Arizona Opioid Essentials of MAT and Live Waiver Training 2018

Jointly Provided by American Psychiatric Association

and the Arizona Psychiatric Society

in conjunction with

Arizona Society of Addiction Medicine

Additional funding provided by the Arizona Psychiatric Society through an expedited grant from the American Psychiatric Association and facilities use and audio-visual support from the Department of Psychiatry, University of Arizona College of Medicine, Phoenix and facilities use and audio-visual support for the Session 1 remote broadcast provided by Flagstaff Medical Center and the Department of Psychiatry, University of Arizona College of Medicine, Tucson.

AGENDA

Welcome and Introduction
James B. McLoone, MD, DLFAPA,
Professor and Chair of Department of Psychiatry, University of Arizona College of Medicine – Phoenix; and
Monica G. Faria, MD, President, Arizona Society of Addiction Medicine (AzSAM), and Conference Moderator
7:50 to 8:00 am

Current State of the Opioid Crisis in Arizona
Shana Malone, MS
Clinical Initiatives Project Manager, Arizona Healthcare Cost Containment System (AHCCCS) – Office of the Director
8:00 to 9:00 am

Opioid Crisis: Identifying My Role as a Community Provider
Simon Olstein, MD, FASAM
Medical Director, Scottsdale Treatment, Inc. and Secretary of the Board of Directors, AzSAM
9:00 to 10:00 am

Morning Break
10:00 to 10:15 am

Opioids in Arizona – Approaches to Treatment
Leonard F. Ditmanson, MD, FACP
Medical Director, 5th Street Clinic, MAT Medical Director, ConnectionsAZ, Tucson, Arizona
10:15 to 11:15 am

Panel: Interdisciplinary Issues in Coordination of and Transitioning Levels of Care (Case Study with Perinatal Considerations (see below))

Panel Members:

Monica G. Faria, MD, Facilitator;
Michael Dekker, DO, Addiction Psychiatrist;
Christopher Luke Peterson, DO, Family Medicine, Banner Health;
Maria Manriquez, MD, FACOG, Interim Associate Dean, Clinical Curriculum Professor, Department of Obstetrics and Gynecology Director, Pathway Scholars Program, University of Arizona College of Medicine, Phoenix;
Elena Volfson, MD, Addiction Psychiatrist, Mayo Clinic Arizona; and
Case Study Developed by:
Edwin Kim, MD, Psychiatric Resident, Maricopa Integrated Health System

11:15 am to 12:15 pm

Thank you and Conclusion Session 1
Aaron Wilson, MD, President, Arizona Psychiatric Society
12:15 pm

Networking Box Lunch
Advance Registration Required
12:15 to 1:00 pm

Session 2: Live Waiver Training
(Separately Accredited) (See Live Waiver Training Document for Complete Information)
Live Waiver Training

Carlos Carrera MD, Anthony Dekker DO, Monica Faria MD,
Anita Karnik MD, Show Lin MD, Luke Peterson DO

1:00 to 5:15 pm

CASE STUDY FOR PANEL DISCUSSION

Prepared by Edwin Kim, MD, PGY-4, Maricopa Integrated Health System, Inc.

A 33 year-old Caucasian G2P0010 female with opioid use disorder and history of peripartum depression presents to your (Primary Care Practice) clinic motivated to seek treatment for ongoing oxycodone and occasional heroin abuse. She denies childhood illness and chronic medical illness. She did have miscarriage of her first pregnancy at age 19. She denies medical illness or surgical history. She did experience depression for over one year after her miscarriage. She experienced some relief from sertraline (unknown dosage) which was prescribed after her depression progressed to strong thoughts of not finding life worth living. She denies suicide attempt, attempt to self-harm and psychiatric hospitalization. While pursuing her associates degree, she worked several side jobs before becoming a legal assistant. During that time, she suffered a back injury which she "self-medicated" with marijuana. She possessed a medical marijuana card which she ultimately gave up after trying her boyfriend's opioid pain medication, oxycodone. She feels the opioids also help her feel less depressed. Today, she expresses her desire to have a safe pregnancy but is worried about possibly losing custody of her child and is willing to seek treatment as long as she can maintain custody. Her boyfriend, who chronically uses opioid pain medication, has not been supportive of her current pregnancy. She has minimal support as her family and relatives live primarily out of state. She denies alcohol use since age 25. She quit smoking cigarettes as soon as she discovered she was pregnant. Her concerns today include maintaining her pregnancy, maintaining her own health, and a fear of her depression returning.

SESSION 1: 4.0 HOURS

GENERAL LEARNING OBJECTIVES

At the conclusion, the attendee should be able to:

1. Discuss current epidemiological data reflecting the extent of the Opioid Use Crisis in AZ.

2. Recognize factors relating to diagnosis, referral to treatment, and management of Opioid Use Disorder as a chronic medical illness.

3. Identify treatment guidelines for Opioid Use Disorder, including Medication Assisted Treatment and psychosocial components.

4. Describe clinically appropriate settings for buprenorphine induction.

5. Employ best courses of treatment, resources, or referral of care in common scenarios requiring multidisciplinary collaboration, including acute pain management for patients on medication assisted treatment of Opioid Use Disorder.

ACCREDITATION

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Psychiatric Association (APA) and the Arizona Psychiatric Society. The APA is accredited by the ACCME to provide continuing medical education for physicians.

DESIGNATION

The APA designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

TARGET AUDIENCE

This educational activity is intended for psychiatrists and primary care and family care physicians. All mental health professionals and general health professionals are welcome, including students and residents.

PCSS-MAT Live Waiver Training

Session 2

Saturday, January 20, 2018

1:00 to 5:15 pm

Faculty: Carlos Carrera MD, Anthony Dekker DO, Monica Faria MD, Anita Karnik MD, Show Lin MD, Luke Peterson DO

SESSION 2: 4.25 HOURS

• The waiver eligibility training is available for physicians interested in seeking their waiver to prescribe buprenorphine in the treatment of opioid use disorders. In order to be eligible for the waiver to prescribe, providers are required to take 8-hours of training.
• PCSS-MAT uses a Half-and-Half format in which 4.25-hours are attended face-to-face with an instructor and is combined with an “on your own” computer-based self-study consisting of 5 modules and a 24-question exam (3.75-hours). The combined face-to-face training and the online computer-study/exam provides the required 8-hours needed to obtain the waiver to prescribe buprenorphine in the office-based treatment of opioid use disorders. The link to access part 2 will be emailed to all participants who complete the 4.25-hour session in its entirety. It is mandatory that all participants sign in at the beginning of the training and again at the end. The AOAAM cannot verify your attendance unless both signatures are confirmed on the roster. Participants are required to complete part 2 within 30 days of receiving the link.
• Following the 8-hour completion, physicians who have successfully completed the course may apply to the Substance Abuse and Mental Health Services Administration (SAMHSA) to obtain the waiver. You will receive an email with directions on how to receive your certificate of completion and apply for the waiver.
• Residents may take the 8-hour course and apply for their waiver once they receive their medical degree and their own DEA #.
• Physician Assistants and Nurse Practitioners are also eligible for the waiver but only after 24-hours of required training have been completed. PAs and NPs are encouraged to participate in this 8-hour training, along with an additional 16-hours of training. The 16-hours can be accessed here:
  http://pcssmat.org/education-training/mat-waiver-training/

This course has been reviewed and is acceptable for 4.25 credits of AOA Category 1A by the AOA CCMEthrough the AOAAM. It has also been reviewed and is acceptable for 4.25 Prescribed credit(s) by the American Academy of Family Physicians.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

TARGET AUDIENCE

This eligibility training is available for physicians interested in seeking their waiver to prescribe buprenorphine in the treatment of opioid use disorders. In order to be eligible for the waiver to prescribe, providers are required to take 8-hours of training. PCSS-MAT uses a Half-and-Half format in which 4.25-hours are attended face-to-face with an instructor and is combined with an “on your own” computer-based self-study consisting of 5 modules and a 24-question exam (3.75-hours). The combined face-to-face training and the online computer-study/exam provides the required 8-hours needed to obtain the waiver to prescribe buprenorphine in the office-based treatment of opioid use disorders. The link to access part 2 will be emailed to all participants who complete the 4.25-hour session in its entirety. It is mandatory that all participants sign in at the beginning of the training and again at the end. The AOAAM cannot verify your attendance unless both signatures are confirmed on the roster. Participants are required to complete part 2 within 30 days of receiving the link.

Following the 8-hour completion, physicians who have successfully completed the course may apply to the Substance Abuse and Mental Health Services Administration (SAMHSA) to obtain the waiver. You will receive an email with directions on how to receive your certificate of completion and apply for the waiver.

Residents may take the 8-hour course and apply for their waiver once they receive their medical degree and their own DEA #.

Physician Assistants and Nurse Practitioners are also eligible for the waiver but only after 24-hours of required training have been completed. PAs and NPs are encouraged to participate in this 8-hour training, along with an additional 16-hours of training. The 16-hours can be accessed here:

http://pcssmat.org/education-training/mat-waiver-training/

Funding for this initiative was made possible (in part) by Providers’ Clinical Support System for Medication Assisted Treatment (1U79TI026556) from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Please note the Live Waiver Training (Session 2 alone) is free. If you wish to register for Session 2 ONLY, please select the registration ticket for that option and then disclosure your role as a provider later in that same registration.

Additional funding provided by the Arizona Psychiatric Society through an expedited grant from the American Psychiatric Association and facilities use and audio-visual support from the Department of Psychiatry, University of Arizona College of Medicine, Phoenix and facilities use and audio-visual support for the remote broadcast provided by Flagstaff Medical Center and the Department of Psychiatry, University of Arizona College of Medicine, Tucson.