CPNP is pleased to announce the development of 19 hours of recorded educational programming on opioid use disorder (OUD) and treatment. These activities are designed to meet the educational needs of pharmacists and other health care professionals who are able to contribute to managing the medication of patients with OUD.

Target Audience

The learning modules in this activity are designed to meet the educational needs of pharmacists and other health care professionals who are able to contribute to managing the medication of patients with OUD.

Description

This activity will consist of the development of 19 hours of recorded educational programming (speaker presentation synced with slides) on OUD and treatment.

Global Learning Objectives:

Although access to individual modules will be provide, individuals completing all of the modules should be able to:

  1. Identify individuals at risk for opioid overdose and develop an appropriate treatment plan
  2. Screen and refer patients with opioid use disorder for treatment
  3. Develop an evidence-based treatment plan for medication assisted treatment
  4. Describe and implement harm reduction strategies for patients with opioid use disorder
  5. Assess, initiate, and modify opioid use disorder treatment planning using evidence-based recommendations
  6. Discuss the psychiatric and medical co-morbidities associated with opioid use disorder
  7. Apply regulatory and best practices to optimize care and safety for patients with opioid use disorder
Topics
Core Topics

The Opioid Epidemic – History, Stigma, Progress, and Pharmacotherapy (1.5 hours)
Julie Kmiec, DO, Western Psychiatric Hospital of UPMC

  1. Describe the development of the opioid epidemic and the epidemiology of OUD in the United States.
  2. Explain the morbidity, mortality, and associated societal costs of OUD and injection drug use.
  3. Discuss the proposed neurobiology of OUD, including the roles of memory, genetics, and environmental factors.
  4. Apply the DSM-5 diagnostic criteria to assess for OUD.
  5. List methods to help address and reduce stigma associated with OUD.
  6. Describe the regulatory and confidentiality requirements for medication management within a licensed opioid treatment program.
  7. Explain the regulatory requirements for obtaining a DATA waiver to prescribe buprenorphine/naloxone.

Screening and Referral (1 hour)
Sarah Melton, PharmD, BCPP, BCACP, FASCP, Gatton College of Pharmacy

  1. Explain the role of the pharmacist in screening for substance use disorders (SUDs). 
  2. Describe the process of Screen, Brief Intervention, and Referral to Treatment (SBIRT) and how pharmacists can be integrated into the process. 
  3. Apply validated screening tools (e.g., Audit, DAST, CAGE, etc.) used in the process of screening for SUDs.
  4. Develop a resource list that can be used to refer patients with suspected or known SUD for evaluation or treatment. 

Diversion (1 hour)
Michael O'Neil, PharmD, South College School of Pharmacy

  1. Describe the scope of the drug diversion problem in the United States.
  2. Identify potential sources and methods of diversion.
  3. Summarize strategies for diversion monitoring within a health care system.
  4. Discuss patient specific strategies for diversion monitoring, including the use of prescription drug monitoring programs.

Naloxone Education and Distribution: Pharmacists on the Frontline in Preventing Opioid Overdose (1 hour)
Sarah Melton, PharmD, BCPP, BCACP, FASCP, Gatton College of Pharmacy

  1. Describe the opioid overdose epidemic on national and state levels.
  2. Discuss Good Samaritan protection provisions for health care providers, first responders, and the layperson.
  3. Explain naloxone distribution models in the pharmacy and community.
  4. Describe the pharmacology of naloxone.
  5. Demonstrate appropriate administration of intranasal and intramuscular naloxone products.
  6. Explain the steps in addressing an opioid overdose emergency including administration of naloxone, positioning patient in the recovery position, calling emergency medical services (911), rescue breathing and role of CPR, and follow-up and assessment of the patient.
  7. Discuss cost and appropriate storage of naloxone products.
  8. Provide appropriate education to at-risk patients and laypersons regarding naloxone rescue.

Pharmacotherapy for OUD: Levels of Care and Types of Service (2 hours)
Cassandra Davis, PharmD, BCPS, BCPP, Orlando VA Medical Center

  1. Explain the basic mechanism of action, dosing and dosage forms, adverse effects, monitoring parameters, and patient considerations for buprenorphine/naloxone, methadone, and naltrexone.
  2. Describe the American Society of Addiction Medicine (ASAM) levels of care and appropriate use in clinical practice.
  3. Develop a care plan for a patient prescribed buprenorphine/naloxone, methadone, or naltrexone for the outpatient treatment of OUD.
  4. Recommend non-pharmacologic treatments and wrap-around services for a patient being treated for OUD.

Common Yet Different Threads: Managing Pain in the Setting of Opioid Use Disorder (1 hour)
Michele Matthews, PharmD, BCACP, CPE, FASHP, MCPHS University

  1. Describe the epidemiology of comorbid pain and OUD in the United States.
  2. Differentiate symptoms of untreated chronic pain from symptoms of OUD.
  3. Develop and design treatment plans to address comorbid chronic pain and OUD.
  4. Develop and design treatment plans to address acute pain in patients with OUD on pharmacotherapy including buprenorphine, methadone and naltrexone.

Comorbid Disorders (1 hour)
Troy Moore, PharmD, MS, BCPP, Eastern Colorado Health Care System/Rocky Mountain Regional VA Medical Center

  1. Identify psychiatric, substance use, and medical disorders that commonly co-occur with OUD.
  2. Describe how to screen for and identify comorbid disorders in patients with OUD.
  3. Distinguish differences in presentation when psychiatric, substance use, or medical disorders present comorbidly with OUD versus independently.
  4. Demonstrate how to develop and modify treatment plans when comorbidities are identified in patients with OUD.

Neonatal, Pregnancy, Lactation (1.5 hours)
Kristin Harter, PharmD, Zuckerberg San Francisco General

  1. Describe screening tools specifically developed to evaluate OUD in pregnant and/or lactating women.
  2. Discuss barriers to treatment engagement.
  3. Evaluate for the risk and prevention of neonatal abstinence syndrome (NAS).
  4. Describe the presenting symptoms of NAS and commonly used assessment tools.
  5. Discuss pharmacologic and non-pharmacologic treatment options for NAS.
  6. Describe the role of breastfeeding in the treatment of NAS or in the post-partum woman on pharmacotherapy for OUD.

Treatment of OUD in Older Adults (1/2 hour)
Ericka Crouse, PharmD, BCPP, BCGP, BCGP, FASHP, FASCP, VCU School of Pharmacy

  1. Recognize OUD in the older adult population.
  2. Discuss barriers to treatment engagement.
  3. Discuss special considerations of pharmacologic and non-pharmacologic treatment options of OUD in older adults.

Treatment of OUD in Children and Adolescents (1/2 hour)
Scott Hadland, MD, MPH, MS, Boston Medical Center / Boston University School of Medicine

  1. Describe the epidemiology of opioid use disorder and overdose among children and adolescents.
  2. Describe screening tools specifically developed to evaluate OUD in adolescents.
  3. Discuss pharmacologic and non-pharmacologic treatment options.
  4. Discuss special considerations in the treatment of OUD for adolescents, including barriers to treatment engagement.

Harm Reduction (1 hour)
Michelle Geier, PharmD, BCPP, San Francisco Department of Public Health

  1. Describe the principles of harm reduction for patients with OUD
  2. Apply evidence-based interventions for harm reduction.
  3. Develop a list of local resources to assist patients with OUD in accessing harm reduction services.

Urine Drug Screens (1 hour)
Karen Moeller, PharmD, BCPP, University of Kansas

  1. Compare the different urine drug screening (UDS) methods and modalities.
  2. Discuss commonly encountered problems with false positive and negative results in UDS.
  3. Interpret UDS results, including for specimen validity.
  4. Redesign treatment plan based on UDS results.

Interprofessional Communication Among Prescribers and Pharmacists who Care for Patients with Opioid Use Disorder (OUD): Barriers and Solutions (1 hour)
Nicholas Hagemeier, PharmD, PhD, East Tennessee State University

  1. Describe common misperceptions among and between prescribers and community pharmacists that impacts care for patients with OUD.
  2. Discuss factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use.
  3. Propose potential solutions to improve communication between prescribers and pharmacists that can improve care for patients with OUD.
Practice Based Topics

Interprofessional Excellence: Integrating Pharmacists into the Team for Pharmacotherapy of OUD (1 hour)
Bethany DiPaula, PharmD, BCPP, University of Maryland; Sarah Melton, PharmD, BCPP, BCACP, FASCP, Gatton College of Pharmacy; Troy Moore, PharmD, MS, BCPP, Eastern Colorado Health Care System/Rocky Mountain Regional VA Medical Center

  1. Identify the unique training and traits pharmacists bring to the interprofessional treatment team caring for patients with opioid use disorder.
  2. Describe the barriers and benefits encountered in establishing a collaborative practice agreement with prescribers to provide pharmacotherapy for opioid use disorder.
  3. Compare outcomes from collaborations integrating pharmacists into the team providing pharmacotherapy for OUD in different practice settings across the United States.

Inpatient Management: Regulatory, Detox, Starting Treatment in the Emergency Room (Acute Care Management) (1 hour)
Curtis Geier, PharmD, BCCCP, San Francisco General Hospital and Trauma Center

  1. Explain the epidemiology of OUD in the acute care setting
  2. Describe the regulatory requirements for initiating detoxification for OUD in the acute care setting.
  3. Describe the regulatory and clinical considerations for initiating and modifying existing pharmacotherapy for OUD in the acute care setting.
  4. Apply evidence based interventions or detoxification and pharmacotherapy for OUD in the acute care setting.

Special Considerations for Incarcerated Patients (1 hour)
Jennifer Nelson, PharmD, BCPP, Parkland Health & Hospital System

  1. Explain the epidemiology of OUD in the incarceration setting.
  2. Describe the role of opioid tolerance in overdose risk in patients with OUD released from incarceration.
  3. Explain the regulations for initiating and continuing pharmacotherapy for OUD in the incarceration setting.
  4. Apply evidence-based interventions to design a treatment plan for pharmacotherapy for OUD in the incarceration setting.
  5. Develop a system to decrease diversion of medications used in the treatment of incarcerated patients.

Health Care Providers in Recovery (1 hour)
Brian Fingerson, BS Pharm, RPh, FAPhA, KY Professionals Recovery Network - KYPRN

  1. Describe the prevalence of SUDs in health care professionals.
  2. List available resources for pharmacy professionals with SUDs.
  3. Create a plan for managing healthcare professionals in recovery.

Setting up an OUD Practice in the Community or Retail Pharmacy Setting (1 hour)
Morgan Miller, PharmD, Alps Specialty Pharmacy

  1. Evaluate the role of the community pharmacist in providing care for the patient with OUD.
  2. Identify pharmacotherapy and harm reduction initiatives which can be implemented within a community pharmacy and develop a plan to execute.
  3. Describe best-practices to overcome barriers in collaborating with prescribers of pharmacotherapy for OUD.