Workshop A – July 16, 2018: 5:30pm – 7:30pm
Evaluating and Accepting Candidates into Office Based Opioid Treatment (OBOT)
This workshop will educate participants on how to apply the American Society of Addiction Medicine’s ASAM 6 Dimension Criteria to determine the following:
- The acceptance of patients into OBOT
- When not to accept a patient/span>
- How/where to refer
- Indications for higher level of care when non-compliant in OBOT
Additional Learning Objectives include:
- Should any opioid use disorder (OUD) patient be accepted into OBOT based upon recommendation from an inpatient Rehab, Partial Hospitalization (PHP) or detox?
- How to deal with co-occurring disorder patients
• ADHD on stimulant medications
• Moderate to severe co-occurring, not under active care with psychiatrist or getting psychotropic Rx only by Primary Care
- How and when to assess the underlying chronic pain of Co-morbid patients stabilized on buprenorphine
- Determine the level of patient counseling
• Who goes to IOP vs. Weekly vs. Bi-weekly?
• Individual, group or both?
• How many weeks before step-down?
- Applying sober living for patients (Half-way vs ¾ house)
- Patient needs a higher level of care: when and how?
- Discharging an addiction patient – when? what indications?
- Some other factors that need acceptance parameters include:
♦ The 2017 FDA guideline accepting patients on Benzodiazepines
• Dose limits
♦ Primary care has patient on other 'abuse potential' substance
♦ How do you know what dose of buprenorphine? Titration protocol.
♦ When is the acceptable time to wean it, and how? (dose, frequency)
♦ Convert buprenorphine to Vivitrol: indications, when & how?
- Discussion on indications for the following:
♦ The patient needs a higher level of care
♦ Can we discharge an addiction patient? When?
About the Speaker:
Dr. Schwarz obtained his MD from the University of Illinois at Chicago, and then completed his Surgery Residency at the University of Toledo; Board Certified in 1994. He was a Level-1 Trauma Surgeon/Clinical Instructor of Surgery at the University of Toledo, while a research fellow at the University of Michigan in Plastic Surgery. He was awarded several grants and awards, while mentoring students and physicians in the Craniofacial Research Laboratory.
Recognizing increased opioid use in surgical and pain management patients, he pursued his interests in Addiction Medicine, completing a fellowship at St. John's Brighton Hospital; Board Certified in 2010. He initiated the first prospective study correlating addiction after gastric bypass surgery, published in 2010. He is a CLIA certified, high-complexity toxicologist. Recent peer reviewed publications include Toxicology in Pain Management, Toxicology in Addiction Medicine and Precision Medicine in Toxicology: Clinics in Laboratory Medicine, Dec 2016.
His practice covers addiction/behavioral medicine, specializing in co-occurring disorders and complex chronic pain. He currently trains physicians and allied health professionals for ASAM's buprenorphine waiver course.