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Buprenorphine Training

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Buprenorphine for Opioid Use Disorder

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Buprenorphine for Opioid Use Disorder

Up to 8.5 hrs CME/CE

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Audience:

Primary care providers, counselors, and social workers

Credits:

Up to 8.5 AMA PRA Category 1 Credits™

Up to 8.5 DCBN

Up to 8.5 FBM

Up to 8.5 FAPA

Up to 8.5 FBN-CNA

Release Date: 03/01/22

Expiration Date: 03/01/25

Funding:

Development of this activity was supported by grant #R43DA050401 from the National Institutes of Health.

This activity is designed to change: Competence, Performance, Patient Outcome. 

Educational Objectives:

After completing this activity participants will be able to:

  • Treat common pain conditions utilizing first-line treatments whenever possible.
  • Follow evidence-based guidelines when prescribing opioids. 
  • Advise patients taking opioids, including buprenorphine, how to avoid and respond to overdose. 
  • Monitor patients in buprenorphine treatment or on other chronic opioid therapy for safety.
  • Screen for and diagnose opioid use disorder in patients
  • Use motivational interviewing skills to evaluate and treat patients having opioid use disorder.
  • Assess whether patients having opioid use disorder are candidates for office-based buprenorphine treatment.
  • Provide effective and successful buprenorphine treatment for patients with opioid use disorder.
  • Describe for patients how to take buprenorphine, how it works, the forms available, and risks.

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Complete as many of the modules below as you’d like to earn up to 8.5 total credits:

Get Started with Buprenorphine

Buprenorphine for Opioid Use Disorder: Overview course image
Buprenorphine for Opioid Use Disorder: Overview

0.5 Hrs

30 min

View Activity Outline

 
Screening, Detection, and Diagnosis of Opioid Use Disorder course image
Screening, Detection, and Diagnosis of Opioid Use Disorder

1 Hr

60 min

View Activity Outline

 
Assessing Patients for Buprenorphine Treatment course image
Assessing Patients for Buprenorphine Treatment

1 Hr

60 min

View Activity Outline

 
Understanding Opioid Medications and Buprenorphine Formulations course image
Understanding Opioid Medications and Buprenorphine Formulations

1 Hr

60 min

View Activity Outline

 

Meet the Patients – Interactive

Prescribing for Pain with Care: 2 Patients course image
Prescribing for Pain with Care: 2 Patients

1 Hr

60 min

View Activity Outline

 
Opioid Misuse – 1 Patient course image
Opioid Misuse – 1 Patient

0.5 Hrs

30 min

View Activity Outline

 
Opioid Use Disorder and Medication Assisted Treatment – 2 Patients course image
Opioid Use Disorder and Medication Assisted Treatment – 2 Patients

0.5 Hrs

30 min

View Activity Outline

 
Opioids and Acute Pain: When and How – 1 Patient course image
Opioids and Acute Pain: When and How – 1 Patient

0.5 Hrs

30 min

View Activity Outline

 

Ready for more? Prescribing Buprenorphine

Buprenorphine Treatment Structure course image
Buprenorphine Treatment Structure

0.5 Hrs

30 min

View Activity Outline

 
Induction – Initiating Buprenorphine Treatment course image
Induction – Initiating Buprenorphine Treatment

1 Hr

60 min

View Activity Outline

 
Maintenance and Discontinuation course image
Maintenance and Discontinuation

1 Hr

60 min

View Activity Outline

 
Authors

As an ACCME accredited provider of continuing medical education, Clinical Tools, Inc.requires everyone who is in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest to the provider. The ACCME defines ‘relevant’ financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Any conflicts of interest are resolved prior to the delivery of the educational activity to the learner. CTI does not permit individuals with financial conflicts of interest to participate in any stage of activity development.

T Bradley Tanner, MD (President, Clinical Tools, Inc.)
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose. Dr. Tanner is the owner of Clinical Tools.

Read Bio
T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on Bup.ClinicalEncounters.com. He also has a strong background in technology and oversees the development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role as a Clinical Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.

Karen Rossie, DDS, PhD (Research Scientist, Clinical Tools, Inc. )
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose.

Read Bio
Karen Rossie, DDS, PhD, directs projects at Clinical Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University, and later, a PhD in Psychology from the Institute of Transpersonal Psychology. She taught and practiced oral pathology and oral medicine for 15 years at the Ohio State University and the University of Pittsburgh, doing research in autoimmune disease, bone marrow transplantation, oral cancer, salivary gland disease, candidiasis, and diabetes. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, screening and brief interventions for substance abuse, obesity, and pain and addiction.
Reviewers

Steve Applegate, MEd, MEd (President, Applegate Consulting, )
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose.

Read Bio
Mr. Applegate has experience in substance use counseling, state initiatives impacting substance use, and professional training. His prior positions include director of higher education and instructional design at the North Carolina Governor’s Institute on Alcohol and Substance Abuse, project director of the North Carolina Initiative of the Mid-Atlantic Addiction Technology Transfer Center, and program director of the Addiction Sciences Center (an outpatient substance abuse treatment center at the University of Virginia Health Sciences Center). Mr. Applegate works as an on-site consultant and travels to the Clinical Tools (CTI) office on a monthly basis from his office in Richmond, VA. Mr. Applegate helped design the CTI Instructional Manual and works to continue to revise it as we expand our Instructional Design methodology. Mr. Applegate has extensive experience in online education and training, especially in the area of substance abuse. He often pushes the envelope of technology and brainstorms with Clinical Tools how we can utilize new technology in our products. He helped guide development of the curriculum plan and assessments in Phase I of the current project.
Most Recent Updates/Reviews

CTI Content Update: 4/30/2021
CTI Editorial Review: 5/12/2021

Accreditation Information:

Audience: Primary care providers, counselors, and social workers

TypeEst. TimeReleasedExpires
AMA PRA Category 1 Credit(s)™Up to 8.5hrs03/01/2203/01/24
DCBNUp to 8.5hrs03/01/2203/01/24
FBMUp to 8.5hrs03/01/2203/01/24
FAPAUp to 8.5hrs03/01/2203/01/24
FBN-CNAUp to 8.5hrs03/01/2203/01/24

Accreditation Statement: Clinical Tools, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 Credits™ Designation Statement:  Clinical Tools, Inc. designates this enduring material for a maximum of 8.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

DCBN Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 8.5 hour(s) of DCBN credit. Clinical Tools, Inc. is an approved provider by the District of Columbia Board of Nursing and is registered with CE Broker, Provider #50-1942.

FBM Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 8.5 hour(s) of Florida Board of Nursing credit. Providers and other health professionals should claim only the credit commensurate with the extent of their participation in the activity.

FBN-CNA Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 8.5 hour(s) of Florida Board of Nursing – Certified Nursing Assistants credit. Providers and other health professionals should claim only the credit commensurate with the extent of their participation in the activity.

FAPA Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 8.5 hour(s) of Florida Physician Assistants credit. Providers and other health professionals should claim only the credit commensurate with the extent of their participation in the activity.

State Medical Board of Ohio Accreditation Statement: Clinical Tools, Inc. is recognized by the State Medical Board of Ohio as an accredited provider of continuing medical education for physicians.

Arkansas State Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Arkansas State Board of Nursing as an accredited provider of continuing medical education for nurses.

Georgia Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Georgia Board of Nursing as an accredited provider of continuing medical education for nurses.

South Carolina Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the South Carolina Board of Nursing as an accredited provider of continuing medical education for nurses.

New Mexico Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the New Mexico Board of Nursing as an accredited provider of continuing medical education for nurses.

A letter of completion for up to 8.5 hour is available for non-physicians.

A score of 70% on the post-test is required to complete the activity.

Please note that these are continuing medical education activities, not waiver training.

Professional Practice Gaps

Training Activity References

Participation Requirements

View Reviews


Reviews for this activity

Well constructed program

Engaging, thoughtfully presented, and easy to work through. Highly recommended.

— Emergency Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:27:21-05:00

— Emergency Medicine Provider

Engaging, thoughtfully presented, and easy to work through. Highly recommended.
https://bup.clinicalencounters.com/blog/testimonials/wow/

Excellent course

Very well presented with excellent case studies.

— OBGYN

About Prescribing Buprenorphine
5
2021-01-28T18:27:21-05:00

— OBGYN

Very well presented with excellent case studies.
https://bup.clinicalencounters.com/blog/testimonials/sample/

Made me a better provider

I am a better provider after completing this CME.

— TX Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— TX Provider

I am a better provider after completing this CME.
https://bup.clinicalencounters.com/blog/testimonials/good-introduction/

Convenient and Effective

A convenient and effective method to gain knowledge regarding the use of buprenorphine for OUD and OBOT.

— Family Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Family Medicine Provider

A convenient and effective method to gain knowledge regarding the use of buprenorphine for OUD and OBOT.
https://bup.clinicalencounters.com/blog/testimonials/a-great-activity/

Excellent program

I learned a lot about medication-assisted opioid treatment.

— Psychiatrist

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Psychiatrist

I learned a lot about medication-assisted opioid treatment.
https://bup.clinicalencounters.com/blog/testimonials/excellent-program/

Feel more confident treating pain

I have more appreciation for those seeking pain management and feel more confident about treating their pain.

— GA Family Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— GA Family Medicine Provider

I have more appreciation for those seeking pain management and feel more confident about treating their pain.
https://bup.clinicalencounters.com/blog/testimonials/quis-autem/

Convenient

Allows a very busy MD to complete at [their] own pace.

— Family Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Family Medicine Provider

Allows a very busy MD to complete at [their] own pace.
https://bup.clinicalencounters.com/blog/testimonials/duis-aute-irure/

Well done!

An exceptional asset to those looking to provide more competent assessment and treatment of the current opioid crisis and all its challenges.

— Psychiatrist

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Psychiatrist

An exceptional asset to those looking to provide more competent assessment and treatment of the current opioid crisis and all its challenges.
https://bup.clinicalencounters.com/blog/testimonials/dignissimos/

Interesting and informative

The training module will enhance my outpatient clinic.

— Internal Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Internal Medicine Provider

The training module will enhance my outpatient clinic.
https://bup.clinicalencounters.com/blog/testimonials/nemo/

FULL of resources

I will be going back to this over and over as I grow my practice treating opioid use disorder.

— Family Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T18:32:54-05:00

— Family Medicine Provider

I will be going back to this over and over as I grow my practice treating opioid use disorder.
https://bup.clinicalencounters.com/blog/testimonials/full-of-resources/

Enjoyed it

Really enjoyed it and expect I will continue to reference this as I treat patients.

— Family Medicine Provider

About Prescribing Buprenorphine
5
2021-05-18T13:22:37-04:00

— Family Medicine Provider

Really enjoyed it and expect I will continue to reference this as I treat patients.
https://bup.clinicalencounters.com/blog/testimonials/enjoyed-it/

Great and Very Effective

This was a great and very effective CME activity in improving my knowledge in the area of Medical-Assisted Treatment for patients with Opioid Use Disorder.

— 11/22/2021

About Prescribing Buprenorphine
5
2022-01-21T17:54:53-05:00

— 11/22/2021

This was a great and very effective CME activity in improving my knowledge in the area of Medical-Assisted Treatment for patients with Opioid Use Disorder.
https://bup.clinicalencounters.com/blog/testimonials/great-and-very-effective/

Good review

Organized to put my experience into practice

Family Medicine Provider

About Prescribing Buprenorphine
5
2021-05-20T11:04:46-04:00

Family Medicine Provider

Organized to put my experience into practice
https://bup.clinicalencounters.com/blog/testimonials/good-review/

Concise and thorough

Highly recommend

Interventional Radiology

About Prescribing Buprenorphine
5
2021-05-20T11:05:55-04:00

Interventional Radiology

Highly recommend
https://bup.clinicalencounters.com/blog/testimonials/concise-and-thorough/

Excellent

Excellent Resource

— Oncology Specialist

About Prescribing Buprenorphine
5
2021-01-28T12:41:25-05:00

— Oncology Specialist

Excellent Resource
https://bup.clinicalencounters.com/blog/testimonials/excellent/

Very helpful

It is invaluable in providing all the information needed to establish a safe and effective way to use buprenorphine in your practice to the benefit of your patients.

— Adult-Gerontology Nurse Practitioner

About Prescribing Buprenorphine
5
2021-01-28T12:42:40-05:00

— Adult-Gerontology Nurse Practitioner

It is invaluable in providing all the information needed to establish a safe and effective way to use buprenorphine in your practice to the benefit of your patients.
https://bup.clinicalencounters.com/blog/testimonials/must-read/

Helpful PDF

PDF format is helpful because you don’t need to worry about saving your place or staying logged in. Easy to download.

— Family Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T15:06:03-05:00

— Family Medicine Provider

PDF format is helpful because you don’t need to worry about saving your place or staying logged in. Easy to download.
https://bup.clinicalencounters.com/blog/testimonials/wonderful/

Thank you!

Efficient, helpful, and effective.

— Psychiatrist

About Prescribing Buprenorphine
5
2021-01-28T15:07:59-05:00

— Psychiatrist

Efficient, helpful, and effective.
https://bup.clinicalencounters.com/blog/testimonials/another-reveiw/

Informative and relevant

I will definitely use the information that I have learned in my clinic.

— Internal Medicine Provider

About Prescribing Buprenorphine
5
2021-01-28T15:10:41-05:00

— Internal Medicine Provider

I will definitely use the information that I have learned in my clinic.
https://bup.clinicalencounters.com/blog/testimonials/interesting/
5
19
About Prescribing Buprenorphine

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Funding Information Development of this website was funded by grant #R44DA12066, contract #HHSN271200655304C, contracts #HHSN271200900003C and Grant #1R44DA027245-01, from the National Institute on Drug Abuse (NIDA) at the National Institutes of Health. The website contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA. Ongoing development and maintenance is funded by the training fee and Clinical Tools, Inc. No commercial support is received.
Clinical Tools is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Buprenorphine for Opioid Disorder Activity References

References for each module within the activity:

Buprenorphine for Opioid Use Disorder: Overview

  1. SAMHSA. Buprenorphine. October 7, 2020.
  2. SAMHSA. Practitioner and Program Data. SAMHSA.gov. 2021.
  3. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  4. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  5. Health and Human Services Department. Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. Fed Regist. April 28, 2021.
  6. SAMHSA. Statutes, Regulations, and Guidelines. October 7, 2020.
  7. CADCA. Comprehensive Addiction and Recovery Act (CARA). CADCA.org. 2016.
  8. Walden G. H.R.6 – 115th Congress (2017-2018): SUPPORT for Patients and Communities Act. October 24, 2018.
  9. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.; 2020.
  10. Madras B, Wilson M, Avula D, et al. Screening, Brief Interventions, Referral to Treatment (SBIRT) for Illicit Drug and Alcohol Use at Multiple Healthcare Sites: Comparison at Intake and Six Months. Drug Alcohol Depend. 2010;99(1-3):280-295. PMCID: PMC2760304. PMID: 18929451.
  11. SAMHSA. SAMHSA report shows increase in opioid treatment facilities. 2017.
  12. Azar A. Announcement of Practice Guidelines for the Administraton of Buprenorphine for Treating Opioid Use Disorder. January 12, 2021.
  13. Townley C, Dorr H. Integrating Substance Use Disorder Treatment and Primary Care. National Academy for State Health Policy. 2017.
  14. Shapiro B, Coffa D, McCance-Katz EF. A Primary Care Approach to Substance Misuse. Am Fam Physician. 2013;88(2):113-121.
  15. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  16. SAMHSA. Methadone. SAMHSA.gov. 2020.
  17. Office of National Drug Control Policy. Medication-Assisted Treatment for Opioid Addiction. 2012.
  18. Maxwell J, McCance-Katz E. Indicators of Buprenorphine and Methadone Use and Abuse: What Do We Know?. Am J Addict. 2010;19(1):73-88. PMCID: PMC3723402. PMID: 20132124.
  19. Drug Enforcement Administration (DEA). Buprenorphine. 2019.
  20. Sokol R, Albanese C, Chaponis D, et al. Why Use Group Visits for Opioid Use Disorder Treatment in Primary Care? A Patient-Centered Qualitative Study.. Subst Abuse. January 2, 2018;39(1):52-58. doi:10.1080/08897077.2017.1356792. PMID: 28723302.
  21. Roll D, Spottswood M, Huang H. Using Shared Medical Appointments to Increase Access to Buprenorphine Treatment.. J Am Board Fam Med JABFM. October 2015;28(5):676-677. doi:10.3122/jabfm.2015.05.150017. PMID: 26355141.
  22. NEJM Catalyst. What Is Patient-Centered Care?. NEJM Catal. January 1, 2017.
  23. Gerteis M. Through the Patient’s Eyes : Understanding and Promoting Patient-Centered Care. Vol 1st ed. San Francisco: Jossey-Bass; 1993.
  24. Davis K, Schoenbaum SC, Audet A-M. A 2020 Vision of Patient-Centered Primary Care. J Gen Intern Med. October 2005;20(10):953-957. PMCID: PMC1490238. PMID: 16191145.
  25. Epstein RM, Street RL. The Values and Value of Patient-Centered Care. Ann Fam Med. March 2011;9(2):100-103. doi:10.1370/afm.1239. PMCID: PMC3056855. PMID: 21403134.
  26. Hashim M. Patient-Centered Communication: Basic Skills. Am Fam Physician. January 2017;95(1):39-34. PMID: 28075109.
  27. Alves PCG, Sales CMD, Ashworth M. Personalising the Evaluation of Substance Misuse Treatment: A New Approach to Outcome Measurement. Int J Drug Policy. April 2015;26(4):333-335. doi:10.1016/j.drugpo.2014.11.014. PMID: 25554362.
  28. Bray JW, Aden B, Eggman AA, et al. Quality of Life as an Outcome of Opioid Use Disorder Treatment: A Systematic Review.. J Subst Abuse Treat. May 2017;76:88-93. doi:10.1016/j.jsat.2017.01.019. PMCID: PMC5402314. PMID: 28190543.
  29. Tofighi B, Grossman E, Buirkle E, McNeely J, Gourevitch M, Lee JD. Mobile Phone Use Patterns and Preferences in Safety Net Office-Based Buprenorphine Patients.. J Addict Med. June 2015;9(3):217-221. doi:10.1097/ADM.0000000000000121. PMCID: PMC4693598. PMID: 25918966.
  30. Alford D, Labelle C, Kretsch N, et al. Collaborative Care of Opioid-Addicted Patients in Primary Care Using Buprenorphine: Five-Year Experience. Arch Intern Med. 2011;171(5):425-431.

Screening, Detection, and Diagnosis of Opioid Use Disorder

  1. U.S. Preventive Services Task Force. Unhealthy Drug Use: Screening. June 9, 2020.
  2. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  3. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  4. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  5. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  6. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  7. NIDA. Screening for Substance Use. Natl Inst Drug Abuse. 2020.
  8. Walden G. Text – H.R.6 – 115th Congress (2017-2018): SUPPORT for Patients and Communities Act. October 4, 2018.
  9. American Psychiatric Association. Substance-Related and Addictive Disorders. APA. 2013.
  10. Shah M, Huecker MR. Opioid Withdrawal. In: StatPearls. Vol Treasure Island (FL): StatPearls Publishing; 2020. PMID: 30252268.
  11. Greene MS, Chambers RA. Pseudoaddiction: Fact or Fiction? An Investigation of the Medical Literature. Curr Addict Rep. 2015;2(4):310-317. doi:10.1007/s40429-015-0074-7. PMCID: PMC4628053. PMID: 26550549.
  12. Chou R, Fanciullo GJ, Fine PG, et al. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. J Pain Off J Am Pain Soc. February 2009;10(2):113-130. doi:10.1016/j.jpain.2008.10.008. PMCID: PMC4043401. PMID: 19187889.
  13. Smith P, Schmidt S, Allensworth-Davies D, et al. A Single-Question Screening Test for Drug Use in Primary Care. Arch Intern Med. 2010;170(13):1155-1160. PMCID: PMC2911954. PMID: 20625025.
  14. UMBCtube. SBIRT: Screen for Substance Use – Negative Screen. UMBCtube; 2011.
  15. McNeely J, Wu L-T, Subramaniam G, et al. Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients. Ann Intern Med. November 15, 2016;165(10):690. doi:10.7326/M16-0317.
  16. Mdege N, Lang J. Screening Instruments for Detecting Illicit Drug Use Abuse That Could Be Useful in General Hospital Wards: A Systematic Review. Addict Behav. 2011;36:1111-1119. PMID: 21821364.
  17. Brown R, Leonard T, Saunders L, et al. The Prevalence and Detection of Substance Use Disorder among Inpatients Ages 18 to 49: An Opportunity for Prevention. Prev Med. 1998;27:101-110. PMID: 9465360.
  18. Babor T, Higgins-Biddle J, Saunders J, et al. AUDIT: The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care. Vol Second edition. World Health Organization, Department of Mental Health and Substance Dependence; 2001.
  19. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Vol 5th edition. Washington, DC: Author; 2013.
  20. Trachtenberg A, Fleming M. Diagnosis and Treatment of Drug Abuse in Family Practice. 1994.
  21. Sullivan J, Sykora K, Schneiderman J, et al. Assessment of Alcohol Withdrawal: The Revised Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar). Br J Addict. 1989;84(11):1353-1357. PMID: 2597811.
  22. Miller WR, Rollnick S. Motivational Interviewing: Helping People Change, 3rd Edition. Vol 3rd edition. New York, NY: The Guilford Press; September 7, 2012.
  23. Lundahl B, Moleni T, Burke B, et al. Motivational Interviewing in Medical Care Settings: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 93. 2013;2:157-168. PMID: 24001658.
  24. Miller W, Rollnick S. An Overview of Motivational Interviewing. 2011.
  25. Magill M, Stout R, Apodaca T. Therapist Focus on Ambivalence and Commitment: A Longitudinal Analysis of Motivational Interviewing Treatment Ingredients. Psychol Addict Behav. 2013;27:754-762.
  26. Clinical Tools, Inc. Motivational Interviewing: Managing Challenging Patient Behavior. Chapel Hill, NC: Clinical Tools, Inc.; 2016.
  27. Schulz JE, Parran T Jr. Principles of Identification and Intervention. In: Principles of Addiction Medicine. Vol 2nd ed. Chevy Chase, Md.: American Society of Addiction Medicine; 1998:250-251.
  28. SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). 2014.
  29. SAMHSA. Talking with Your Adult Patients about Alcohol, Drug, and/or Mental Health Problems. Publ Digit Prod. August 2010.
  30. Pickett M, Rogers P, Cavanaugh Jr R. Screening for alcohol, tobacco, and drug use in children and adolescents. In: In: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, Eds. Principles of Addiction Medicine. Vol Third Edition. Chevy Chase, Md: American Society of Addiction Medicine; 2003.
  31. American Academy of Pediatrics. Alcohol Use by Youth and Adolescents: A Pediatric Concern. Pediatrics. 2010;125(5):1078-1087.
  32. Kaul P, Coupey S. Clinical Evaluation of Substance Abuse. Pediatr Rev. March 2002;23(3):85-94. PMID: 11875181.
  33. Knight J, Shrier L, Bravender T, et al. A New Brief Screen for Adolescent Substance Abuse. Arch Pediatr Adolesc Med. 1999;153(6):591-596.
  34. Marshal MP, Molina BSG, Pelham WE. Childhood ADHD and Adolescent Substance Use: An Examination of Deviant Peer Group Affiliation as a Risk Factor. Psychol Addict Behav J Soc Psychol Addict Behav. December 2003;17(4):293-302. doi:10.1037/0893-164X.17.4.293. PMCID: PMC3652274. PMID: 14640825.
  35. Al-Tayyib A, Rice E, Rhoades H, et al. Association between Prescription Drug Misuse and Injection among Runaway Homeless Youth. Drug Alcohol Depend. 2013;134:406-409. PMCID: PMC3886282. PMID: 24300900.
  36. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT). A Guide to Substance Abuse Services for Primary Care Clinicians. Rockville, Md: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2008.
  37. Tamm L, Trello-Rishel K, Riggs P, et al. Predictors of Treatment Response in Adolescents with Comorbid Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder. Subst Abuse Treat. 2013;44(2):224-230. PMCID: PMC3499678. PMID: 22889694.
  38. Warden D, Riggs PD, Min S-J, et al. Major Depression and Treatment Response in Adolescents with ADHD and Substance Use Disorder. Drug Alcohol Depend. August 31, 2011;120(1-3):214-219. PMCID: PMC3245790. PMID: 21885210.
  39. Cirone S. Brief Intervention: Adolescent with Prescription Opioid Use Disorder. 2013.
  40. Dowell D, Haegerich T, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49. doi:10.15585/mmwr.rr6501e1er.
  41. Madras B, Wilson M, Avula D, et al. Screening, Brief Interventions, Referral to Treatment (SBIRT) for Illicit Drug and Alcohol Use at Multiple Healthcare Sites: Comparison at Intake and Six Months. Drug Alcohol Depend. 2010;99(1-3):280-295. PMCID: PMC2760304. PMID: 18929451.
  42. Food and Drug Administration (FDA). Buprenorphine-containing Transmucosal products for Opioid Dependence (BTOD) Risk Evaluation and Mitigation Strategy (REMS). Initial REMS / , updated 6/2015 2013.

Assessing Patients for Buprenorphine Treatment References

  1. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  2. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  3. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  4. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  5. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  6. USDHHS. Medication Assisted Treatment for Opioid Use Disorders Reporting Requirements. 2016.
  7. Farmer CM, Lindsay D, Williams J, et al. Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process. Subst Abuse. 2015;36(2):209-216. doi:10.1080/08897077.2015.1012613. PMCID: PMC4470850. PMID: 25844527.
  8. SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). 2014.
  9. Hale D, Viner R. Trends in the Prevalence of Multiple Substance Use in Adolescents in England, 1998-2009. J of Public Health, Oxford. 2013;35(3):367-374. PMID: 23528672.
  10. Farmer C, Lindsay D, Williams J, et al. Practice Guidelines for Burprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process. 2015;36(2).
  11. Strain E. Assessment and treatment of comorbid psychiatric disorders in opioid-dependent patients. Clin J Pain. 2AD;18(4 Suppl)(S14-27). PMID: 12479251.
  12. Kidorf M, Disney E, King V, et al. Prevalence of Psychiatric and Substance Use Disorders in Opioid Abusers in a Community Syringe Exchange Program. Drug Alcohol Depend. 2004;74(2):115-122. PMID: 15099655.
  13. UMBCtube. SBIRT: Screen for Substance Use – Negative Screen. UMBCtube; 2011.
  14. FDA. CLIA – Clinical laboratory improvement amendments – currently waived analytes. 2021.
  15. Richert T, Johnson B. Long-term self-treatment with methadone or buprenorphine as a response to barriers to opioid substitution treatment: the case of Sweden. Harm Reduct J. February 18, 2015;12. doi:10.1186/s12954-015-0037-2. PMCID: PMC4337060. PMID: 25889208.
  16. VA/DoD. Management of Substance Use Disorder (SUD) (2015) – VA/DoD Clinical Practice Guidelines. 2015.
  17. Klimas J, Field C-A, Cullen W, et al. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: Cochrane Review. Syst Rev. January 12, 2013;2.
  18. Gudin J, Mogali S, Jones J. Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use. Postgrad Med. 2013;125(4):115-130. PMCID: PMC4057040. PMID: 23933900.
  19. Sterling S, Chi F, Hinman A. Integrating Care for People With Co­-Occurring Alcohol and Other Drug, Medical, and Mental Health Conditions. Alcohol Res Health. 2011;33(4):338-349.
  20. FDA. Medication Guide: Zubsolv Sublingual Tablet (CIII). July 2013.
  21. Kraus M, Alford D, Kotz M, et al. Statement of the American Society of Addiction Medicine Consensus Panel on the Use of Buprenorphine in Office-Based Treatment of Opioid Addiction. J Addict Med. 2011;5(4):254-263.
  22. Brands B, Blake J, Sproule B, et al. Prescription Opioid Abuse in Patients Presenting for Methadone Maintenance Treatment. Drug Alcohol Depend. 2004;73(2):199-207. PMID: 14725960.
  23. Moore B, Fiellin D, Barry D, et al. Primary Care Office-Based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients. J Gen Intern Med. 2007;22:527-530. PMCID: PMC1829433. PMID: 17372805.
  24. Nielsen S, Hillhouse M, Thomas C. A Comparison of Buprenorphine Taper Outcomes between Prescription Opioid and Heroin Users. J Addict Med. 2013;7(1):33-38. PMCID: PMC3567310. PMID: 23222095.
  25. Potter J, Marino E, Hillhouse M. Buprenorphine/Naloxone and Methadone Maintenance Treatment Outcomes for Opioid Analgesic, Heroin, and Combined Users: Findings from Starting Treatment with Agonist Replacement Therapies (START). J Stud Alcohol Drugs. 2013;74(4):605-613. PMCID: PMC3711351. PMID: 23739025.
  26. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.; 2020.
  27. Eggleston W, Clark K, Marraffa J. Loperamide abuse associated with cardiac dysrhythmia and death. Ann Emerg Med. 2016. doi:http://dx.doi.org/10.1016/j.annemergmed.2016.03.047.
  28. Kleber H, Weiss R, Anton R, et al. Practice guideline for the treatment of patients with substance use disorders. Vol 3rd edition. American Psychiatric Association; 2010.
  29. Renner J, Saxon A, Levounis P. Buprenorphine Update and Evolving Standards of Care. IPS: The Mental Health Services Conference. October 2015. New York City.
  30. Harned M, Sloan P. Safety Concerns with Long-Term Opioid Use. Expert Opin Drug Saf. 2016;15(7):955-962. PMID: 27070052.
  31. Marshall P. Physical Functional Ability Questionnaire (FAQ5). In: In: Assessment and Management of Chronic Pain. Vol 14. 5th edition. Institute for Clinical Systems Improvement; 2011:Appendix C:99.
  32. Erdemoglu A, Koc R. Brief Pain Inventory Score Identifying and Discriminating Neuropathic and Nociceptive Pain. Acta Neurol Scand. 2013;128(5):351-358. PMID: 23594114.
  33. Fishbain D, Cole B, Lewis J, et al. What Percentage of Chronic Nonmalignant Pain Patients Exposed to Chronic Opioid Analgesic Therapy Develop Abuse/Addiction and/or Aberrant Drug-Related Behaviors? A Structured Evidence-Based Review. Pain Med. 2008;9(4):444-459. PMID: 18489635.
  34. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  35. Reisfield GM, Maschke KJ. Urine Drug Testing in Long-Term Opioid Therapy: Ethical Considerations. Clin J Pain. August 2014;30(8):679-684. doi:10.1097/01.ajp.0000435448.34761.c9. PMID: 24281293.
  36. Gourlay D. Urine Drug Testing in Chronic Pain: A Patient Centered Approach (AMA) [webinar]. 2013.
  37. American Society of Addiction Medicine (ASAM). Drug Testing As A Component Of Addiction Treatment and Monitoring Programs and in Other Clinical Settings. ASAM.org. 2010.
  38. SAMHSA. Clinical Drug Testing in Primary Care. SAMHSA Website. 2012.
  39. Romano G, Barbera N, Spadaro G, et al. Determination of Drugs of Abuse in Hair: Evaluation of External Heroin Contamination and Risk of False Positives. Forensic Sci Int. 2003;131(2-3):98-102.
  40. Wu L, Woody G, Yang C, et al. Subtypes of Nonmedical Opioid Users: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend. 2010;112:69-80. PMCID: PMC2967592. PMID: 20580168.
  41. USPSTF. Unhealthy Alcohol Use in Adolescents and Adults, Including Pregnant Women: Screening and Behavioral Counseling Interventions – US Preventive Services Task Force. 2018.
  42. Hasin D, Liu X-H, Nunes E, et al. Effects of Major Depression on Remission and Relapse of Substance Dependence. Arch Gen Psychiatry. 2002;59:375-380.
  43. Fishman M, Wu L, Woody G. Buprenorphine for Prescription Opioid Addiction in a Patient With Depression and Alcohol Dependence. Am J Psychiatry. 2011;168(7):675-679. PMCID: PMC3178807. PMID: 21724673.
  44. Fiellin D, Rosenheck R, Kosten T. Office-Based Treatment for Opioid Dependence: Reaching New Patient Populations. Am J Psychiatry. 2001;158(8):1200-1204.
  45. Mee-Lee D. The ASAM Criteria. Vol 3rd edition. ASAM; 2013.
  46. McClellan A, McKay J. Components of successful addiction treatment. In: N: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, Eds. Principles of Addiction Medicine. Vol Third Edition. Chevy Chase, Md: American Society of Addiction Medicine; 2003:3.
  47. Stine S, Greenwald M, Kosten T. Pharmacologic interventions for opioid addiction. In: In: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, Eds. Principles of Addiction Medicine. Vol Third Edition. Chevy Chase, Md; 2003.
  48. Fishman M, Mee-Lee D, Schulman G, et al. Supplement to the ASAM Patient Placement Criteria on the Management of Alcohol Use Disorders. Baltimore, MD: Lippincott, Williams & Wilkins, Inc; 2010.
  49. VA/DoD. Management of Substance Use Disorder (SUD) (2015). VA/DoD. 2015.
  50. Jones H, Fischer G, Heil S. Maternal Opioid Treatment: Human Experimental Research (MOTHER) – approach, issues and lessons learned. Addiction. 2012;107:28-35.
  51. Hopfer C, Khuri E, Crowley T, et al. Adolescent Heroin Use: A Review of the Descriptive and Treatment Literature. J Subst Abuse Treat. 2002;23(3):231-237. PMID: 12392810.
  52. SAMHSA. Treatment of Adolescents With Substance Use Disorders. Treatment Improvement Protocol Series, No. 32. Rockville, Md: Center For Substance Abuse Treatment; 1999.
  53. Conigliaro J, Reyes C, Parran T, et al. Principles of screening and early intervention. In: In: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, Eds. Principles of Addiction Medicine. Vol Third Edition. Chevy Chase, Md: American Society of Addiction Medicine; 2003.
  54. CADCA. Comprehensive Addiction and Recovery Act (CARA). CADCA.org. 2016.
  55. Madras B, Wilson M, Avula D, et al. Screening, Brief Interventions, Referral to Treatment (SBIRT) for Illicit Drug and Alcohol Use at Multiple Healthcare Sites: Comparison at Intake and Six Months. Drug Alcohol Depend. 2010;99(1-3):280-295. PMCID: <a href=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC276

Understanding Opioid Medications and Buprenorphine Formulations References

  1. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  2. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  3. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  4. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  5. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  6. Trescot A, Datta S, Lee M, Hansen H. Opioid Pharmacology. Pain Physician. 2008;11(2 Suppl):S133-153.
  7. Williams J. Basic Opioid Pharmacology. Rev Pain. March 2008;1(2):2-5. doi:10.1177/204946370800100202. PMCID: PMC4589929. PMID: 26524987.
  8. Pathan H, Williams J. Basic Opioid Pharmacology: An Update. Br J Pain. February 2012;6(1):11-16. doi:10.1177/2049463712438493. PMCID: PMC4590096. PMID: 26516461.
  9. Substance Abuse and Mental Health Services Administration. Medications for Opioid Use Disorder. In: Vol Publication No. PEP20-02-01-006. Treatment Improvement Protocol (TIP). Rockville, MD: SAMHSA; 2020.
  10. Richardson MG, Raymond BL. Lack of Evidence for Ceiling Effect for Buprenorphine Analgesia in Humans. Anesth Analg. July 2018;127(1):310-311. doi:10.1213/ANE.0000000000003368. PMID: 29624528.
  11. Paulozzi L, Baldwin G. CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic. CDC Morb Mortal Wkly Rep. 2012;61(01):10-13.
  12. Rudd RA. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65. doi:10.15585/mmwr.mm655051e1.
  13. Dunn K, Saunders K, Rutter C, et al. Opioid Prescriptions for Chronic Pain and Overdose: A Cohort Study. Ann Intern Med. 2010;152(2):85-92. PMCID: PMC3000551. PMID: 20083827.
  14. American Psychiatric Association. Substance-Related and Addictive Disorders. APA. 2013.
  15. Kosten T, George T. The Neurobiology of Opioid Addiction: Implications for Treatment. NIDA Sci Pract Perspect. 2002;1(1):13-20. PMCID: PMC2851054. PMID: 18567959.
  16. Henry J. Metabolic Consequences of Drug Misuse. Br J Anaesth. 2000;85(1):136-142. PMID: 10928002.
  17. Volkow N. NIDA-supported science leads to first FDA-approved medication for opioid withdrawal. NIDA. 2018.
  18. FDA. FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults. 2018.
  19. National Drug Intelligence Center (NDIC). Intelligence Bulletin: Buprenorphine: Potential for Abuse. 2004.
  20. SAMHSA. Protracted withdrawal. SAMHSA Advis. 2010;9(1).
  21. Oreskovich M, Saxon A, Ellis M, et al. A Double-Blind, Double-Dummy, Randomized, Prospective Pilot Study of the Partial Mu Opiate Agonist, Buprenorphine, for Acute Detoxification from Heroin. Drug Alcohol Depend. 2005;77(1):71-79. PMID: 15607843.
  22. Amass L, Ling W, Freese T, et al. Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers: The NIDA Clinical Trials Network Field Experience. Am J Addict. 2004;13:Suppl 1: S42-66. PMCID: PMC1255908. PMID: 15204675.
  23. Kakko J, Svanborg K, Kreek M, et al. 1-Year Retention and Social Function after Buprenorphine-Assisted Relapse Prevention Treatment for Heroin Dependence in Sweden: A Randomised, Placebo-Controlled Trial. Lancet. 2003;361(9358):662-668. PMID: 12606177.
  24. 21 USC § 812. Schedules of controlled substances. 2012.
  25. Johnson R, Strain E, Amass L. Buprenorphine: How to Use It Right. Drug Alcohol Depend. 2003;70(suppl 2):S59-S77. PMID: 12738351.
  26. Mendelson J, Jones R. Clinical and Pharmacological Evaluation of Buprenorphine and Naloxone Combinations: Why the 4:1 Ratio for Treatment?. Drug Alcohol Depend. 2003;70(2S):S29-S37. PMID: 12738348.
  27. Walsh S. Clinically Relevant Pharmacology of Buprenorphine. 2009.
  28. Kahan M, Srivastava A, Ordean A, et al. Buprenorphine: New Treatment of Opioid Addiction in Primary Care. Can Fam Physician. 2011;57(3):281-289. PMCID: PMC3056674. PMID: 21402963.
  29. Renner J, Saxon A, Levounis P. Buprenorphine Update and Evolving Standards of Care. IPS: The Mental Health Services Conference. October 2015. New York City.
  30. Kissin W, McLeod C, Sonnefeld J, et al. Experiences of a National Sample of Qualified Addiction Specialists Who Have and Have Not Prescribed Buprenorphine for Opioid Dependence. J Addict Dis. 2006;25(4):91-103. PMID: 17088229.
  31. Alford D, Labelle C, Kretsch N, et al. Collaborative Care of Opioid-Addicted Patients in Primary Care Using Buprenorphine: Five-Year Experience. Arch Intern Med. 2011;171(5):425-431.
  32. Arfken C, Johanson C, di Menza S, et al. Expanding Treatment Capacity for Opioid Dependence with Office-Based Treatment with Buprenorphine: National Surveys of Physicians. J Subst Abuse Treat. 2010;39(2):96-104. PMID: 20598829.
  33. Mintzer I, Eisenberg M, Terra M, et al. Treating Opioid Addiction with Buprenorphine-Naloxone in Community-Based Primary Care Settings. Ann Fam Med. 2007;5(2):146-150. PMCID: PMC1838690. PMID: 17389539.
  34. FDA. FDA approves first buprenorphine implant for treatment of opioid dependence. FDA News Events. May 26, 2016.
  35. FDA. FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder. November 30, 2017.
  36. Labelle C, Han S, Bergeron A, et al. Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers. J Subst Abuse Treat. 2015;15. PMCID: PMC4682362. PMID: 26233698.
  37. FDA. Medication Guide: ButransTM CIII (buprenorphine) Transdermal System. 2010.
  38. Kraus M, Alford D, Kotz M, et al. Statement of the American Society of Addiction Medicine Consensus Panel on the Use of Buprenorphine in Office-Based Treatment of Opioid Addiction. J Addict Med. 2011;5(4):254-263.
  39. FDA. Bunavail prescribing information. 2014.
  40. Stanton A, McLoed C, Luckey B, et al. SAMHSA/CSAT Evaluation of the Buprenorphine Waiver Program. 37th Annual Medical- Scientific Conference of the American Society of Addiction Medicine. 2006.
  41. Dahan A, Yassen A, Romberg R, et al. Buprenorphine Induces Ceiling in Respiratory Depression but Not in Analgesia. Br J Anaesth. 2006;96(5):627-632. PMID: 16547090.
  42. Huestis M. High-dose buprenorphine in humans. In: In: Kintz P, Marquet P, Eds. Buprenorphine Therapy of Opiate Addiction. Vol Totowa, NJ: Humana Press, Inc; 2002.
  43. Chiang C, Hawks R. Pharmacokinetics of the Combination Tablet of Buprenorphine and Naloxone. Drug Alcohol Depend. 2003;70(suppl 2):S39-S47. PMID: 12738349.
  44. Tzschentke TM. Behavioral Pharmacology of Buprenorphine, with a Focus on Preclinical Models of Reward and Addiction. Psychopharmacology (Berl). April 2002;161(1):1-16. doi:10.1007/s00213-002-1003-8. PMID: 11967625.
  45. Donaher P, Welsh C. Managing Opioid Addiction with Buprenorphine. Am Fam Physician. 2006;73(9):1573-1578.
  46. SAMHSA. Substance Use Disorders. SAMHSA Website. 2014.
  47. Yokell M, Zaller N, Green T, et al. Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Curr Drug Abuse Rev. 2011;4:28-41. PMCID: PMC3154701. PMID: 21466501.
  48. Nasser A, Heidbreder C, Liu Y, et al. Pharmacokinetics of Sublingual Buprenorphine and Naloxone in Subjects with Mild to Severe Hepatic Impairment (Child-Pugh Classes A, B, and C), in Hepatitis C Virus-Seropositive Subjects, and in Healthy Volunteers. Clin Pharmacokinet. 2015;54(8):837-849. PMID: 25603822.
  49. Reckitt Benckiser Pharmaceuticals Inc. Suboxone Prescribing Information. 2014.
  50. Farney R, McDonald A, Boyle K, et al. Sleep Disordered Breathing in Patients Receiving Therapy with Buprenorphine/Naloxone. Eur Respir. 2013;42:394-403. PMID: 23100497.
  51. Lintzeris N, Clark N, Muhleisen P, et al. National Clinical Guidelines and Procedures for the Use of Buprenorphine in the Treatment of Heroin Dependence. 2001.
  52. Weiss R, Potter J, Fiellin D. Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence. Arch Gen Psychiatry. 2012;68(12):1238-1246. PMCID: PMC3470422. PMID: 22065255.
  53. Fiellin D, Schottenfeld R, Cutter C, et al. Primary Care-Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial. JAMA Intern Med. 2014;174(12):1947-1954.
  54. Dunn K, Sigmon S, Strain E. The Association between Outpatient Buprenorphine Detoxification Duration and Clinical Treatment Outcomes: A Review. Drug Alcohol Depend. 2011;119(1-2):1-9. PMCID: PMC3205338. PMID: 21741781.
  55. Kao M-C, Zheng P, Mackey S, et al. Trends in Benzodiazepine Prescription and Co-Prescription with Opioids in the United States, 2002––2009. AAPM Annual Meeting. July 2014.
  56. Maxwell J, McCance-Katz E. Indicators of Buprenorphine and Methadone Use and Abuse: What Do We Know?. Am J Addict. 2010;19(1):73-88. PMCID: PMC3723402. PMID: 20132124.
  57. ASAM. The ASAM National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use. June 1, 2015.
  58. Stein D, Isper J, Seedat S. Pharmacotherapy for Post Traumatic Stress Disorder (PTSD). Cochrane Database Syst Rev. 2006;1:CD002795. PMCID: PMC6993948. PMID: 16437445.
  59. Taylor F, Martin P, Thompson C, et al. Prazosin Effects on Objective Sleep Measures and Clinical Symptoms in Civilian Trauma Posttraumatic Stress Disorder: A Placebo-Controlled Study. Biol Psychiatry. 2008;63(6):629-632. PMCID: PMC2350188. PMID: 17868655.
  60. Drugs.com. Doxazosin. Drugs.com. January 6, 2000.
  61. McNicholas L. Buprenorphine: Induction, Dosing and Related Issues. American Psychiatric Association Sponsored Webinar; 2011.
  62. Food and Drug Administration (FDA). Buprenorphine-containing Transmucosal products for Opioid Dependence (BTOD) Risk Evaluation and Mitigation Strategy (REMS). Initial REMS / , updated 6/2015 2013.
  63. NIAAA. Alcohol Facts and Statistics. NIAAA. 2018.
  64. Saber-Tehrani A, Bruce R, Altice F. Pharmacokinetic Drug Interactions and Adverse Consequences between Psychotropic Medications and Pharmacotherapy for the Treatment of Opioid Dependence. Am J Drug Alcohol Abuse. 2011;37(1):1-11. PMID: 21247284.
  65. Guo A, Ma J, Best B, et al. Urine Specimen Detection of Concurrent Nonprescribed Medicinal and Illicit Drug Use in Patients Prescribed Buprenorphine. J Anal Toxicol. 2013;37(9):636-641. PMID: 24080973.
  66. NIH. National Trends. 2014.
  67. APA. Focus on Marijuana: Current Risks and Controversies. Am Psychiatr Assoc Webinar. 2012.
  68. Gruber V, McCance-Katz E. Methadone, Buprenorphine, and Street Drug Interactions with Antiretroviral Medications. Curr HIV/AIDS Rep. 2010;7(3):156-160. PMCID: PMC2892618. PMID: 20532839.
  69. McCance-Katz E, Moody D, Morse G, et al. Interaction between Buprenorphine and Atazanavir or Atazanavir/Ritonavir. Drug Alcohol Depend. 2007;91(2-3):269-278. PMCID: PMC3272856. PMID: 17643869.
  70. McCance-Katz E. Treatment of Opioid Dependence and Coinfection with HIV and Hepatitis C Virus in Opioid-Dependent Patients: The Importance of Drug Interactions between Opioids and Antiretroviral Agents. Clin Infect Dis. 2005;41(suppl 1):S89-95. PMID: 16265622.
  71. Saxon A, Ling W, Hillhouse M, et al. Buprenorphine/Naloxone and Methadone Effects on Laboratory Indices of Liver Health: A Randomized Trial. Drug Alcohol Depend. 2013;128:71-76. PMCID: PMC3543467. PMID: 22921476.
  72. Herve S, Riachi G, Noblet C, et al. Acute Hepatitis Due to Buprenorphine Administration. Eur J Gastroenterol Hepatol. 2004;16(10):1033-1037. PMID: 15371928.
  73. Durand F, Valla D. Assessment of Prognosis of Cirrhosis. Clin Pharmacokinet. 2008;28(1):110-122. PMID: 18293281.
  74. DailyMed. Buprenorphine and Naloxone- buprenorphine hydrochloride and naloxone hydrochloride tablet. DailyMed US Natl Libr Med. December 6, 2016.
  75. ASAM. Summary of the Comprehensive Addiction and Recovery Act. 2016.
  76. SAMHSA. Methadone. SAMHSA.gov. 2020.
  77. Mattick R, Breen C, Kimber J. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Libr. 2014.
  78. Borg L, Kreek M. The pharmacology of opioids. In: In: Graham AW, Schultz TK, Mayo-Smith MF, Ries RK, Wilford BB, Eds. Principles of Addiction Medicine. Vol 3. 3rd ed. Chevy Chase, Md: American Society of Addiction Medicine; 2003.
  79. Lee J, Friedmann P, Kinlock T, et al. Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders. N Engl J Med. 2016;374:1232-1242.
  80. PCSS. Vivitrol: How important is this piece of the treatment puzzle?. 2015.
  81. PCSS. XR-Naltrexone: A step-by-step guide. 2017.
  82. Substance Abuse and Mental Health Services Administration (US), Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington (DC): US Department of Health and Human Services; 2016. PMID: 28252892.
  83. SAMHSA. Decisions in Recovery. Treatment for Opioid Use Disorder.. 2017.
  84. Fudin J. A Brief Review of Buprenorphine Products. March 22, 2016.
  85. Breen C. There’s a New Buprenorphine on the Block | Dr. Jeffrey Fudin. PainDr. February 12, 2018.
  86. Strain E, Moody D, Stoller K, et al. Relative Bioavailability of Different Buprenorphine Formulations under Chronic Dosing Conditions. Drug Alcohol Depend. 2004;74(1):37-43. PMID: 15072805.
  87. Ling W, Casadonte P, Bigelow G. Buprenorphine Implants for Treatment of Opioid Dependence. JAMA. 2010;304(14):1576-1583. PMID: 20940383.
  88. Larance B, Lintzeris N, Dietze P, et al. The Diversion and Injection of a Buprenorphine-Naloxone Soluble Film Formulation. Drug Alcohol Depend. 2014;136:21-27.
  89. Rx List. Suboxone. Rx List Website. July 14, 2020.
  90. Sontag D. Addiction Treatment With a Dark Side. N Y Times. 2013.
  91. Orexo US Inc. Zubsolv prescribing information. October 2019.
  92. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  93. Dart R. Evaluation of ADFs Using RADARS System Data. 2011.
  94. Alho H, Sinclair D, Vuori E, et al. Abuse Liability of Buprenorphine-Naloxone Tablets in Untreated IV Drug Users. Drug Alcohol Depend. 2007;88(1):75-78. PMID: 17055191.
  95. Chen M, Beebe K. A randomized trial of Probuphine implants in adults stabilized on sublingual buprenorphine. American Society of Addiction Medicine (ASAM) Annual Meeting. 2016.
  96. Rosenthal R, Lofwall M, Kim S, et al. Effect of Buprenorphine Implants on Illicit Opioid Use among Abstinent Adults with Opioid Dependence Treated with Sublingual Buprenorphine. A Randomized Clinical Trial. JAMA. 2016;316:282-290.
  97. Sublocade. Medication Guide Sublocade (buprenorphine extended-release) injection, for subcutaneous use (CIII). November 2017.
  98. Medscape. Sublocade (buprenorphine, long-acting injection) dosing, indications, interactions, adverse effects, and more. 2018.
  99. American Society of Health-System Pharmacists. Buprenorphine Injection: MedlinePlus Drug Information. April 15, 2018.
  100. Reckitt Benckiser Pharmaceuticals Inc. Buprenex injectable – RX only – Schedule III. 2007.
  101. Belbuca. Belbuca HPC important safety information. www.belbuca.com. 2015.
  102. Purdue Pharma. Butrans – buprenorphine patch, extended release. 2019.
  103. Sullivan M, Gordon A. MAT training: Provider’s clinical support system for medication assisted treatment. 2013.

Prescribing for Pain with Care: 2 Patients

Russell Williams Case References

  1. Bates D, Schultheis BC, Hanes MC, et al. A Comprehensive Algorithm for Management of Neuropathic Pain. Pain Med. 01 2019;20(Suppl 1):S2-S12. PMCID: PMC6544553. PMID: 31152178.
  2. Brown RL, Rounds LA. conjoint screening questionnaires for alcohol and other drug abuse: Criterion validity in a primary care practice. Wis Med J. 1995; 94:135-140.
  3. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016; ePub: March 2016: DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er. Available at: http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm Accessed on: 2016-03-16.
  4. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9): 606-613.
  5. Marshall, PS. Physical Functional Ability Questionnaire (FAQ5). Institute for Clinical Systems Improvement. 2010; 14: Appendix B:63. Available at: https://www.icsi.org/_asset/bw798b/ChronicPain.pdf Accessed on: 2014-10-09.
  6. Qaseem A, Wilt TJ, Mclean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017. DOI: 10.7326/M16-2367. Available at: http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice Accessed 2017-07-03.
  7. Trelle S, Reichenbach S, Wandel S, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011; 342: c7086. Available at: http://www.bmj.com/content/342/bmj.c7086. Accessed on: 2016-02-03.
  8. Varga Z, Sabzwari SRA, Vargova V. Cardiovascular risk of non-steroidal anti-inflammatory drugs: an under-recognized public health issue. Cureus. 2017; 9(4): e1444. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422108/ Accessed on: 2018-05-08.

Olivia Burch Case References

  1. The American Geriatric Society. Pharmacological Management of Persistent Pain in Older Persons.
    2009. Available at: https://www.painbc.ca/sites/default/files/events/materials/AmericanGeriatricSociety-Guidelines2009.pdf
  2. Cleveland Clinic. When You Can’t Stomach NSAIDs. May 2015. https://www.arthritis-advisor.com/issues/14_5/features/When-You-Cant-Stomach-NSAIDs_1092-1.html
  3. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016; ePub: March 2016: DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er. Available at: http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
  4. Harvard Medical School. Heart Safer NSAID alternatives. Harvard Health Publishing. November 2015. https://www.health.harvard.edu/heart-health/heart-safer-nsaid-alternatives
  5. Mayo Clinic. Arthritis. 3/7/18 https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350777
  6. McAlindon T, Bannuru R, Sullivan M, et al. OARSI Guidelines for the Non-Surgical Management of Knee Osteoarthritis. Osteoarthritis Cartilage. 2014;22:363-388. http://dx.doi.org/http://dx.doi.org/10.1016/j.joca.2014.01.003 doi:http://dx.doi.org/10.1016/j.joca.2014.01.003.

Opioid Misuse Case References

  1. American Academy of Orthopedic Surgeons. Treatment of Osteoarthritis of the Knee 2nd edition. 2011; Available at: https://www.ncbi.nlm.nih.gov/pubmed/23996988 Accessed 02/14/2019.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC, American Psychiatric Association. 2013 page 541.
  3. PCSS-MAT/APA. Opioid use disorder diagnostic criteria. Reprinted from Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013) American Psychiatric Association. Available at: https://pcssnow.org/resource/opioid-use-disorder-opioid-addiction/ Accessed 02/14/2019.
  4. Babor TF, de la Fluente JF, Saunders J, Grant M. AUDIT: The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Generva, Switzerland: World Health Organization. 1992.
  5. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review. 1988; 8(1):77-100.
  6. Belgrade M, Schamber CD, Lindgren BR. The DIRE score. Predicting outcomes of opioid prescribing for chronic pain. The Journal of Pain. 2006; 7(9): 671-81. Available at: http://www.jpain.org/article/S1526-5900(06)00626-2/abstract. Accessed 02/14/2019.
  7. Briley M, Moret C. Treatment of comorbid pain with serotonin norepinephrine reuptake inhibitors. CNS Spectr. 2008; 13(7): 22-26.
  8. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016; ePub: March 2016: DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er. Available at: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm. Accessed 02/14/2019.
  9. FDA. Drug Safety and Availability – FDA Drug Safety Communication: FDA recommends against the continued use of propoxyphene. https://www.fda.gov/Drugs/DrugSafety/ucm234338.htm. Accessed 02/14/2019.
  10. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann. Rheum. Dis. 2000;16 (4): 494-502. Available at https://www.ncbi.nlm.nih.gov/pubmed/13498604. Accessed 02/14/2019.
  11. Krebs EE, Lorenz KA, Bair MJ. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009; 24(6): 733-738. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686775/ Accessed 02/14/2019.
  12. Kumar L, Barker C, Emmanuel A. Opioid-induced constipation: Pathophysiology, clinicial consequences, and management. Gastroenterology Research and Practice. 2014; 2014. Available at: https://www.hindawi.com/journals/grp/2014/141737/ Accessed 02/14/2019.
  13. Marshall, PS. Physical Functional Ability Questionnaire (FAQ5). In: Assessment and Management of Chronic Pain, 5th edition. Institute for Clinical Systems Improvement. 2011; 14: Appendix C:99. Available at: http://www.generationsprimarycare.com/assets/pain-contract.pdf Accessed 02/14/2019.
  14. Merrill JO, Von Korff M, Banta-Green CJ, et al. Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients. General Hospital Psychiatry. 2012; 34: 581-587. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22959422 Accessed 02/14/2019.
  15. Pani PP, Vacca R, Troqu E, Amato L, Davoli M. Pharmacological treatment for depression during opioid agonist treatment for opioid dependence. Cochrane Database of Systematic Reviews. 2010; 8(9): CD008373. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008373.pub2/abstract Accessed 02/14/2019.
  16. Passik SD, Kirsh KL, Casper D. Addiction-related assessment tools and pain management: instruments for screening, treatment planning and monitoring compliance. Pain Med. 2008; 9: S145-S166.
  17. Webster LR. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the opioid risk tool. Pain Medicine. 2005;6(6):432-442. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16336480 Accessed 02/14/2019.

Opioid Use Disorder and Medication Assisted Treatment References
  1. American Academy of Orthopedic Surgeons. Treatment of Osteoarthritis of the Knee 2nd edition. 2011; Available at: https://www.aaos.org/research/guidelines/OAKSummaryofRecommendations.pdf
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC, American Psychiatric Association. 2013 page 541.
  3. Babor TF, de la Fluente JF, Saunders J, Grant M. AUDIT: The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Geneva, Switzerland: World Health Organization. 1992.
  4. Bates D, Schultheis BC, Hanes MC, et al. <i>A Comprehensive Algorithm for Management of Neuropathic Pain</i>. <i>Pain Med</i>. 01 2019;20(Suppl 1):S2-S12. PMCID: PMC6544553</a>. PMID: 31152178</a>.
  5. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review. 1988; 8(1):77-100.
  6. Belgrade M, Schamber CD, Lindgren BR. The DIRE score. Predicting outcomes of opioid prescribing for chronic pain. The Journal of Pain. 2006; 7(9): 671-81. Available at: http://www.jpain.org/article/S1526-5900(06)00626-2/abstract. Accessed on: 2017-04-10.
  7. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016; ePub: March 2016: DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er. Available at: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm. Accessed on: 2017-04-10.
  8. FDA. Drug Safety and Availability – FDA Drug Safety Communication: FDA recommends against the continued use of propoxyphene. https://www.fda.gov/Drugs/DrugSafety/ucm234338.htm. Accessed April 7, 2017.
  9. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website http://www.fsmb.org. 2013. Available at: https://www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/2013_model_policy_treatment_opioid_addiction.pdf Accessed on: 2017-05-23.
  10. HHS. HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. September 2019. https://www.hhs.gov/opioids/sites/default/files/2019-10/Dosage_Reduction_Discontinuation.pdf
  11. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann. Rheum. Dis. 2000;16 (4): 494-502. Available at https://www.ncbi.nlm.nih.gov/pubmed/13498604. Accessed 5/29/2017.
  12. Kraus ML, Alford DP, Kotz MM, et al. Statement of the American Society of Addiction Medicine Consensus Panel on the Use of Buprenorphine in Office-Based Treatment of Opioid Addiction.. Journal of Addiction Medicine. 2011; 5(4): 254-263. Available at: http://www.asam.org/docs/advocacy/use-of-buprenorphine-in-office-based-treatment-of-opioid-addiction.pdf Accessed on: 2017-05-23.
  13. Krebs EE, Lorenz KA, Bair MJ. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009; 24(6): 733-738. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686775/ Accessed on: 2017-04-10.
  14. Kumar L, Barker C, Emmanuel A. Opioid-induced constipation: Pathophysiology, clinical consequences, and management. Gastroenterology Research and Practice. 2014; 2014. Available at: https://www.hindawi.com/journals/grp/2014/141737/.
  15. Marshall, PS. Physical Functional Ability Questionnaire (FAQ5). In: Assessment and Management of Chronic Pain, 5th edition. Institute for Clinical Systems Improvement. 2011; 14: Appendix C:99. Available at: http://www.generationsprimarycare.com/assets/pain-contract.pdf Accessed on: 2017-04-10.
  16. Merrill JO, Von Korff M, Banta-Green CJ, et al. Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients. General Hospital Psychiatry. 2012; 34: 581-587. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22959422 Accessed on: 2017-04-17.
  17. Pani PP, Vacca R, Troqu E, Amato L, Davoli M. Pharmacological treatment for depression during opioid agonist treatment for opioid dependence. Cochrane Database of Systematic Reviews. 2010; 8(9): CD008373. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008373.pub2/abstract Accessed on: 2017-04-10.
  18. Passik SD, Kirsh KL, Whitcomb, et al. A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy. 2004. Clin Ther.; 26(4):552-61. https://www-ncbi-nlm-nih-gov.libproxy.lib.unc.edu/pubmed/15189752 PMID: 15189752
  19. PCSS-MAT/APA. Opioid use disorder diagnostic criteria. Reprinted from Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013) American Psychiatric Association. Available at: http://pcssmat.org/wp-content/uploads/2014/02/5B-DSM-5-Opioid-Use-Disorder-Diagnostic-Criteria.pdf Accessed on: 2017-04-10.
  20. SAMHSA. “Buprenorphine.” Text. SAMHSA, updated 4/27/2021. https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
  21. Substance Abuse and Mental Health Services Administration. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Advisory. Winter 2016; 15 (1): . Available at: http://store.samhsa.gov/shin/content//SMA16-4938/SMA16-4938.pdf Accessed on: 2016-03-05.
  22. Substance Abuse and Mental Health Services Administration. What Individuals in Recovery Need to Know About Wellness. 2016: Available at: http://store.samhsa.gov/shin/content//SMA16-4950/SMA16-4950.pdf Accessed on: 2016-08-30.
  23. Sheng J, Liu S, Wang Y, Cui R, Zhang X. The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural Plast. 2017;2017. PMCID: PMC5494581. PMID: 2
  24. Webster LR. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the opioid risk tool. Pain Medicine. 2005;6(6):432-442. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16336480. Accessed on: 2017-04-10.
  25. Weiss RD, Potter JS, Fiellin DA, Byrne M, Connery HS, Dickinson W, Gardin J, Griffin ML, Gourevitch MN, Haller DL, Hasson HL, Huang Z, Jacobs P, Kosinski AS, Lindblad R, McCance-Katz EF, Provost SE, Selzer J, Somoza EC, Sonne SC, Ling W. Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence. Arch Gen Psychiatry. 2012; 68(12): 1238-1246. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470422/ Accessed on: 2017-05-23.

Opioids and Acute Pain References

  1. Chou R, Fanciullo G, Fine P, et al. Clinical guidelines for the use of chronic opioid therapy in chronic non-cancer pain. J Pain. 2009; 10(2): 113-130. Available at: http://www.jpain.org/article/S1526-5900(08)00831-6/abstract Accessed 02/13/2019.
  2. Dumitrascu CD, Mannes PZ, Gamble LJ, Selzer JA. Substance use among physicians and medical students. MSRJ. 2014: 03 (Winter): 26-35. Available at: http://msrj.chm.msu.edu/wp-content/uploads/2014/04/MSRJ-Winter-2014-Substance-Use-Among-Physicians-and-Medical-Students.pdf Accessed 02/13/2019.
  3. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016; ePub: March 2016: DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er. Available at: http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm?s_cid=rr6501e1er_w Accessed 02/13/2019.
  4. Drug Enforcement Administration. State Prescription Drug Monitoring Programs. U.S. Department of Justice. 2011. Available at: http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm Accessed 02/13/2019.
  5. Jackson ER, Shanafelt TD, Hasan O, Satele DV, Dyrbye LN. Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students. Acad Med. 2016. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26934693 Accessed on: 2016-03-31.

Buprenorphine Treatment Structure References
  1. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  2. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  3. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  4. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  5. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  6. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  7. Öhlin L, Fridell M, Nyhlén A. Buprenorphine maintenance program with contracted work/education and low tolerance for non-prescribed drug use: a cohort study of outcome for women and men after seven years. BMC Psychiatry. March 24, 2015;15(56).
  8. Chou R, Fanciullo GJ, Fine PG, et al. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. J Pain Off J Am Pain Soc. February 2009;10(2):113-130. doi:10.1016/j.jpain.2008.10.008. PMCID: PMC4043401. PMID: 19187889.
  9. CDC. Prescription Drug Monitoring Programs (PDMPs) | Drug Overdose. June 10, 2020.
  10. Dowell D, Haegerich T, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. 2016;65(1):1-49. doi:10.15585/mmwr.rr6501e1er.
  11. U.S. House of Representatives. Comprehensive Addiction and Recovery Act of 2016. docs.house.gov. 2016

Induction – Initiating Buprenorphine Treatment References

  1. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  2. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  3. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  4. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  5. Food and Drug Administration (FDA). Appropriate Use Checklist. http://btodrems.com/. 2020.
  6. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  7. Gunderson E. Models of Buprenorphine Induction. PCSSMAT Train. 2014.
  8. McNicholas L. Buprenorphine: Induction, Dosing and Related Issues. American Psychiatric Association Sponsored Webinar; 2011.
  9. Indivior Inc. Suboxone Highlights of Prescribing Information. http://www.suboxone.com/. December 2016.
  10. Labelle C, Han S, Bergeron A, et al. Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers. J Subst Abuse Treat. 2015;15. PMCID: PMC4682362. PMID: 26233698.
  11. Orexo US Inc. Zubsolv prescribing information. October 2019.
  12. Alford D, Labelle C, Richardson J, et al. Treating Homeless Opioid Dependent Patients with Buprenorphine in an Office-Based Setting. Soc Gen Intern Med. 2007;22:171-176. PMCID: PMC1824722. PMID: 17356982.
  13. Lee J, Grossman E, DiRocco D, et al. Home Buprenorphine/Naloxone Induction in Primary Care. J Gen Intern Med. 2009;24(2):226-232.
  14. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  15. Kraus M, Alford D, Kotz M, et al. Statement of the American Society of Addiction Medicine Consensus Panel on the Use of Buprenorphine in Office-Based Treatment of Opioid Addiction. J Addict Med. 2011;5(4):254-263.
  16. Casadonte P. PCSS Guidance: Buprenorphine Induction. Physician Clin Support Syst Website. 2009.
  17. Johanson C, Arfken C, DiMenza S, et al. Diversion and Abuse of Buprenorphine: Findings from National Surveys of Treatment Patients and Physicians. Drug Alcohol Depend. 2012;120(1-3):190-195. PMID: 21862241.
  18. Lofwall M, Havens J. Inability to access buprenorphine treatment as a risk factor for using diverted buprenorphine. Drug Alcohol Depen. 2012;Jun 13 [Epub ahead of print].
  19. Wish E, Artigiani D, Billing A, et al. The Emerging Buprenorphine Epidemic in the United States. J Addict Dis. 2012;31(1):3-7. PMID: 22356664.
  20. Farmer CM, Lindsay D, Williams J, et al. Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process. Subst Abuse. 2015;36(2):209-216. doi:10.1080/08897077.2015.1012613. PMCID: PMC4470850. PMID: 25844527.
  21. Lintzeris N, Clark N, Muhleisen P, et al. National Clinical Guidelines and Procedures for the Use of Buprenorphine in the Treatment of Heroin Dependence. 2001.

Maintenance and Discontinuation References

  1. Weiss R, Potter J, Griffin M, et al. Long-term outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study. Drug Alcohol Depend. 2015. PMCID: PMC4407806. PMID: 25818060.
  2. Ling W, Hillhouse M, Domier C, et al. Buprenorphine Tapering Schedule and Illicit Opioid Use. Addiction. 2009;104(2):256-265. PMCID: PMC3150159. PMID: 19149822.
  3. SAMHSA. Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update. Winter 2016.
  4. ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.
  5. SAMHSA/CSAT. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. 2004. PMID: 22514846.
  6. FSMB. Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office. FSMB Website. 2013.
  7. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: A Rapid Review. J Gen Intern Med. December 2020;35(Suppl 3):954-963. doi:10.1007/s11606-020-06257-4. PMCID: PMC7728943. PMID: 33145687.
  8. McNicholas L. Buprenorphine: Induction, Dosing and Related Issues. American Psychiatric Association Sponsored Webinar; 2011.
  9. Kosten T, George T. The Neurobiology of Opioid Addiction: Implications for Treatment. NIDA Sci Pract Perspect. 2002;1(1):13-20. PMCID: PMC2851054. PMID: 18567959.
  10. Fiellin D, Schottenfeld R, Cutter C, et al. Primary Care-Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial. JAMA Intern Med. 2014;174(12):1947-1954.
  11. Weiss R, Potter J, Fiellin D. Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence. Arch Gen Psychiatry. 2012;68(12):1238-1246. PMCID: PMC3470422. PMID: 22065255.
  12. FDA. FDA approves first buprenorphine implant for treatment of opioid dependence. FDA News Events. May 26, 2016.
  13. ASAM. The ASAM National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use. June 1, 2015.
  14. Kraus M, Alford D, Kotz M, et al. Statement of the American Society of Addiction Medicine Consensus Panel on the Use of Buprenorphine in Office-Based Treatment of Opioid Addiction. J Addict Med. 2011;5(4):254-263.
  15. Substance Abuse and Mental Health Services Administration (SAMHSA). About Buprenorphine Therapy. 2011.
  16. Farmer C, Lindsay D, Williams J, et al. Practice Guidelines for Burprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process. 2015;36(2).
  17. NIDA. Principles of drug addiction treatment: A research-based guide (Third Edition_. January 2018.
  18. USDHHS. Medication Assisted Treatment for Opioid Use Disorders Reporting Requirements. 2016.
  19. Emrick CD. Alcoholics Anonymous and Other 12-Step Groups. Textb Subst Abuse Treat. 1999:403-411.
  20. ASAM. 2020 National Practice Guideline. Am Soc Addict Med. 2020.
  21. Raouf M, Bettinger JJ, Fudin J. A Practical Guide to Urine Drug Monitoring. Fed Pract. April 2018;35(4):38-44. PMCID: PMC6368048. PMID: 30766353.
  22. Gourlay D, Heit H, Caplan Y. Urine Drug Testing in Clinical Practice: The Art and Science of Patient Care. Johns Hopkins Med. 2012;5.
  23. FDA. CLIA – Clinical laboratory improvement amendments – currently waived analytes. 2021.
  24. Christo P, Manchikanti L, Ruan X, et al. Urine Drug Testing In Chronic Pain. Pain Physician. 2011;14:123-143. PMID: 21412368.
  25. TransMed. CLIA Screen In-Vitro (CSI) 12-Panel Drug Test Screening Cup CLIA Waived. TransMed Drug Test Lab Supplies. 2018.
  26. Finch J, Kamien J, Amass L. Two-Year Experience with Buprenorphine-Naloxone (Suboxone) for Maintenance Treatment of Opioid Dependence within a Private Practice Setting. J Addict Med. 2014;1(2):104-110. PMID: 21768942.
  27. Nixon LL, Marlinga JC, Hayden KA, Mrklas KJ. Barriers and Facilitators to Office-Based Opioid Agonist Therapy Prescribing and Effective Interventions to Increase Provider Prescribing: Protocol for a Systematic Review. Syst Rev. July 25, 2019;8(1):186. doi:10.1186/s13643-019-1076-7. PMCID: PMC6657163. PMID: 31345258.
  28. Soyka M. Buprenorphine and Buprenorphine/Naloxone Intoxication in Children — How Strong Is the Risk?. Curr Drug Abuse Rev. 2013;6(1):63-70.
  29. Drug Enforcement Administration (DEA). Buprenorphine. 2019.
  30. SAMHSA Press Office. Sharp rise in buprenorphine-related emergency department visits from 2005 to 2010. 2013.
  31. Martin T, Rocque M. Accidental and Non-Accidental Ingestion of Methadone and Buprenorphine in Childhood: A Single Center Experience, 1999-2009. Curr Drug Saf. 2009;6:12-16.
  32. Indivior Inc. Suboxone Highlights of Prescribing Information. http://www.suboxone.com/. December 2016.
  33. Food and Drug Administration (FDA). Buprenorphine-containing Transmucosal products for Opioid Dependence (BTOD) Risk Evaluation and Mitigation Strategy (REMS). Initial REMS / , updated 6/2015 2013.
  34. FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. US Food Drug Adm Cent Drug Eval Res. August 31, 2016.
  35. FDA Drug Safety Communication: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks. US Food Drug Adm Cent Drug Eval Res. September 20, 2017.
  36. Wartenberg A. Management of Buprenorphine Side Effects. 2013.
  37. RxList. Oxazepam (Oxazepam Tablets): Side Effects, Interactions, Warning, Dosage & Uses. RxList. 2017.
  38. RxList. Ativan (Lorazepam): Side Effects, Interactions, Warning, Dosage & Uses. RxList. 2017.
  39. RxList. Diazepam (Diazepam Tablets): Side Effects, Interactions, Warning, Dosage & Uses. RxList. 2017.
  40. Drugs.com. Naloxone. Drugs.com. January 6, 2021.
  41. Irwin R, Rippe J. Irwin and Rippe’s Intensive Care Medicine. Lippincott Williams & Wilkins; 2012.
  42. BMJ. Benzodiazepine overdose. 2017.
  43. SAMHSA. Opioid Overdose Prevention Toolkit | SAMHSA Publications. SAMHSA. June 2018.
  44. Morasco B, Cavanagh R, Gritzner S, et al. Care Management Practices for Chronic Pain in Veterans Prescribed High Doses of Opioid Medications. Farm Pract. 2013;6:671-678. PMCID: PMC2972371. PMID: 20801580.
  45. Jones H, Fischer G, Heil S. Maternal Opioid Treatment: Human Experimental Research (MOTHER) – Approach, Issues and Lessons Learned. Addiction. 2012;107:28-35.
  46. Daitch D, Daitch J, Novinson D, et al. Conversion from High-Dose Full-Opioid Agonists to Sublingual Buprenorphine Reduces Pain Scores and Improves Quality of Life for Chronic Pain Patients. Pain Med. 2014;15(12):2087-2094. PMID: 25220043.
  47. Waknine Y. FDA Approves 7-Day Buprenorphine Pain Patch. 2010.
  48. FDA. Medication Guide: ButransTM CIII (buprenorphine) Transdermal System. 2010.
  49. Purdue Pharma. Butrans – buprenorphine patch, extended release. 2019.
  50. Davis M. Twelve reasons for considering buprenorphine as a frontline analgesic in the management of pain. SupportiveOncology.net. 2012.
  51. Fiellin D. Treatment of acute pain in patients receiving buprenorphine/naloxone. March 9, 2014.
  52. Alford D, Labelle C, Kretsch N, et al. Collaborative Care of Opioid-Addicted Patients in Primary Care Using Buprenorphine: Five-Year Experience. Arch Intern Med. 2011;171(5):425-431.
  53. Alford D, Compton P, Samet J. Acute Pain Management for Patients Receiving Maintenance Methadone or Buprenorphine Therapy. Ann Intern Med. 2006;144(2):127-134. PMCID: PMC1892816. PMID: 16418412.
  54. Stephenson D, SAM Committee on Treatment of Opioid Dependence. Guidelines for Physicians Working in California Opioid Treatment Programs. 2008.
  55. Weiss RD, Potter JS, Copersino ML, et al. Conducting Clinical Research with Prescription Opioid Dependence: Defining the Population. Am J Addict. April 2010;19(2):141-146. doi:10.1111/j.1521-0391.2009.00017.x. PMCID: PMC2852106. PMID: 20163386.
  56. VA/DoD. Management of Substance Use Disorder (SUD) (2015) – VA/DoD Clinical Practice Guidelines. 2015.
  57. Melemis S. Relapse Prevention and the Five Rules of Recovery. Yale J Biol Med. 2015;88:3. PMCID: PMC4553654. PMID: 26339217.
  58. Department of Veterans Affairs, Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders Stabilization Pocket Card. 2015.
  59. Nielsen S, Hillhouse M, Thomas C. A Comparison of Buprenorphine Taper Outcomes between Prescription Opioid and Heroin Users. J Addict Med. 2013;7(1):33-38. PMCID: PMC3567310. PMID: 23222095.
  60. Dunn K, Sigmon S, Strain E. The Association between Outpatient Buprenorphine Detoxification Duration and Clinical Treatment Outcomes: A Review. Drug Alcohol Depend. 2011;119(1-2):1-9. PMCID: PMC3205338. PMID: 21741781.
Buprenorphine Practice Gaps

Professional practice gaps exist when there is a disparity between educational needs and the ideal or desired level of knowledge, competence, and performance. Despite demonstrated effectiveness of buprenorphine (SAMHSA, 2020), only around 95,000 providers prescribe buprenorphine for office-based treatment of opioid use disorder, which is a small percentage considering that the pool of potential prescribers is well over a million (SAMHSA, 2021). Physicians, nurse practitioners, and physician assistants are likely to encounter patients having this disorder due to the size of the opioid epidemic:

  • 9.5 million people (3.4%) aged 12 or older engaged in misuse of opioids in 2020 (SAMHSA, 2021a). 
  • Many people who need treatment are still not receiving it; in 2019 only 18.1% of those needing it received medication-assisted treatment for opioid use disorder (SAMHSA, 2020a).
  • Practitioners having a DEA registration to prescribe controlled substances can prescribe buprenorphine for opioid use disorder and detoxification (HHS, 2021). Federal law requires practitioners wishing to see more than 30 patients to complete an 8-hour certification training in order to prescribe buprenorphine (SAMHSA, 2020b; HHS, 2021).
  • This training is intended for practitioners who are not required to complete a certification training for a waiver and others who wish to refresh skills or learn more about buprenorphine.

Buprenorphine is a safe and effective treatment for opioid use disorder. Until the exemption for practitioners with DEA registration announced on April 28, 2021 (HHS, 2021), 8 hours of training by an approved organization was required by law in order to prescribe it (SAMHSA, 2020b). Providing information on all aspects of buprenorphine treatment will help address this knowledge need. Moreover, buprenorphine treatment has a protocol for successful outcomes and to minimize risks of overdose, death, and diversion (ASAM, 2020), which validates a need for training for many providers. New, extended-release formulations of buprenorphine have been released over the past several years, resulting in the need to learn new clinic protocols and understanding of patient needs (Compton & Volkow, 2021).

Understanding of clinical protocol and how to apply it will help address this competence need. Experience with interactive case scenarios helps address the performance need of translating competence in following the protocol into actual practice. 

Practice Gap References

ASAM. The ASAM National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update. 2020.

Compton W & Volkow N. Extended-Release Buprenorphine and Its Evaluation With Patient-Reported Outcomes. JAMA Netw Open. 2021;4(5):e219708. doi:10.1001/jamanetworkopen.2021.9708

Health and Human Services Department. Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. Fed Regist. April 28, 2021.

Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.; 2020a.

Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.; 2021a.

SAMHSA. Buprenorphine. October 7, 2020b.

SAMHSA. Practitioner and Program Data. SAMHSA.gov. 2021b.

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