• Explain the rationale and core principles of low-dose buprenorphine initiation, highlighting its pharmacologic basis and advantages over traditional induction methods in patients using fentanyl, methadone, and other opioids.
• Compare and contrast low-dose initiation protocols across diverse clinical settings, including outpatient care, ASAM Level 3.7 withdrawal management, and inpatient hospital environments.
• Identify practical strategies for implementation, including patient selection, counseling approaches, monitoring processes, and interprofessional collaboration among prescribers, pharmacists, and behavioral health clinicians.
• Discuss the role of adjunctive medications in optimizing patient comfort, safety, and outcomes during low-dose buprenorphine initiation.

Rachel Solotaroff, MD, is the Executive Clinical Director of Substance Use Disorder Services at Penobscot Community Health Care, where she provides patient care, oversees substance use disorders care delivery in the outpatient setting, and providing medical direction for withdrawal management at New Horizons. Prior to moving to Maine, Rachel served as Chief Medical Officer and then CEO at Central City Concern in Portland, Oregon. Rachel’s interest lies in using a population health framework to address the complex intersection of homelessness and substance use disorders, often accompanied by trauma, social isolation, and mental illness. Rachel is a general internist with additional board certification in Addiction Medicine and holds a Masters in Clinical Research.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Hanley Center for Health Leadership and Education and CCSME. The Hanley Center for Health Leadership and Education is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

The Hanley Center for Health Leadership and Education designates this regularly scheduled series for a maximum of 1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

*Nurses and Nurse Practitioners will be awarded a certificate of participation with a maximum of 1 AMA PRA Category 1 Credit ™.

• Contact Hours 1 contact hours for social workers, licensed clinical professional counselors, and behavioral health professionals.
• 1 Category 1 Contact hours for psychologists. CCSME is a pre-approved sponsor and provider of Professional Education Activities for Psychologists.
• 1 contract hours CHES. CCSME is a designated provider of continuing education contact hours (CECH) in health education by the National Commission of Health Education Credentialing, Inc.
• 1 contact hours for Alcohol and Drug Counselors pending approval by the Maine Board of Alcohol and Drug Counselors

This course has been approved by Co-Occurring Collaborative Serving Maine (CCSME), as a NAADAC Approved Education Provider, for 1 educational credits. NAADAC Provider #324712, CCSME is responsible for all aspects of the programming.

This course qualifies for 1 credits of the 3 CME credit requirement for opioid medication education found in P.L. 2015, Chapter 488, Maine’s legislation to address the opioid drug crisis.

This course is self-paced and the estimated time to complete is approximately 60 minutes. In addition to viewing a 50-minute video presentation, learners must earn a score of 80% or higher on a post-assessment and complete the post evaluation to receive contact hours or CME credits for completing the course. Supplemental course materials (i.e. pdf of slides) are also provided.

The Hanley Center for Health Leadership and Education designates this regularly scheduled series for a maximum of 1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This course qualifies for 1 credits of the 3 CME credit requirement for opioid medication education found in P.L. 2015, Chapter 488, Maine’s legislation to address the opioid drug crisis.

• Estimated Time to Complete: 60 minutes (includes viewing recording, and completing both the quiz and evaluation)
• Registration Fee: FREE for Maine Clinicians
• CME Credits Offered: 1

• Computer with Internet connection.
• Current version of Chrome, Firefox or Safari browser.
• You must have javascript enabled.
• The quiz tools thin the online modules are not fully compatible with smartphones or tablets. In order to avoid issues, such as answers not being recorded, we recommend using a computer to complete the pre- and post-tests.

At the end of the course, there is a post-test, and you will have as many attempts as needed to earn a grade of 80% or higher to receive contact hours or CME credit. The survey to evaluate the course at the conclusion is also required to receive credit.