This hour will feature 3 presentations:

Pain Management in Patients with OUD on Extended-Release Buprenorphine
This lecture will discuss pain management for patients with opioid use disorder on extended-release buprenorphine using a case-based approach. 

Extended-release Buprenorphine causing iatrogenic opioid intoxication and the need for surgical excision.
This talk will describe a case of a patient without opioid tolerance who inappropriately received a Sublocade injection; he subsequently developed opioid intoxication and respiratory depression that lasted multiple days, despite repeated administrations of Naloxone. He ultimately required hospital admission and surgical excision of the Sublocade depot. His symptoms resolved after the procedure.

Extended-Release Buprenorphine in Pregnancy
Extended-release buprenorphine (XR-BUP) is showing improved outcomes for people with an opioid use disorder (OUD) diagnosis. It has not been determined to be safe in pregnancy, largely due to the presence of an excipient that has shown to cause adverse fetal developmental effects in rats. While there are no case reports showing adverse fetal effects, previously existing data is limited. I will present 2 published case reports along with a collection of other patient cases demonstrating the outcomes from pregnant patients administered XR-BUP at a walk-in clinic for OUD treatment.

1. Explain the need for pain management in patients with opioid use disorder on extended-release buprenorphine.
2. Describe a patient-centered approach to pain management for patients with opioid use disorder on extended-release buprenorphine.
3. Apply pain management strategies to different types of pain in patients with opioid use disorder on extended-release buprenorphine.

1. Describe the potential harms of using monthly, long acting injectable (LAI) buprenorphine in someone without demonstrated opioid tolerance.
2. Describe the pros and cons for removal of LAI buprenorphine in the case of adverse reactions.
3. List the considerations in determining the appropriate setting--and level of monitoring--for excision of LAI buprenorphine.

1. Outline the current evidence of XR-BUP efficacy.
2. Describe the limited literature surrounding XR-BUP in pregnancy.
3. Apply our current knowledge to risk/benefit discussions with patients.
4. Apply this framework to new XR-BUP products as they are more widely available.

• Help is here! The Opioid Response Network (ORN) is your resource for no-cost education, training and consultation to enhance efforts addressing opioid and stimulant use disorders.
• ORN has consultants in every state and territory to deploy across prevention, treatment, recovery and harm reduction.
• Share your needs via the “Submit a Request” form at www.OpioidResponseNetwork.org. Within one business day, your regional point person will be in touch to learn more.

ACCREDITATION:
This actvity 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 American Osteopathic Association and The American Osteopathic Academy of Addiction Medicine (AOAAM). The American Osteopathic Association is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT HOURS:
The American Osteopathic Association designates this other activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

DISCLOSURE AND CONFLICT OF INTEREST RESOLUTION:
All conflicts of interest of any individual(s) in a position to control the content of this CME activity will be identified and resolved prior to this educational activity being provided. Disclosure about provider and faculty relationships, or the lack thereof, will be provided to learners.

Funding for this initiative was made possible (in part) by grant no. 1H79TI085588-02 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.