ASAM Physicians Provide Medical Community with Valuable Training on Buprenorphine
A new online course offers advanced knowledge and skills in the use of buprenorphine, focusing on the latest standards and information about initiation, management, and dosing strategies — and it’s free.
The 90-minute course, “Advanced Buprenorphine Education: Best Practices and Emerging Evidence in Opioid Use Disorder Treatment,” complements the recently released ASAM Clinical Considerations: Buprenorphine Treatment of Opioid Use Disorder for Individuals Using High-Potency Synthetic Opioids. Melissa B. Weimer, DO, MCR, DFASAM, spearheaded both projects.
In addition to Dr. Weimer, the workshop was developed by Stephen Holt, MD, MS, FACP, FASAM; Susan Calcaterra, MD, MPH, MSPH; Tiffany Lu, MD, MS, FASAM; Laura Kehoe, MD, MPH; and ASAM staff.
Dr. Calcaterra helped create the hour-long first part of the course. “It provides background on the emerging drug supply, including fentanyl, and discusses how to start your patients on buprenorphine using different techniques. The course covers the management of opioid use disorder when people are using these synthetic opioids,” said Susan Calcaterra, associate professor of medicine, director of the Addiction Medicine Consult Liaison Service, and associate program director of the Addiction Medicine Fellowship at the University of Colorado School of Medicine.
Workshop participants explore specific clinical situations that call for low- or high-dose initiation, strategies to address patient discomfort and withdrawal, dosing considerations during stabilization and long-term treatment, indications for injectable extended-release buprenorphine, and alternative options for individuals with unsuccessful attempts at buprenorphine treatment.
Physicians, nurse practitioners/nurses, physician assistants, pharmacists, counselors, and other clinicians will benefit from the course, which is geared toward anyone who sees patients with addiction in primary care, emergency/urgent care, treatment center, or general psychiatry settings.
“The course is for anyone familiar with buprenorphine and comfortable doing a traditional buprenorphine initiation but is interested in learning about other ways to stabilize a patient on buprenorphine when they're unable to tolerate a traditional initiation,” said Dr. Calcaterra.
Dr. Lu, Associate Director for Addiction Services at NYC Health and Hospitals/Jacobi and Associate Professor of Medicine and Psychiatry at the Albert Einstein College of Medicine, helped create the second and third modules of the course, which include brief videos and interactive patient cases. The videos cover many topics, such as tapering and stopping buprenorphine treatment; how to stabilize patients in buprenorphine treatment; and how to implement buprenorphine treatment in the outpatient setting.
“These are all clinically relevant topics to our practice, both on an individual patient level and also a practice structuring level,” said Dr. Lu, who is also education committee chair for the New York Chapter of ASAM and a member of ASAM’s Quality Improvement Council.
The interactive case-based segment allows participants to evaluate their understanding of the subject matter in various scenarios.
“I envision this course as a user-friendly tool that clinicians can rely on with confidence. The content, curated by addiction experts and educators, reflects a careful integration of existing knowledge on the subject. Our commitment extends to crafting practical frameworks and approaches, empowering clinicians to seamlessly apply this valuable information in their practice,” Dr. Lu said.
Both doctors said they enjoyed working on the project.
“It's been fantastic,” Dr. Calcaterra said. “I love hearing about other people's experiences in their practices, how they care for patients in different parts of the country, and how they treat patients using different types of drugs. The drug supply is so varied across the country. I enjoy collaborating with colleagues on projects like this one. It's my favorite part of what we do: learning from each other.”
Dr. Calcaterra also appreciated working with Veena Radhakrishnan, EdD, senior director of Learning, Design, and Innovation for ASAM.
“As project manager, she worked hard to ensure we produced a quality product, and she has been an absolute dream to work with,” Dr. Calcaterra said. “She's incredible. She's professional. She's helpful and timely. I just really appreciated working with her.”
Dr. Lu also said participating in this project helped her grow professionally.
“I've been providing buprenorphine treatment for almost 10 years, and over that time, I have evolved as an educator, starting from educating the staff in my clinic to educating the trainees who work with me and my colleagues in my clinical and medical institutions,” she said. “For me, working on this course has taken my educational skills to the next level, from more of a local regional perspective to a national perspective. Also, I appreciated working with the educational specialists at ASAM and the feedback they provided through the process.”
Why I Treat
Drs. Calcaterra and Lu said they treat addiction because it allows them to make a lasting difference in people’s lives.
“I treat addiction because it is rewarding, lifesaving, satisfying, and -- especially in the hospital setting – ensures patients remain in the hospital and receive necessary medical treatment,” Dr. Calcaterra said. “I also enjoy working with this patient population because they appreciate the care that we are so fortunate to provide them.”
Dr. Lu said it is humbling and rewarding to see people’s lives change for the better as she has grown in her career as an addiction medicine specialist.
“Treating addiction is important to me,” she said, “So I can help patients access life-saving medications to stabilize withdrawal and cravings, incorporate practical strategies and tools to reduce harms, and make incremental steps toward an overall arc of positive change. Being able to help move our clinics and hospitals toward systemic change and build a better care delivery system for people with substance use disorders is what I love about being an addiction medicine specialist.”