BUPRENORPHINE TRAINING 2.0: NEXT STEPS AFTER WAIVER

Abstract

Multiple barriers exist to prescribe buprenorphine effectively and widely for adolescents and young adults with opioid use disorder (OUD), including limited clinical time, insufficient office support, low reimbursement, and concern about medication diversion, resulting in many waivered physicians never prescribing buprenorphine or only prescribing it to a small number of patients. Physicians working with adolescents with OUD who may want to prescribe buprenorphine may feel uncomfortable or ill-equipped to handle the complexities and challenges that come with managing patients with a substance use disorder. This presentation is geared toward physicians who have already completed their waiver training and want to take the next steps to begin prescribing buprenorphine to their patients. This presentation will use simulated case-study examples, small group discussion, and an audience poll to identify challenges and problem-solve ways to mitigate barriers when working with individuals with OUD. Diana Deister, MD, will provide an overview of a typical treatment plan for a youth with an OUD who is prescribed buprenorphine that looks to demystify the complexities of managing patients with OUD. Peter Jackson, MD, will review the pros and cons of different buprenorphine induction strategies to successfully start patients on buprenorphine. Paul Glaser, MD, PhD, will review common challenges in longer term clinical management of youth with OUD, including frequency of contact and patients with concurrent use of illicit substances. Nihit Kumar, MD, will present considerations when patients request to stop buprenorphine treatment, including strategies for successfully tapering off buprenorphine. Finally, Matthew LaCasse, DO, and Brady Heward, MD, will act as discussants to strengthen the understanding of critical concepts when it comes to prescribing buprenorphine, and identify barriers to prescribing in youth with OUD. Medications for OUD including buprenorphine are evidence-based and lifesaving and should be combined with ongoing psychosocial treatments. With the availability of effective treatments to mitigate the effects of the worsening opioid epidemic, physicians should feel empowered and be willing to use buprenorphine as a standard of care when treating adolescents with OUD.