Broad Learning Objectives:
At the conclusion of this workshop, participants will:
- Have acquired the prerequisite knowledge to initiate and monitor patients on methadone and/or buprenorphine/naloxone.
- Be able to demonstrate basic decision making skills essential to providing or dispensing safe and effective opioid agonist therapy.
- Be able to explore the value of sensitivity, understanding and commitment in the delivery of addictions medicine in clinical or pharmacy practice
Specific Learning Objectives:
At the conclusion of this workshop, participants will be able to:
- Identify opioid use disorder (neuroanatomy and pathophysiology of the brain’s reward system, typical clinical presentations, typical behaviours, DSM-5 criteria).
- Explain the model of addiction as a chronic disease, requiring long term management by health care professional(s) as well as mental health, spiritual and social support.
- Perform a comprehensive assessment of an individual with opioid use disorder and select appropriate treatment options.
- Recognize the unique pharmacology of methadone and buprenorphine/naloxone and participate effectively in prescriber – pharmacist collaborative care.
- Identify potential and actual drug interactions.
- Select an appropriate methadone induction dose and manage initial methadone induction, dose adjustments and early stabilization issues appropriately.
- Assess a patient’s appropriateness for carry doses, including frequent reassessment and as-needed adjustments to carry status.
- Discuss important issues in the maintenance phase of treatment, including urine toxicology, prolonged QT, split dosing, smoking cessation support and withdrawal of treatment.
- Identify special considerations in the treatment of pregnant women with opioid use disorder, in the ante-natal period, during labour and post- partum, including breast feeding.
- Examine neonatal opioid withdrawal and recognize how treatment decisions may impact withdrawal severity and overall maternal/neonatal outcomes.
- Examine the role education and advocacy plays in promoting improved neonatal/maternal outcomes and strengthening the family unit.
- Discuss special issues in the management of individuals with opioid use disorder and concurrent major psychiatric disorders.
- Discuss special issues in the management of individuals with opioid use disorder and concurrent acute, chronic, and post-operative pain.
- Identify special considerations in the management of individuals with opioid use disorder and hepatitis C and/or HIV.
- Identify special considerations in the management of individuals with opioid use disorder who are indigenous and/or from indigenous communities.
- Formulate a practical approach to managing insomnia in the patient with opioid use disorder.
- Discuss important safety considerations and formulate a practical approach to managing individuals with opioid use disorder who also abuse alcohol.
- Discuss important safety considerations and formulate a practical approach to managing individuals with benzodiazepine use and/or with complex polypharmacy.
- Distinguish different models of service delivery in opioid agonist therapy including the comprehensive care model, private clinic model, community clinic model and family practice model. Compare and contrast the strengths and weaknesses of each model.
- Implement and integrate safe preparation, documentation, and dispensing of methadone and buprenorphine/naloxone into pharmacy practice.