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Buprenorphine Training: Treating Opioid Use Disorder

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    • Buprenorphine Training: Treating Opioid Use Disorder


      Welcome to "Buprenorphine Training: Treating Opioid Use Disorder," a comprehensive course designed to equip healthcare professionals with the knowledge and skills necessary to effectively manage opioid use disorder using Buprenorphine in the Emergency Department. This course provides an in-depth understanding of opioids, Opioid Use Disorder (OUD), and the critical role of Buprenorphine in treating opioid overdoses.

      The course is structured to help you:

      • Understand the neurophysiology of addiction and opioid use disorder
      • Recognize the signs and symptoms of opioid overdose
      • Gain comprehensive knowledge about Buprenorphine and its mechanism of action
      • Learn proper administration techniques and patient monitoring protocols
      • Navigate the ethical and legal considerations of Buprenorphine use in emergency settings
      • Apply your knowledge through real-world case studies and problem-based learning

      This Open Online Course (OOC) was developed by NextGenU.org and created by a team of expert healthcare professionals and educators. It aims to address the critical need for comprehensive training in opioid overdose management, particularly focusing on the use of Buprenorphine in emergency settings. 

      The course was developed by Dr. Anthony Schlaff, MD, MPH; Dr. Magali Collonnaz, MD, PHD, MSC, MPH, FFPH; and Dr. Vasant Basdeo, M.B.B.S., PGDip.

      By the end of this course, you will be well-equipped to make informed decisions about Buprenorphine use in opioid overdose situations, potentially saving lives and improving patient outcomes.

      This course consists of four modules:

      1. Understanding Opioids, Opioid Use Disorder, and Opioid Overdose
      2. Overview of Buprenorphine
      3. Buprenorphine Administration and Patient Monitoring
      4. Treatment and Referral

      Additionally, at the end of the course, there is a series of problem-based learning case studies to help ensure that you are able to apply the knowledge gained through Modules 1 to 4.

      Each module is designed to build upon the previous one, providing you with a solid foundation in opioid overdose management using Buprenorphine.


      The estimated completion time for this course is 16 hours.

      Engaging with this course
      • You may browse this course for free to learn for your personal enrichment. There are no requirements.
      • To register for this course, complete the registration form.

      To PASS and Obtain a Certificate, a learner must successfully complete:
      • All reading requirements,
      • All quizzes and pass with a 80% with unlimited attempts,
      • The final exam with a minimum of 80% and a maximum of 3 attempts, and
      • The self and course evaluation forms.

      • Module 1: Understanding Opioids,Opioid Use Disorder and Opioid Overdose.

        Competency covered in this module:
        • Understand the fundamentals of opioid neuroscience :
          a. Neurophysiology of addiction
          b. Neurophysiologic changes associated with chronic opioid use
        • Understand the fundamentals of Opioid Use Disorder (OUD) and opioid overdose including its epidemiology, symptoms, and complications.
        • Understand the risk factors for Opiod Use Disorder (OUD), opioid overdose and why there is an increased risk of overdose after a relapse.
        • Learn about the different treatment options for Opioid Use Disorder.
        • Recognize the signs and symptoms of opioid overdose in a timely manner, including polydrug overdose.
        • Understand the health implications and mortality rates associated with opioid overdoses.

        Approximate time required for the readings for this module (at 144 words/minute): 4 hours 22 minutes.

        Click here to start this module

        13 URLs, 1 Quiz
        • Module Summary:

          Please review the learning resource summarizing the key concepts and information for Module 1. This resource provides a comprehensive overview, highlighting the most important points and insights to help you grasp the foundational elements of the topic.

          • Understand the fundamentals of opioid neuroscience :
            a. Neurophysiology of addiction
            b. Neurophysiologic changes associated with chronic opioid use
          • Understand the fundamentals of Opioid Use Disorder (OUD) and opioid overdose including its epidemiology, symptoms, and complications.
          • Understand the risk factors for Opiod Use Disorder (OUD), opioid overdose and why there is an increased risk of overdose after a relapse.
          • Learn about the different treatment options for Opioid Use Disorder.
          • Recognize the signs and symptoms of opioid overdose in a timely manner, including polydrug overdose.
          • Understand the health implications and mortality rates associated with opioid overdoses.

          If you would like more detailed information, please refer to the supplementary links provided below.

        • Supplementary Learning Resources:

        • Drugs, Brains, and Behavior: The Science of Addiction URL

          Read entire page. (9 minutes)

          National Institute on Drug Abuse - 2020

        • Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management URL

          Read section 1 to 3.4 (23 minutes)

          John Wiley & Sons - 2020

        • Opioid Use Disorder URL

          Read only the following section: Introduction, Etiology, Epidemiology, Pathophysiology and History and Physical (23 minutes)

          StatPearls Publishing LLC.- 2024

        • Opioid Overdose URL

          Read only the following sections:Introduction, Etiology, Epidemiology, Pathophysiology, and History and Physical (20 minutes)

          StatPearls Publishing LLC.-2024

        • A conceptual model for understanding post-release opioid-related overdose risk URL

          Read entire page (52 minutes)

          Addiction Science & Clinical Practice - 2019

        • Therapeutic Approaches to Opioid Use Disorder: What is the Current Standard of Care? URL

          Read entire page (23 minutes) 

          DovePress - 2021

        • Opioid use disorder and treatment: challenges and opportunities URL

          Read entire page (18 minutes)

          BMC Health Services Research - 2019

        • How effective are medications to treat opioid use disorder? URL

          Read entire page (5 minutes)

          National Institute on Drug Abuse, 2021

        • Opioid Overdose URL

          Read entire page (4 minutes)

          SAMHSA - 2024

        • Opioid Overdose URL

          Read only the section: History and Physical (2 minutes)

          StatPearls Publishing LLC.- 2023

        • Polydrug Definition and Assessment: The State of the Art URL

          Read entire page (33 minutes) 

          International Journal of Environmental Research and Public Health - 2022

        • The Challenge of Polysubstance Use Overdose URL

          Read entire page (27 minutes)

          Open Journal of Social Sciences - 2021

        • Opioid overdose URL

          Read entire page (23 minutes)

          WHO- 2023

        • Quiz
        • Quiz Module 1

          To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.

      • Module 2 : Overview of Buprenorphine

        Competency covered in this module:

        • Gain a comprehensive understanding of Buprenorphine, its mechanism of action, and its role in treating opioid overdoses.
        • Understand the pharmacokinetics and pharmacodynamics of Buprenorphine.
        • Learn about the potential side effects and contraindications of Buprenorphine.
        • Learn about both existing and emerging Buprenorphine formulations.

        Approximate time required for the readings for this module (at 144 words/minute): 3 hours 9 minutes.

        Click here to start this module

        4 URLs, 1 Quiz
        • Module Summary:

          Please review the learning resource summarizing the key concepts and information for Module 2. This resource provides a comprehensive overview, highlighting the most important points and insights to help you grasp the foundational elements of the topic.

          • Gain a comprehensive understanding of Buprenorphine, its mechanism of action, and its role in treating opioid overdoses.
          • Understand the pharmacokinetics and pharmacodynamics of Buprenorphine.
          • Learn about the potential side effects and contraindications of Buprenorphine.
          • Learn about both existing and emerging Buprenorphine formulations.

          If you would like more detailed information, please refer to the supplementary links provided below.

        • Supplementary Learning Resources:

        • Buprenorphine URL

          Read entire page (48 minutes)

          StatPearls Publishing LLC.-2023

        • Buprenorphine Pharmacology Review: Update on Transmucosal and Long-Acting Formulations URL

          Read entire page (47 minutes)

          Journal of Addiction Medicine -2019

        • Buprenorphine URL

          Read entire page (5 minutes)

          SAMHSA - 2024

        • Current and emerging pharmacotherapies for opioid dependence treatments in adults: a comprehensive update URL

          Read sections 3 to 12 only (42 minutes)

          Expert Opinion on Pharmacotherapy - 2022

        • Quiz
        • Quiz Module 2
          To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.

      • Module 3 : Buprenorphine Administration and Patient Monitoring

        Competency covered in this module:

        • Understand the critical steps involved in ED-initiated Buprenorphine administration as a medication for opioid use disorder (MOUD), including dosage, route of administration, and timing.
        • Learn about various ED and non ED initiated buprenorphine adminsitration protocols.
        • Learn the principles involved in patient monitoring post Buprenorphine administration in the ED.
        • Understand how to manage potential side effects and complications of Buprenorphine administration.
        • Learn how to educate patients about the use of Buprenorphine as a MOUD, including its benefits and potential side effects.
        • Get to know how to involve patients in the decision-making process regarding the use of Buprenorphine as MOUD, fostering patient autonomy and informed consent.

        Approximate time required for the readings for this module (at 144 words/minute): 6 hours 11 minutes.

        Click here to start this module

        13 URLs, 1 Quiz
        • Module Summary:

          Please review the learning resource summarizing the key concepts and information for Module 3. This resource provides a comprehensive overview, highlighting the most important points and insights to help you grasp the foundational elements of the topic.

          • Understand the critical steps involved in ED-initiated Buprenorphine administration as a medication for opioid use disorder (MOUD), including dosage, route of administration, and timing.
          • Learn about various ED and non ED initiated buprenorphine adminsitration protocols.
          • Learn the principles involved in patient monitoring post Buprenorphine administration in the ED.
          • Understand how to manage potential side effects and complications of Buprenorphine administration.
          • Learn how to educate patients about the use of Buprenorphine as a MOUD, including its benefits and potential side effects.
          • Get to know how to involve patients in the decision-making process regarding the use of Buprenorphine as MOUD, fostering patient autonomy and informed consent.

          If you would like more detailed information, please refer to the supplementary links provided below.

        • Supplementary Learning Resources:

        • Emergency department‐initiated buprenorphine protocols: A national evaluation URL

          Read entire page ( 37 minutes)

          Journal of the American College of Emergency Physicians Open - 2021

        • Overview of best practices for buprenorphine initiation in the emergency department URL

          Read entire page (25 minutes)

          International Journal of Emergency Medicine - 2024

        • A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder URL

          Read entire page (80 minutes)

          Springer - 2023

        • Early emergency department experience with 7-day extended-release injectable buprenorphine for opioid use disorder URL

          Read entire page (27 minutes) 

          A Global Journal of Emergency Care (John Wiley & Sons, Inc) - 2023

        • High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder URL

          Read entire page (27 minutes)

          JAMA Network Open - 2021

        • Telemedicine Flexibilities for Prescribing Controlled Medications URL

          Read entire page (27 minutes)

          American Society of Addiction Medicine.- 2023

        • Emergency department‐initiated buprenorphine protocols: A national evaluation URL

          Read the "Introduction" and "Discussion" sections only (24 minutes)

          Journal of the American College of Emergency Physicians Open - 2021

        • Buprenorphine URL

          Read the"monitoring" section only (3 minutes)

          StatPearls Publishing LLC - 2023

        • Buprenorphine URL

          Read entire page (5 minutes)

          SAMHSA - 2024

        • A Patient’s Guide to Starting Buprenorphine at Home URL

          Read entire page (10 minutes)

          American Society of Addiction Medicine. - 2019

        • Buprenorphine Quick Start Guide - SAMHSA URL

          Read entire page (7 minutes)

          SAMHSA - 2021

        • Patient Decision Aid for Medication Treatment for Opioid Use Disorder (PtDA-MOUD): Rationale, Methodology, and Preliminary Results URL

          Read entire page (42 minutes)

          Journal of Substance Abuse Treatment - 2019

        • “Just give them a choice”: Patients' perspectives on starting medications for opioid use disorder in the ED URL
          Read entire page (57 minutes)
          John Wiley & Sons, Inc- 2022
        • Quiz
        • Quiz Module 3

          To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.

      • Module 4 : Treatment and Referral

        Competency covered in this module:
        • Understand the ethical and legal considerations related to the administration of Buprenorphine in an ED setting.
        • Apply the knowledge of opioid overdose and Buprenorphine management to real-world patient scenarios and case studies.
        • Demonstrate the ability to make informed decisions for the use of Buprenorphine in the management of patients with opioid overdose.

        Approximate time required for the readings for this module (at 144 words/minute): 1 hour 40 minutes.

        Click here to start this module

        6 URLs, 1 Quiz
        • Module Summary:

          Please review the learning resource summarizing the key concepts and information for Module 4. This resource provides a comprehensive overview, highlighting the most important points and insights to help you grasp the foundational elements of the topic.

          • Understand the ethical and legal considerations related to the administration of Buprenorphine in an ED setting.
          • Apply the knowledge of opioid overdose and Buprenorphine management to real-world patient scenarios and case studies.
          • Demonstrate the ability to make informed decisions for the use of Buprenorphine in the management of patients with opioid overdose.

          If you would like more detailed information, please refer to the supplementary links provided below.

        • Supplementary Learning Resources:

        • Overcoming Stigma and Discrimination Fundamental to OUD Care in the ED URL

          Read entire page (13 minutes)

          Emergency Medicine News (2024)

        • Variation in intervention stigma among medications for opioid use disorde URL

          Read entire page (60 minutes)

          Elsevier B.V. - 2022

        • Emergency Department Interventions for Opioid Use Disorde URL

          Read entire page (86 minutes)

          Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health & Human Services - 2023

        • Select Federal Policies Governing Methadone and Buprenorphine for Opioid Use Disorder URL

          Website for information on government policies on buprenorphine use. Regularly updated. (27 minutes)

          American Society of Addiction Medicine.- 2023

        • CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022 URL

          Guideline/Toolkit for reference if needed (6 hours 40 minutes)

          CDC - 2022

        • SAMHSA Overdose Prevention and Response Toolkit URL

          Guideline/Toolkit for reference if needed (6 hours 40 minutes)

          SAMHSA - 2024

        • Quiz Module 4

          To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.

      • Additional Tools and Resources

        7 URLs
        • COWS Score for Opiate Withdrawal URL
        • Questions for Identification of Opioid Use Disorder based on DSM-5 URL
        • ED-Initiated Buprenorphine URL
        • Opioid Overdose: ED-Initiated Buprenorphine URL
        • Opioid Overdose: Harm Reduction URL
        • Adolescent Presenting with Opioid Overdose: Assessment, Intervention and Referral URL
        • Prescription Opioid Withdrawal Symptoms: Assessment, Treatment and Referral URL
      • Case Study Practice

        8 Forums
        • PBL Case Study Analysis - Activity 1 Forum

          Case: John, a 35-year-old male, presents to the ED with signs of opioid withdrawal. He is restless, anxious, exhibiting profuse sweating, and complaining of body aches. John confirms that he has been using heroin for the past seven years and had his most recent dose about 14 hours ago. He expresses a desire to quit using but has failed to manage withdrawal symptoms on his own.

          Activity: Analyze this case according to these prompts:

          • Using your knowledge of the Clinical Opiate Withdrawal Scale (COWS), identify and rate the withdrawal symptoms John is demonstrating.
          • Discuss the suitability of ED-Initiated Buprenorphine for John, considering his opioid use history, the timing of his last use, and his current state of withdrawal.
          • Describe the process of initiating Buprenorphine in an ED setting, focusing on the steps necessary to manage John's current situation and level of withdrawal.
        • PBL Case Study Analysis - Activity 2 Forum

          Case: Emily, a 30-year-old female, presents to the ED with complaints of severe abdominal pain. Upon further probing, she admits to misusing prescription opioids for the past 18 months, specifically OxyContin. The last time she took the pills was 36 hours ago. She expresses wanting to quit but is fearful of withdrawal symptoms.

          Activity: Analyze Emily's case and answer the following prompts:

          • Identify and rate the withdrawal symptoms Emily might be experiencing, using the COWS as a guide.
          • Discuss the risks and benefits of initiating Buprenorphine for Emily, considering her opioid use history, the time since her final use, and her current symptoms.
          • Explore potential complications due to Emily's complaint of severe abdominal pain. Discuss how to manage this situation while considering her withdrawal.

        • PBL Case Study Analysis - Activity 3 Forum

          Case: Alex, a 22-year-old college student, is brought to the ED by his roommate who found him in a state of distress, complaining of restlessness, irritability, and abdominal cramping. Alex admits to misusing prescription opioids, particularly Percocet, for about two years and his latest intake was 20 hours ago.

          Activity: Analyze the provided case, considering the following:

          • Using the Clinical Opiate Withdrawal Scale (COWS), rate the symptoms that Alex is showing.
          • Discuss the applicability of ED-Initiated Buprenorphine for Alex. Consider factors like his opioid use history, the timing of his last use, and current withdrawal symptoms.
          • Discuss the protocol for Buprenorphine administration in the ED, focusing on the steps required for Alex's current case.

        • PBL Case Study Analysis - Activity 4 Forum

          Case: Sarah, a 40-year-old woman, presents to the ED with feelings of nausea, sweating, and shaky hands. She reveals she has been misusing her husband's prescribed Oxycodone for six months. The last time she took the prescription opioid was about 30 hours ago.

          Activity: Analyze Sarah's case, considering the following:

          • Using the COWS scale, identify and rate the withdrawal symptoms Sarah is demonstrating.
          • Discuss the indications of initiating Buprenorphine in an ED setting for Sarah, focusing on her opioid use history, the time since her last use, and her current symptoms.
          • Deliberate on the possible complications due to Sarah's misuse of someone else's prescription and discuss how to manage this situation.

        • Treatment Plan Development PBL - Activity 1 Forum

          Case: Michael, a 28-year-old male, enters the ED demonstrating clear signs of opioid withdrawal. He reports feelings of intense discomfort, restlessness, excessive yawning, and runny nose. Upon questioning, he admits to using fentanyl and reports that his last dose was 12 hours ago.

          Activity: Develop a comprehensive treatment plan for Michael by following these prompts:

          • Reflecting on Michael's use of fentanyl, the timing of his last dose, and his withdrawal symptoms, discuss the potential induction dosage of Buprenorphine.
          • Identify potential complications that might arise during the treatment process, focusing on Michael's use of fentanyl.
          • Outline the necessary steps for his ongoing treatment following the ED visit, considering the accessing treatment resources in the community for patient transitioning.

        • Treatment Plan Development PBL - Activity 2 Forum

          Case: Lisa, a 33-year-old female, appears at the ED exhibiting signs of opioid withdrawal. Upon questioning, she confesses to using a combination of heroin and prescription opioids, specifically morphine. Her last dose was roughly 24 hours ago, and she wishes to quit.

          Activity: Develop a detailed treatment plan for Lisa, focusing on:

          • A discussion around the likelihood of precipitated withdrawal due to Lisa's use of both heroin and prescription opioids, including when and how to initiate Buprenorphine.
          • Identification of potential complications that may arise during Lisa's treatment, specifically considering her use of a combination of opioids.
          • A detailed plan for her ongoing treatment and follow-up care post-ED visit, including the consideration for community-based referrals for seamless continuity of care.

        • Treatment Plan Development PBL - Activity 3 Forum

          Case: Robert, a 45-year-old construction worker, arrives at the ED showing signs of opioid withdrawal. He admits to using heroin and his last dose was 16 hours ago. He expresses his readiness to quit.

          Activity: Develop a comprehensive treatment plan for Robert by answering the following prompts:

          • Contemplating Robert's use of heroin, the time of his last dose, and his withdrawal symptoms, discuss the potential initiation dosage of Buprenorphine.
          • Identify possible complications that might arise during Robert's treatment process.
          • Outline the necessary steps for ongoing treatment post-ED visit, including the process of transitioning Robert to community-based resource care.
        • Treatment Plan Development PBL - Activity 4 Forum

          Case: Michelle, a 37-year-old single mother, comes to the ED exhibiting signs of opioid withdrawal. She admits to using a combination of prescription opioids, specifically, she’s been misusing hydrocodone. Her last dose was approximately 18 hours ago, and she is eager to receive help.

          Activity: Develop a detailed treatment plan for Michelle, considering:

          • Discuss the likelihood of precipitated withdrawal due to Michelle's use of hydrocodone, and the suitable time and method to initiate Buprenorphine.
          • Identify potential complications that may emerge during Michelle's treatment, considering her use of hydrocodone.
          • Detail the steps for Michelle's ongoing treatment and follow-up care following the ED visit, considering the importance of family support in her case.
      • Final Exam

        Click here to start Final Examination

        • Final Exam Quiz
          Restricted Not available unless:
          • All of:
            • The activity Course Registration is marked complete
            • The activity Quiz Module 1 is marked complete
            • The activity Quiz Module 2 is marked complete
            • The activity Quiz Module 3 is marked complete
            • The activity Quiz Module 4 is marked complete
          • All of:
            • The activity PBL Case Study Analysis - Activity 1 is marked complete
            • The activity PBL Case Study Analysis - Activity 2 is marked complete
            • The activity PBL Case Study Analysis - Activity 3 is marked complete
            • The activity PBL Case Study Analysis - Activity 4 is marked complete
            • The activity Treatment Plan Development PBL - Activity 1 is marked complete
            • The activity Treatment Plan Development PBL - Activity 2 is marked complete
            • The activity Treatment Plan Development PBL - Activity 3 is marked complete
            • The activity Treatment Plan Development PBL - Activity 4 is marked complete

          To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 20 questions, and you will have 20 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.

          To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Course and Self Evaluation & Certificate

        In this section, you can provide feedback about this course to help us make NextGenU.org better. Once evaluations are completed, you will be able to download your certificate of completion.

        Click here give your feedback

        • Course Evaluation Questionnaire
          Restricted Not available unless: The activity Final Exam is complete and passed
        • Self Evaluation Questionnaire
          Restricted Not available unless: The activity Final Exam is complete and passed
      Skip Course Activities and Resources
      Course Activities and Resources

      • Syllabus
      • Resources
      • Quizzes

      • Buprenorphine
      • General
      • How to create an account and enroll in the course?
      • Buprenorphine Training: Treating Opioid Use Disorder
      • Module 1: Understanding Opioids,Opioid Use Disorder and Opioid Overdose.
      • Module 2 : Overview of Buprenorphine
      • Module 3 : Buprenorphine Administration and Patient Monitoring
      • Module 4 : Treatment and Referral
      • Additional Tools and Resources
      • Case Study Practice
      • Final Exam
      • Course and Self Evaluation & Certificate
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