Medications for Opioid Use Disorder CEUS - Introduction

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Medications for Opioid Use Disorder Presented by Lance J. Parks, LCSW 8 CE Credits/Contact Hours Price: $40 Instructions How to get your certificate of completion: On the left column, click on 'Download the Course.' [ ] It would be helpful to 'print the test' to fill out as you read the course. After reading the course, click on the link to 'Take Test' If you have not already registered and logged in you will be prompted to do so. After passing the test, fill out the Course Evaluation, choose the method of payment then click submit (We accept PayPal, most major credit cards and echecks). You will then be taken to the payment page. After submitting payment, you will be able to print your certificate of completion on your member account page. Test results of courses passed, receipts, and certificates of CE credit, are kept on your member account page for you to retrieve as needed. Board and Agency Approvals SpeedyCeus.com, provider #1613, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. SpeedyCeus.com maintains responsibility for this course. ACE provider approval period: (12/15/21 to 12/15/24). Social Workers completing this course receive 8 continuing education credits. CALIFORNIA: This program meets the requirements for the California Board of Behavioral Sciences for 8 hours of CE Credit TEXAS: This course meets the criteria for acceptable continuing education as defined by the Texas State Boards of Professional Counselors, Marriage and Family Therapists and Social Workers for 8 hours of CE Credit. This program is approved for 8 continuing education credits/contact hours by: The California Board of Registered Nursing # CEP 14462 The National Board for Certified Counselors # 6412 The Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling #50-14000 The California Consortium of Addiction Programs and Professionals: CCAPP-IE Provider # 1N-16-256-0726 The California Associations of Alcohol and Drug Educators (CAADE) #CP40 977 H 0425 It is the responsibility of the participant to check with their board regarding specific CE requirements. CE Course Description Opioid Use had become a serious problem leading to serious addictions and many death and near deaths. This course, published by SAMHSA, addresses how medications may be necessary to help some manage or overcome Opioid Use Disorder (OUD). There is no “one size fits all” approach to OUD treatment. Many people with OUD benefit from treatment with medication for varying lengths of time, including lifelong treatment. Ongoing outpatient medication treatment for OUD is linked to better retention and outcomes than treatment without medication. Even so, some people stop using opioids on their own; others recover through support groups or specialty outpatient or 8 residential treatment with or without medication. Still, FDA-approved medication should be considered and offered to patients with OUD as part of their treatment. This course is an online, non-interactive, reading based, self-paced, and asynchronous course. If you have questions about the course, require accessibility accommodations or need assistance, please email [email protected] or call (909) 628-4216. CE Learning Objectives At the end of the course, the participant will be able to: Define the key terms commonly used and associated with Opioid Use Disorder. Explain what Opioid Use Disorder is. Discuss the benefits, effectiveness cost-effectiveness and cost benefits of Medication for OUD. Identify the challenges to expanding Access to OUD Medication Explain and apply the Opioid Use Disorder in General Medical Settings Recognize the Need for and Extent of Assessment in OUD. Assess and provide treatment planning or Referral to patients. Discuss Medical Management of Patients Taking OUD Medications in Hospital Settings Summarize the different types Addiction Treatment. Course Outline: Chapter 1: Introduction to Medications for Opioid Use Disorder Treatment The Approach to OUD Care A noticeable theme in chronic disease management is patient-centered care. Key Terms Overview of Medications for OUD Benefits Effectiveness Methadone Naltrexone Buprenorphine Cost Effectiveness and Cost Benefits Requirements and Regulations Duration of Treatment With OUD Medication Maintenance Treatment Medication Taper Medically Supervised Withdrawal Treatment Settings Challenges to Expanding Access to OUD Medication Resources (4565 words) Notes Chapter 2: Addressing Opioid Use Disorder in General Medical Settings Scope of the Problem Screening Alcohol Screening Tobacco Screening Drug Screening Assessment Determine the Need for and Extent of Assessment Set the Stage for Successful Assessment Take a Complete History Medical history Mental health history Substance use history SUD treatment history Social history Family history Conduct a Physical Examination Opioid withdrawal Other laboratory tests Treatment Planning or Referral Understanding Treatment Settings and Services Outpatient OUD Treatment Settings Outpatient medical settings Residential drug treatment settings Determining OUD Service Intensity and Ensuring Follow-Through Referring patients to behavioral health and support services Helping patients who are not ready to engage in OUD treatment Resources Appendix Notes Chapter 3: Pharmacotherapy for Opioid Use Disorder Scope of the Problem Overview of Pharmacotherapy for Opioid Use Disorder Introduction to Medications That Address OUD Methadone Naltrexone Buprenorphine Choosing an OUD Medication Comparative Effectiveness Duration of Medication Principles of OUD Pharmacotherapy Basic Function Intrinsic Activity Overview of Medication Indications and Dosing Methadone Formulations Pharmacology Bioavailability Dosing Considerations Contraindications Precautions and Warnings Respiratory Depression Concurrent substance use disorders (SUDs) involving benzodiazepines or alcohol QTc prolongation and cardiac arrhythmia Accidental Ingestion Neonatal abstinence syndrome (NAS) Misuse and diversion Physical dependence Sedation Adrenal insufficiency Drug Interactions Side Effects Assessment Patient Selection Informed Consent Initiating Methadone Treatment Day 1 First dose for patients with opioid tolerance First dose for patients without current opioid dependence Dose Titration (Weeks 1 to 2) Dose Titration (Weeks 3 to 4) Serum Levels Dose Stabilization (Week 5 and Beyond) Take-Home Medication Assessing responsible handling of take-home doses Duration of Methadone Treatment Dose Tapering and Methadone Discontinuation Methadone Dosing Summary Enhancing Access to OUD Medication in OTPs Appendix Naltrexone Formulations Pharmacology Bioavailability Dosing Considerations Contraindications Precautions and Warnings Side Effects Assessment Patient Selection Informed Consent Initiating XR-NTX treatment Storage and preparation Administration Follow-up care after first dose Duration of treatment Treatment discontinuation Rapid naltrexone induction Oral Naltrexone All are similar to those for XR-NTX, save issues specific to suspension/diluent contents and the injection itself. Patient Selection Dosing Duration of treatment Naltrexone Dosing Summary Appendix Buprenorphine Formulations History of Approvals Implants Injectables Pharmacology Bioavailability Metabolism and Excretion Dosing Considerations Contraindications Precautions and Warnings Drug Interactions Side Effects Assessment Patient Selection Informed Consent Initiating Buprenorphine Treatment Office-Based Induction Home Induction Induction Patients who are currently physically dependent on opioids Patients with a history of OUD who are not currently physically dependent on opioids Patients who are currently taking methadone Dose Stabilization Risk Evaluation and Mitigation Strategy Transmucosal Buprenorphine Dosing Summary Induction and stabilization Maintenance Duration of treatment Initiation of Buprenorphine Implants Implant procedure Wound care Stabilization Removal Initiation of Buprenorphine Extended Release Injection Storage Administration Medical management Duration of Buprenorphine Treatment Dose Tapering and Buprenorphine Discontinuation Appendix Medical Management Strategies for Patients Taking OUD Medications in Office-Based Settings Patient Selection Patient Management and Treatment Monitoring Course of Treatment Role of the Treatment Plan and Treatment Agreement in Medical Management Medical Management Strategies Referral to counseling and other psychosocial supports Frequency of medical management visits Drug testing in ongoing medical management Opioids and opiates in point-of-service tests Assessing buprenorphine adherence Discontinuing medication for OUD Forced tapers or abrupt discontinuation Patient follow-up Administrative Considerations Storage of Buprenorphine Records for Dispensers Recordkeeping for ordering, storing, and dispensing buprenorphine in the office Recordkeeping for prescribing buprenorphine DEA Inspections Emergency Protocols and Patient Safety Measures Recommendations for Staff & Member Training Appendix Medical Management of Patients Taking OUD Medications in Hospital Settings Hospitalized or ED Patients Taking Medication for OUD Pain Management Buprenorphine Methadone Naltrexone Hospitalized or ED Patients Not Taking Medication for OUD Buprenorphine Induction in the Hospital Setting Methadone Induction in the Hospital Setting Naltrexone Induction in the Hospital Setting Medical Management Plan Notes Chapter 4: Partnering Addiction Treatment Counselors with Clients and Healthcare Professionals Overview and Context Scope of the Problem Setting the Stage Distinguishing OUD From Physical Dependence on Opioid Medications Understanding the Benefits of Medication for OUD Reviewing the Evidence on Counseling in Support of Medication To Treat OUD Using a Recovery-Oriented Approach to Treating Patients With OUD Acknowledge many pathways to recovery Promote recovery for clients with OUD Provide person-centered care Promote family and social support Provide trauma-informed care Quick Guide to Medications Understanding the Neurobiology of OUD Buprenorphine Methadone Naltrexone Knowing What Prescribers Do Administer buprenorphine Administer methadone Administer naltrexone Set expectations Counselor-Prescriber Communications Obtaining Consent Structuring Communications With Prescribers Helping Clients Overcome Challenges in Accessing Resources Creating of a Supportive Counseling Experience Maintaining the Therapeutic Alliance Educating Patients About OUD and a Chronic Care Approach to Its Treatment Counseling Patients on Overdose Prevention and Treatment Helping Patients Cope With Bias and Discrimination Helping Patients Advocate for Themselves Addressing Discrimination Against Clients Who Take OUD Medication Help clients address employment related issues Understand potential legal issues Address issues in dealing with healthcare providers Demonstrate awareness of pregnancy and parenting issues Helping Clients Find Accepting Mutual Help Groups Prepare clients who take medication for OUD to attend mutual-help meetings Facilitate positive mutual-help group experiences Online mutual-help groups Mutual-help groups specific to OTPs Facilitating Groups That Include Patients Taking OUD Medication Other Common Counseling Concerns Notes Chapter 5: Resources Related to Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families General Resources Facts and Figures Groups and Organizations General Information Practice Guidelines and Decision Support tools Assessment Scales and Screening Tools Resources for Counselors and Peer Provides Organizations Publications and Other Resources Resources for Clients and Families Organizations Publications and Other Resources Treatment Locators Patient Success Stories Online Boards and Chat Rooms Provider Tools and Sample Forms Provider Screening and Assessment Tools and Aids Drug Abuse Screening Test (DAST-10) DSM-5 Opioid Use Disorder Checklist TAPS Tool Part I TAPS Tool Part 2 Two-Item Drug Use Disorder Screener for Primary Care Clinics Serving U.S. Veterans Urine Drug Testing Window of Detection Provider Informational, Educational, and Decision-Making Tools Key Points of Patient Education for Buprenorphine Key Points of Patient Education for Methadone Key Points of Patient Education for Naltrexone Monitoring Recovery Activities Strategies for Managing Benzodiazepine Use by Patients in OUD Treatment Buprenorphine Forms Naltrexone forms Glossary of TIP Terminology Notes Course Development Course topics are chosen based on various board requirements and professionals needs. Licensed professionals oversee, compile and develop course materials, posttest, and other course materials, determine the level of difficulty, and ensure course content is appropriate. The course developer bio is available here. Course Update February 2020

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