Prescribing Buprenorphine: What is the Role and Risk of Monoproduct in Maintenance Therapy of Opioid Use Disorder (OUD)?
Is monoproduct (buprenorphine) truly lower risk than combination (buprenorphine-naloxone) therapy and if so, how much? What should a provider do with patients who report adverse effects of buprenorphine/naloxone? This session will review evidence to understand the risk of monoproduct compared to combination product when used for maintenance of opioid use disorder (OUD). With this evidence as background, we will discuss recommendations for clinical decisions about prescribing monoproduct for OUD.
Learning Objectives:
- Recognize the evidence that characterizes mono versus combination product risk
- Describe factors that mitigate risk of buprenorphine misuse and diversion including treatment access, choice of combination vs monoproduct, injectable buprenorphine, clinical monitoring
- Articulate indications for monoproduct prescribing and their likely frequency
Continuing Medical Education
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 Maine Medical Education Trust and CCSME. The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.
The Maine Medical Education Trust 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 I contact hours for psychologists. CCSME is a pre-approved sponsor and provider of Professional Education Activities for Psychologists.
1 contact hours for Alcohol and Drug Counselors pending approval by the Maine Board of Alcohol and Drug Counselors
1 contact hours CHES. CCSME is a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc.
Speakers
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Andrea Truncali MD MPHMD, MPHAndrea Truncali, MD, MPH is a board-certified physician in both Internal and Addiction Medicine, and an Assistant Professor of Medicine at Tufts University. She completed medical school and residency at New York University, followed by further training in preventive medicine and public health. In pursuit of improving the health and well-being of underserved people, Dr Truncali takes care of patients in specialty substance use treatment as well as primary care settings, provides education and guidance to physicians on the topic of substance use disorder, and contributes to activities at the state level regarding substance use prevention and treatment.
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Stephanie Vail PharmD BCPP MPH FCCP FAAPPStephanie Vail, PharmD, MPH, BCPP, FCCP, FAAPP is a Professor in the University of New England School of Pharmacy, Adjunct Clinical Assistant Professor of Psychiatry in the Tufts University School of Medicine, Core Faculty in the Maine Medical Center (MMC) Addiction Medicine Fellowship Program, and an Instructor in the MMC Psychiatry Residency Program. She is a Board-Certified Psychiatric Pharmacist (BCPP) with 20 years’ experience providing direct patient care and interprofessional teaching, including clinical precepting for over 200 pharmacy and medical students, residents, and fellows on the MMC psychiatry consult-liaison and addiction medicine services. She has been inducted as a Fellow of the American College of Clinical Pharmacists (FCCP) and the American Association of Psychiatric Pharmacists (FAAPP), and has co-authored over 40 publications in journals including Journal of Addiction Medicine, Pharmacotherapy, Current Psychiatry, Journal of Psychopharmacology, and Journal of Studies on Alcohol and Drugs. Outside of work, she enjoys spending time with her pups: Sage, Basil, & Penny, and being among trees. She also enjoys the ocean, yoga, reading non-fiction, gardening, watercolor painting, visiting lighthouses, and looking at the sky.
