Pain and Addiction Course: Common Threads XV

The Agony and the Partial Agonist

Overview:  Buprenorphine Neurobiology and Clinical Practice

Buprenorphine was discovered in the late 1960’s. Its inventors hoped to find the elusive “Holy Grail” of opioid pharmacology—a morphine analog effective for pain, but not associated with addiction or overdose. It is now understood that buprenorphine falls short of “Holy Grail” status on all of these parameters, but can often, sometimes elusively, demonstrate superior pharmacologic and clinical properties than any other opioid analgesic. In its fifteenth consecutive year, The ASAM Pain & Addiction Course: Common Threads XV will focus on the challenges and risks, as well as the opportunities, in prescribing buprenorphine. The Course will cover: basic mechanisms; analgesic history; opioidinduced hyperalgesia; use in hospitalized, pregnant, and highutilizing patients; perioperative considerations; and the drug’s intersection with cannabis and benzodiazepines.

Educational Purpose

Physicians, both primary care as well as various specialists who prescribe buprenorphine for either pain or to treatment addiction to opioids, will understand both the benefits as well the potential risks of prescribing and adopt standard of practice to enhance patient outcomes.

Learning Format and Methodologies

Utilizing dynamic media presentation tools, this live course’s essential content will be presented through a variety of formats including lecture, highly interactive panel discussions, case studies and interactive audience discussions.

Who Should Attend

Primary care physicians, addiction medicine physicians, psychiatrists, neurologists, psychologists, anesthesiologists, nurse practitioners, therapists, addiction counselors, social workers, any health care professionals working with addiction or pain management and related issues.

Course Topics

  • Buprenorphine Basics
  • From Opium to Buprenorphine—
  • Buprenorphine Clincial Research & Practice
  • Therapeutic Strategies for the Super-Utilizer and Opioid Induced Hyperalgesia
  • Marijuana
  • Perioperative Buprenorphine, Hospitalized Patients and Butrans Assisted Opioid Rotation to Sublingual Buprenophine
  • Pregnant Patients
  • Benzos and Buprenorphine
  • Integration of Pharmocological Treatment with 12-Step Programs or Non-Pharmacological Treatment Alternatives
  • What's Ahead for Buprenorphine


Herbert L. Malinoff, MD, FACP, FASAM
R. Corey Waller, MD, MS, FACEP,
Carl Christensen, MD, PhD, FACOG,CRMO, ABAM
Howard G. Kornfeld, MD, FASAM
Joseph Pergolizzi, Jr., MD
Melvin I. Pohl, MD, FASAM
Robert B. Raffa, PhD
Mark A. Weiner, MD
Howard Wetsman, MD, FASAM
Steven A. Wyatt, DO 

Learning Objectives

Upon completion of this educational activity participants should be able to:

  • Identify and explain the molecular mechanisms of buprenorphine, its pharmacokinetics and dynamics and its impact on a patient’s neurobiology.
  • Describe the role of buprenorphine in the historical development of analgesia and articulate the risks and benefits of its use to patients from an addiction medicine perspective.
  • Utilize current clinical research and practice evidence to describe the efficacy of buprenorphine in U.S. pain medicine practice.
  • Define appropriate therapeutic strategies for the use of buprenorphine among super-utilizer and opioid-induced hyper-algesia patients.
  • Articulate appropriate responses to patient inquiries about the use of medical marijuana in pain management.
  • Identify appropriate buprenorphine prescribing and management procedures for special patient situations such as: perioperative, hospitalized patients, and transdermal-assisted opioid rotation to sublingual buprenorphine.
  • Assist opioid-addicted pregnant patients through use and management of buprenorphine to ensure positive patient/child outcomes.
  • Define appropriate recommendations, dosing and management of patients on benzodiazepines who are also prescribed buprenorphine for either pain or opioid addiction or both.
  • Integrate a pharmacological treatment program utilizing buprenorphine with 12-Step programs or other non-pharmacological behavioral treatment alternatives.
  • Identify the current and future legal and regulatory challenges faced by prescribers of buprenorphine either for pain management or opioid addiction.

Program Planning Committee

Herbert L. Malinoff, MD, FACP, FASAM, Chair, 
R. Corey Waller, MD, MS, FACEP, Vice Chair
Howard G. Kornfeld, MD, FASAM
Melvin I. Pohl, MD, FASAM
Mark A. Weiner, MD
Howard C. Wetsman, MD, FASAM

CME Committee Reviewers

James Ferguson, DO, FASAM

Continuing Medical Education Credit

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 

This live activity, Pain and Addiction: Common Threads XV Course, has been approved for a maximum of 8 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

ABAM Maintenance of Certification Program 
Application has been made for the Annual Medical-Scientific Conference and its pre-courses to be an approved CME Activity by the American Board of Addiction Medicine (ABAM) for the Maintenance of Certification (MOC) Program for the CME requirement for Part II: Lifelong Learning and Self-Assessment. 

American Academy of Family Physicians (AAFP) 
Many of the sessions have been identified as of interest and value to primary care physicians. Application has been made to the American Academy of Family Physicians for Live Prescribed and/or Elective Credit.


Online Course Preview

Slide presentations and handouts for Med-Sci educational sessions will be available to registrants through ASAM’s e-Live Learning Center after April 1, 2014. Attendees are encouraged to download and print, or upload these course materials to their laptops or hand-held devices prior to the course. No printed copies of presentations will be made available on site.


Course Staff


Ken Fox, Senior Manager, Professional Development