disorders.
  2. Clinicians and health care team members working with physicians who prescribe buprenorphine in office based treatment of opioid use disorders.

The ASAM Treatment of Opioid Use Disorder Course has been made available in part by an unrestricted educational grant from Indivior Inc.


Daniel P. Alford

MD, MPH, FACP, DFASAM

Dr. Daniel P. Alford is an Associate Professor of Medicine, Assistant Dean of CME and Director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program at Boston University School of Medicine. He is a diplomate in Addiction Medicine by the American Board of Addiction Medicine (ABAM).

He is director of the Clinical Addiction Research and Education Unit medical director of the Office-Based Opioid Treatment (OBOT) program and of the Massachusetts Screening, Brief Intervention, Referral to Treatment Training and Technical Assistance (MASBIRT TTA) program and former program director for the Addiction Medicine Fellowship program at Boston Medical Center (BMC). Since 2001 he has served as the course director of the Chief Resident Immersion Training (CRIT) Program in Addiction Medicine: Improving Clinical and Teaching Skills for Generalists funded by NIDA. He is president of the Association for Medical Education and Research in Substance Abuse (AMERSA). In 2011, he was recognized as a Champion of Change by the White House. In 2014 he received the Health Education Award from the American Medical Association.

Edwin A. Salsitz

MD, DFASAM

Dr. Edwin A. Salsitz has been an attending physician in the Mount Sinai Beth Israel , Division of Chemical Dependency, New York City, since 1983, and is an Assistant Professor of Psychiatry at the Mount Sinai School of Medicine. He is the principal investigator of the Methadone Medical Maintenance (office-based methadone maintenance) research project. 

Dr. Salsitz is certified by the American Board of Addiction Medicine (ABAM), as well as by the Board of Internal Medicine and Pulmonary Disease. He has published and lectures frequently on addiction medicine topics.Dr. Salsitz is a course director for ASAM sponsored buprenorphine trainings,and is a mentor in the PCSS-MAT mentoring program. He has co-chaired the ASAM Review Course, the ASAM Common Threads Course, the ASAM State of the Art course and is a reviewer for the Journal of Addiction Medicine and Drug and Alcohol Dependence. He is the chair of the ASAM REMS course on safe and effective prescribing of opioids. 

Dr. Salsitz was the Co-chair of the ASAM CME committee and Chair of the New York Society of Addiction Medicine CME and Education committee. Dr. Salsitz is a member of the medical advisory panel, for the New York State Office of Alcohol and Substance Abuse Services.  Dr. Salsitz is the recipient of the 2014 ASAM Annual Award, and the 2018 ASAM Annual Educator of the Year Award.

Sarah Bagley

MD

Sarah Bagley, MD, is an attending in the Departments of Medicine and Pediatrics at Boston Medical Center. Sarah completed a Combined Residency in Internal Medicine and Pediatrics at Brown and then an Addiction Medicine Fellowship at Boston University. Her clinical and research interest are related to the impact of substance use on families and in the treatment of adolescents with substance use disorders.

Jeffrey Baxter

MD

Jeff Baxter, MD, is an Associate Professor of Family Medicine and Community Health at the University of Massachusetts Medical School. Dr. Baxter completed a fellowship in Addiction Medicine at the Boston VA Medical Center, and is board certified in Family Medicine and Addiction Medicine. He currently serves as the Chief Medical Officer for Spectrum Health Systems Addiction Treatment Services, overseeing inpatient, outpatient and residential divisions.

Colleen LaBelle

BSN, RN-BC, CARN

Colleen LaBelle has certifications in addiction nursing and HIV with over 20 years of clinical experience in HIV and addiction, and co-authored a publication in the Journal of General Internal Medicine, “Treating Homeless Opioid Dependent Patients with Buprenorphine in an Office-based Setting." She was instrumental in the start up of the OBOT Program in the BMC Primary Care Clinic, which manages over 450 active patients with buprenorphine. This program provides buprenorphine treatment for patients in primary care, homeless, HIV, Family Medicine, OB, and support to the affiliated community health centers. She is the program director of the STATE OBOT B (State Technical Assistance, Treatment Expansion of Buprenorphine) working with 14 community health centers implementing a nurse care manager model for the expansion of buprenorphine. Since 2003, Ms. LaBelle has served as Faculty for the buprenorphine certification course of the American Society of Addiction Medicine. She frequently gives presentations on buprenorphine and provides consultation and technical assistance on- and offsite and by telephone. She oversees the MDPH buprenorphine list-serve and provides liaison for MDPH supported buprenorphine training, education and start-up in Massachusetts. She speaks on a local and national level, and has been a part of the SAMHSA Summit on Buprenorphine. Ms. LaBelle has served as a member of the Scientific Study (Study Section) Review Committee for the National Institute on Drug Abuse. Since 2004, she has served on the National Advisory Committee on Buprenorphine for the Health Resources and Services Administration and participated in professional editing of TAP 30 Technical Assistance Publication for Nurses with SAMHSA, 2009. Co-author : Five Year Experience with Collaborative Care of Opioid Addicted Patients using Buprenorphine in Primary Care, published Archives of Internal Medicine. In May 2011 she was the recipient of Individual Leadership Award, for Innovation In Health Care from MA Bureau of Substance Abuse Services as well as a NIATX award recipient 2011 Innovations in Behavioral Health Services award for Process Improvements. She is a board member of the Addiction Nurses Certification Board, and recently started a MA Chapter for addiction nurses.

Sharon Levy

MD, MPH

Sharon Levy, MD, MPH, is a board certified Developmental-Behavioral Pediatrician and an Assistant Professor of Pediatrics at Harvard Medical School; she also has a Master's degree from the Harvard School of Public Health. She is the Director of the Adolescent Substance Abuse Program in the Divi-sion of Developmental Medicine at Boston Children's Hospital where she has evaluated and treated hundreds of adolescents with substance use disorders. She has published extensively on the outpatient management of substance use disorders in adolescents, including screening and brief advice in primary care, the use of drug testing and the outpatient management of opioid de-pendent adolescents. She is the PI of the SAMHSA-funded medical residen-cy SBIRT project at Children's Hospital Boston and an NIAAA-funded study validating the youth alcohol screening tool in a population of youth with chronic medial illness. Dr. Levy currently serves as the chair of the American Academy of Pediatrics Committee on Substance Abuse.

Paula Lum

MD, MPH, FASAM

Dr. Lum is a general internist and primary care physician, and Professor of Medicine in the HIV/AIDS Division in the University of California, San Francisco's Department of Medicine at San Francisco General Hospital. She is certified by the American Boards of Internal Medicine and Addiction Medicine.

Kelley Saia

MD

Kelley Saia, MD, is an attending obstetrician in the Department of Obstetrics and Gynecology at Boston Medical Center and an Assistant Professor of Obstetrics and Gynecology at Boston University School of Medicine.Dr. Saia received her medical degree from the University of Vermont, College of Medicine and completed her residency in obstetrics and gynecology at Boston Medical Center.

In addition to caring for women with general obstetrics and gynecologic issues, she is the director of Project RESPECT, Substance Use Disorder Treatment in pregnancy at Boston Medical Center. Project RESPECT has been caring for pregnant women with substance use disorder for over 30 years and Dr. Saia, established the first obstetric buprenorphine clinic in the greater Boston area in 2006. RESPECT cares for over 125 mother-baby pairs per year with a multidisciplinary team consisting of obstetricians, addiction medicine specialist, pediatrics, psychiatry, social work, lactation consultants and nursing. Dr. Saia is actively engaged in patient care QI, clinical and scientific research, community outreach and medical training.

Andrew Saxon

MD, FASAM

Andrew J. Saxon, M.D. Professor, Department of Psychiatry and Behavioral Sciences, University of Washington Director, Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System Director, Addiction Psychiatry Residency Program, University of Washington Preceding his entry into psychiatry, Dr. Saxon completed an internal medicine internship and worked for 4 years as an emergency room physician. Subsequent to his general psychiatry residency at the University of Washington, Dr. Saxon has more than a quarter century of experience as a clinical and research addiction psychiatrist. Dr. Saxon is board certified with added qualifications in addiction psychiatry by the American Board of Psychiatry and Neurology. Dr. Saxon sits on the editorial boards of the journals, Drug and Alcohol Dependence and General Hospital Psychiatry. Dr. Saxon's current research work is supported by the VA, the Department of Defense, and the National Institute on Drug Abuse and involves pharmacotherapies and psychotherapies for alcohol, cocaine, tobacco, and opioid use disorders as well work in co-occurrence of substance use disorders and posttraumatic stress disorder and on reducing homelessness.

Alexander Y. Walley

MD, MSc, FASAM

Alexander Y. Walley, M.D., M.Sc., is an Associate Professor of Medicine at Boston University School of Medicine, a general internist and addiction medicine specialist at Boston Medical Center. He is the director of the Addiction Medicine Fellowship program and founded the Inpatient Addiction Consult Service at Boston Medical Center. He does clinical and research-related work on the medical complications of substance use, specifically HIV and overdose. He provides primary care and office-based buprenorphine treatment for HIV patients and methadone maintenance treatment. He is the medical director for the Massachusetts Department of Public Health’s Opioid Overdose Prevention Pilot Program. 

Apply

SAMHSA reviews waiver applications within 45 business days of receipt. If approved, you will receive a letter via email that confirms your waiver and includes your prescribing identification number.

Waiver applications are forwarded to the DEA. DEA regulations require your prescribing identification number to be included on all buprenorphine prescriptions for opioid dependency treatment, along with your regular DEA number.

If you have not received confirmation of receipt of your application, or if it has been more than 45 business days since submitting it, contact CSAT by email: infobuprenorphine@samhsa.hhs.gov or call 866.287.2728.

Key:

Complete
Failed
Available
Locked
Pre-Course Survey
4 Questions
4 Questions Please answer the following
Module 1 Part 1
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover the neurobiology of opioid use disorders, epidemiology of heroin use and prescription opioid misuse, the Drug Addiction Treatment Act of 2000, opioid pharmacology and treatment with medications.
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 1, Part 1.
Module 1 Part 2
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover the neurobiology of opioid use disorders, epidemiology of heroin use and prescription opioid misuse, the Drug Addiction Treatment Act of 2000, opioid pharmacology and treatment with medications.
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 1, Part 2.
Module 1 Part 3
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover the neurobiology of opioid use disorders, epidemiology of heroin use and prescription opioid misuse, the Drug Addiction Treatment Act of 2000, opioid pharmacology and treatment with medications.
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 1, Part 3.
Module 1 Quiz
7 Questions
7 Questions Module 1 Quiz
Module 2 Part 1
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover an overview of implementing Office-Based Opioid Treatment (OBOT) including: patient assessment, office management, medication management, role of nonpharmacotherapy and patient monitoring.
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 2, Part 1.
Module 2 Part 2
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover an overview of implementing Office-Based Opioid Treatment (OBOT) including: patient assessment, office management, medication management, role of nonpharmacotherapy and patient monitoring.
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 2, Part 2.
Module 2 Quiz
8 Questions
8 Questions Module 2
Module 3 Part 1
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover adolescents and young adults, pregnancy, neonatal abstinence and breastfeeding, medical co-morbidities, psychiatric co-morbidities and managing acute and chronic pain (requiring opioid analgesics) in patients on Opioid Agonist Treatment (OAT).
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 3, Part 1.
Module 3 Part 2
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover adolescents and young adults, pregnancy, neonatal abstinence and breastfeeding, medical co-morbidities, psychiatric co-morbidities and managing acute and chronic pain (requiring opioid analgesics) in patients on Opioid Agonist Treatment (OAT).
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 3, Part 2.
Module 3 Part 3
Recorded 12/31/1969
Recorded 12/31/1969 This module will cover adolescents and young adults, pregnancy, neonatal abstinence and breastfeeding, medical co-morbidities, psychiatric co-morbidities and managing acute and chronic pain (requiring opioid analgesics) in patients on Opioid Agonist Treatment (OAT).
Certificate code
Enter code to continue.
Enter code to continue. Please enter the certificate code given at the end of Module 3, Part 3.
Module 3 Quiz
11 Questions
11 Questions Module 3
The ASAM Treatment of Opioid Use Disorder Course Online Portion Evaluation
15 Questions
15 Questions CME Evaluation for the Online Portion of the ASAM Treamtent of Opioid Use Disorder Course
Live In-Person Event
09/14/2018 at 6:00 AM (MDT)   |  4 hours, 30 minutes
09/14/2018 at 6:00 AM (MDT)   |  4 hours, 30 minutes
The ASAM Treatment of Opioid Use Disorder Course Live Portion CME Evaluation
17 Questions
17 Questions Complete the evaluation to earn CME credit.
CME Certificate
Up to 8.00 medical credits available  |  Certificate available
Up to 8.00 medical credits available  |  Certificate available 8 Credits

Please ensure that your state regulations allow you to prescribe buprenorphine and other medications to treat OUD before you apply for the waiver.  Some states may have overriding state legislation that will prevent NPs and PAs from prescribing these medications even if Federal law allows it.

Apply

SAMHSA reviews waiver applications within 45 business days of receipt. If approved, you will receive a letter via email that confirms your waiver and includes your prescribing identification number.

Waiver applications are forwarded to the DEA. DEA regulations require your prescribing identification number to be included on all buprenorphine prescriptions for opioid dependency treatment, along with your regular DEA number.

If you have not received confirmation of receipt of your application, or if it has been more than 45 business days since submitting it, contact CSAT by email: infobuprenorphine@samhsa.hhs.gov or call 866.287.2728.

Qualify 

To qualify for a waiver to treat patients with Opioid Use Disorder, NPs and PAs must: 

  • Be licensed under state law to prescribe schedule III, IV, or V medications for pain
  • Complete no less than 24 hours of appropriate education through a qualified provider
  • Through other training or experience, demonstrate the ability to treat and manage OUD
  • If required by state law, supervision or working in collaboration with a qualifying physician to prescribe medications for the treatment of OUD may be required.