Short-Term Opioid Withdrawal Using Buprenorphine: Evidence from Research

ATTC Supplemental Materials * Physician Education & Training * Web-based Education for Allied Health Professionals * Additional Websites and Resources

ATTC Supplemental Materials
In addition to disseminating the official Blending products, the ATTC Network draws on it expertise in technology transfer to extend the reach of the Blending Initiative by re-packaging the approved information and materials in creative and innovative ways. These ATTC-developed products have not been reviewed or approved by NIDA and are not part of the Blending Team packages. They do, however, facilitate the understanding and adoption of evidence-based treatment interventions by professionals in the substance abuse treatment field.

The following ATTC supplementary products have been developed to enhance the official NIDA/SAMHSA Buprenorphine Treatment Blending Team product:


Physican Education and Training

Physician Continuing Medical Education (CME): “Notification of Intent” Form must be filed with CSAT to obtain waiver to prescribe. This can be done on-line at http://buprenorphine.samhsa.gov/waiver_qualifications.html. The physician training organizations listed below give eight (8) hours of Category I Continuing Medical Education (CME) creditfor completing courses.

Live, Face-to-Face Trainings

Opt-In: Opioid Dependence Physicians Training (8 hour face-to-face training courses: http://www.docoptin.org/Physician/)

Organizations Authorized to Provide Waiver-Qualifying Buprenorphine Training to Physicians: To sponsor a live waiver-qualifying physician buprenorphine training event, organizations must work directly with one of the five organizations authorized in DATA 2000 to sponsor such trainings. (Note: the American Medical Association is currently not conducting DATA-qualifying training events.) Financial support for waiver-qualifying buprenorphine trainings may be available from CSAT. Residents train at reduced or no cost at live AAAP/ASAM/AAAOA sponsored events – ask about discounts offered at the specific training that is of interest to you. Please contact the organization of your choice to learn how to schedule a training event in your area:

American Academy of Addiction Psychiatry (AAAP)
Contact: Jan M. Armstrong, Executive Director
Phone: 202-393-4484
E-Mail: jarmstrong@aaap.org

American Osteopathic Academy of Addiction Medicine (AOAAM)
Contact: Anthony Dekker, D.O.
Phone: 602-263-1567
E-mail: anthony.dekker@mail.ihs.gov

American Psychiatric Association (APA)
Contact: Ms. Beatrice Edner
Phone: 888-357-7924, ext. 8598
E-mail: bedner@psych.org

American Society of Addiction Medicine (ASAM)
Contact: Ms. Tracy Gartenmann
Phone: 301-656-3920
E-mail: tgart@ASAM.ORG

Web-based CME Training for Office Based Opioid Treatment Certification

American Academy of Addiction Psychiatry (AAAP) - Free Online Certification Now Available (non-CME)! The AAAP online course now offers users the option to request a non-CME credit scholarship once they have completed their online test.  Users will still qualify to submit for a waiver and will not be required to pay but they will not receive CME credits if they opt for a scholarship. http://www.aaap.org/buprenorphine/buprenorphine.htm

New AAAP "Half and Half" Course for Buprenorphine Training: In an effort to provide training in a way that is flexible for the practicing physician AAAP has created the “Half and Half” course.

  • This option is designed for any currently certified physician to request if they have a small group (up to 20) of physicians they would like to train.
  • The certified physician who would like to be a course director should contact AAAP at https://www.aaap.org to request the course kit and will be required to make all course arrangements, conduct the program (including registration) and complete the required paperwork.
  • Course director candidates will be asked to submit a CV and interview with AAAP via phone.  No specific degrees or specialties are required.  The kit cost is $5,000.00 to the certified physician/organization that wants to conduct the training. This fee covers only the training materials kit.

American Society of Addiction Medicine (ASAM) http://www1.buprenorphinecme.com/PageReq

  • Registration is $150.00
  • Development of BuprenorphineCME.com is funded by the NIH National Institute on Drug Abuse (#R44DA12066).
  • This course can be completed in increments.
  • Time spent on the course is logged and registrants may be contacted to resolve discrepancies regarding time online vs. credit hours claimed.
  • http://www.asam.org/conf/Buprenorphineconferences.htm   

American Osteopathic Academy of Addiction Medicine (AOAAM)  http://www.aoaam.org/

American Psychiatric Association (APA) Online Course www.psych.org/cme or www.psych.org/edu/bup_training.cfm  

  • Self-Paced Complete at your own pace - Exit program at any time, your progress will be saved
  • 8-Hour course fee $100 for APA Members and $200 for Non-Members - FREE for residents who are APA members

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Web-based Education for Allied Health Professionals
The physician training organizations listed above DO NOT provide discipline-specific CEU's for other Allied Health Professions, although they may register for and complete those courses (space permitting). Allied Health Professionals would NOT qualify for the waiver (only physicians can prescribe buprenorphine). Allied health Professionals should contact their own professional licensing body regarding the application of CME credit to their profession's CEU requirements. Some Allied Health Professions may permit CMEs to be applied as CEUs. This will vary, state to state.

Buprenorphine Treatment of Opioid Addiction: A Guide for Counselors

International Nurses Society on Addictions (IntNSA): Counseling Points™, an official publication of IntNSA http://www.intnsa.org/
Available for online reading. Counseling Points™ is an opportunity to earn continuing education (CE) credit. This continuing nursing education activity was approved by the Wisconsin Nurses Association Education Approval Program committee for one contact hour. It was also approved by the Pennsylvania Certification Board for one hour of substance abuse continuing education credit. See page 2 of the publication for complete details.

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Additional Websites & Resources

SAMHSA/CSAT Buprenorphine Information Center http://buprenorphine.samhsa.gov

This is the site of SAMHSA/CSAT’s Buprenorphine Information Center. Included in the site are: general information (e.g., buprenorphine, DATA 2000, Physician and Treatment Program Locator), links to buprenorphine-related reports and publications, and a section specifically for physicians.

Buprenorphine Physician and Treatment Program Locator
http://buprenorphine.samhsa.gov/bwns_locator/index.html

The Buprenorphine Physician and Treatment Program Locator is a service of SAMHSA/CSAT. It is an online resource designed to assist States, medical and addiction treatment communities, potential patients, and/or their families in finding information on locating physicians and treatment programs authorized to treat opioid addiction with buprenorphine.

SAMHSA’s latest TIP on buprenorphine
http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.72248

TIP 40Treatment Improvement Protocol (TIP), Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, provides consensus - and evidence -based treatment guidance for the use of buprenorphine. The goal of TIP 40 is to provide physicians with information they can use to make practical and informed decisions about the use of buprenorphine to treat opioid addiction. These guidelines address the pharmacology and physiology of opioids, opioid addiction, and treatment with buprenorphine; describe patient assessment and the choice of opioid addiction treatment options; provide detailed treatment protocols for opioid withdrawal and maintenance therapy with buprenorphine; and include information on the treatment of special populations, e.g., pregnant women, adolescents, and polysubstance users. TIP 40 represents another step by the Center for Substance Abuse Treatment (CSAT) toward its goal of bringing national leaders together to improve substance use disorder treatment in the United States.

U.S. Food and Drug Administration’s Center for Drug Evaluation and Research
http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm


This is the buprenorphine-specific information page on the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research. Included on this site is: an FDA Talk Paper, the drug labels for Subutex and Suboxone, physician information, information for pharmacists, and questions and answers about Subutex and Suboxone.

Integrated Buprenorphine & HIV Care Evaluation & Support Center (BHIVES)
http://www.bhives.org/

bhives.org logoIn September 2004, the HIV/AIDS Bureau of the Health Resources and Services Administration (HRSA) funded an initiative through its Special Projects of National Significance (SPNS) branch to develop and evaluate programs that integrated HIV primary care and buprenorphine treatment for opioid dependence. This website contains information and resources related to those programs.

“Buprenorphine: A New Tool in the Arsenal” from HRSA http://www.hab.hrsa.gov/publications/march04/

Buprenorphine: A New Tool in the Arsenal, by Richard Seaton (Ed), U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA Care Action), March 2004, reviews buprenorphine treatment approaches in providing comprehensive medical care to HIV-positive opiate addicts, as well as subsequent barriers to that treatment. Links to additional special topics such as A Primer on Opiate Addiction, New Report: SPNS Information Technology Initiative; Buprenorphine 101; and Buprenorphine and HIV/AIDS Drugs are included in the article.

Reckitt Benckiser Suboxone Web site
http://www.suboxone.com


This is the official website of Reckitt Benckiser, the manufacturer of Suboxone. The site, which breaks down information into two main sections (one for patients and caregivers and a second for healthcare providers), includes information on understanding opioid dependence, information about Suboxone (how it works, frequently asked questions, etc.), and resources. Also included is a physician locator. Patient stories and information about clinical trials are featured on the site’s home page. 

Reckitt Benckiser Buprenorphine Bibliography
http://www.coretext.org

This is the home of Reckitt Benckiser’s Buprenorphine Bibliography. The bibliography is updated frequently, and contains details of more than 9,000 publications, most with an abstract. The topics cover preclinical safety and efficacy, including the use of buprenorphine in analgesia, opioid dependence, and veterinary medicine. Publications are grouped in several ways, including by date of publication, author name, and publication title.

“About Methadone and Buprenorphine” by the Drug Policy Alliance http://www.drugpolicy.org/docUploads/aboutmethadone.pdf

This link will take you to a 52-page PDF of a Drug Policy Alliance booklet entitled, “About Methadone and Buprenorphine (2nd edition).” The booklet includes information about updated information on methadone and buprenorphine as important options for the treatment of opioid addiction.

American Academy of Addiction Psychiatry: Buprenorphine http://www.aaap.org/buprenorphine/buprenorphine.htm

This is the buprenorphine section of the American Academy of Addiction Psychiatry’s website. Featured on this page is a listing of upcoming AAAP-sponsored buprenorphine training sessions, including web-based and CD-Rom training. Also included is information about becoming a member of AAAP, general information on buprenorphine, meetings, patient referrals, and publications.

“Managing Opioid Addiction with Buprenorphine” in American Family Physician
http://www.aafp.org/afp/20060501/1573.html

This is a link to the website for American Family Physician, a peer reviewed journal of the American Academy of Family Physicians. This particular link features a 2006 article published in American Family Physician by Drs. Paul A. Donaher and Christopher Welsh entitled, “Managing Opioid Addiction with Buprenorphine.” Also accessible from this site are past issues of AFP, an Evidence-Based Medicine Toolkit, and information for subscribing to the journal.

American Society of Addiction Medicine: Buprenorphine http://www.asam.org/BuprenorphineCME.html

This link takes you to the buprenorphine section of the American Society of Addiction Medicine’s website. ASAM logoIncluded on this page is a buprenorphine training calendar and links to online buprenorphine training. From this page, you can access other sections of the ASAM website, including advocacy, opportunities for Continuing Medical Education, a Mentor Network, and publications.

“National Poll of Physicians Finds Barriers to Widespread Buprenorphine Use”, Join Together, October 9, 2003
http://www.jointogether.org/sa/news/features/reader/0,1854,567169,00.html

This article presents results of a national poll of 415 doctors authorized to prescribe buprenorphine for opioid addiction, reviews buprenorphine’s history, and the barriers presented to prescribing physicians in the use of this available medication.

“Mentoring Key to Upping Physician Use of Buprenorphine”, Experts Say, by Bob Curley, Join Together, October 29, 2004
http://www.jointogether.org/sa/news/features/reader/0,1854,575061,00.html

The author of this article focuses the importance of peer mentoring for the purpose of getting more physicians to accept buprenorphine treatment for opioid treatment since integrating the prescribing of this medication has been slow.

ASAM DATA 2000 Qualifying Training Program
http://www2.buprenorphinecme.com/?id=5407:27326

This website is an ASAM DATA 2000 Qualifying Training Program on buprenorphine offered by Clinical Tools, Inc, which is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Narrative Review: Buprenorphine for Opioid-Dependent Patients in Office Practice
http://www.rwjf.org/pr/product.jsp?id=29451

This article by Sullivan LE and Fiellin DA, Robert Wood Johnson Foundation, May 06, 2008, American College of Physicians, addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphine-naloxone. The different components of treatment, the role of the physician who provides this treatment, and the logistics of treating this growing multifaceted patient population also are examined.

 Buprenorphine: A New Drug for Treatment Heroin Addiction http://www.health.state.ny.us/publications/9555.pdf

This article by the New York State Department of Health AIDS Institute, April 2007, includes information about the benefit of using of buprenorphine as a treatment option for opioid addiction.  

“State Issue Brief on the Use of Buprenorphine and Implication for State AOD Systems” from NASADAD
http://www.nasadad.org/resource.php?base_id=718

The National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD) issued this report in May 2006.  The report, which was primarily distributed to State Alcohol and Other Drug (AOD) agencies and their constituents, provides a compilation of findings and the implications for administrators of AOD treatment systems related to issues surrounding the use of buprenorphine.

New Innovations in Opioid Treatment Buprenorphine Seminar Series http://naadac.org/documents/display.php?DocumentID=165#innovations

NAADAC: The Association of Addiction Professionals’ educational program discusses the four facets of opioid dependence and addiction (biological, psychological, social and spiritual), addiction as a disease, and the scientific evidence to support this claim. This seminar also addresses the three FDA-approved medications for opioid dependence, applying strategies to match patients to the most appropriate therapy, methods of motivating patients in opioid dependence treatment, and building cooperative relationships between addiction professionals and prescribers.

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