Pediatric Grand Rounds (RECORDING) Curbing the Opioid Epidemic: Buprenorphine For Adolescents

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. 

The opioid epidemic is worsening around the nation and in our community. In this session, Dr. Trope discusses a life-saving treatment for opioid use disorder, buprenorphine, and shares details of Santa Clara Valley Medical Center's new buprenorphine program for adolescents.

  Release Date: April 15, 2022
  Expiration Date: April 14, 2023
  Estimated Time to Complete: 1.0 hours 
  Registration Fee: FREE
 *Originally recorded 01/07/2022.

1. Understand the magnitude of the opioid epidemic and how we got here.
2. Describe how buprenorphine works and how it can help adolescent patients with opioid use disorder.
3. Details the new adolescent buprenorphine program at SCVMC.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association. p. 541.

Dupouy, J., Palmaro, A., Fatséas, M., Auriacombe, M., Micallef, J., Oustric, S., &Lapeyre-Mestre, M. (2017). Mortality Associated With Time in and Out ofBuprenorphine Treatment in French Office-Based General Practice: A 7-Year CohortStudy. Annals of family medicine, 15(4), 355–358. https://doi.org/10.1370/afm.2098

Evans, E., Li, L., Min, J., Huang, D., Urada, D., Liu, L., Hser, Y. I., & Nosyk, B. (2015).Mortality among individuals accessing pharmacological treatment for opioid dependencein California, 2006-10. Addiction (Abingdon, England), 110(6), 996–1005.https://doi.org/10.1111/add.12863

Matson, S. C., Hobson, G., Abdel-Rasoul, M., & Bonny, A. E. (2014). A retrospective study ofretention of opioid-dependent adolescents and young adults in an outpatientbuprenorphine/naloxone clinic. Journal of Addiction Medicine, 8(3), 176–182.https://doi.org/10.1097/ADM.0000000000000035

Mutlu, C., Demirci, A. C., Yalcin, O., Kilicoglu, A. G., Topal, M., & Karacetin, G. (2016).One-Year Follow-Up of Heroin-Dependent Adolescents Treated withBuprenorphine/Naloxone for the First Time in a Substance Treatment Unit. Journal of substance abuse treatment, 67, 1–8. https://doi.org/10.1016/j.jsat.2016.04.002

Schuman-Olivier, Z., Weiss, R. D., Hoeppner, B. B., Borodovsky, J., & Albanese, M. J. (2014).Emerging adult age status predicts poor buprenorphine treatment retention. Journal of substance abuse treatment, 47(3), 202–212. https://doi.org/10.1016/j.jsat.2014.04.006

Smyth, R. M., Gargon, E., Kirkham, J., Cresswell, L., Golder, S., Smyth, R., & Williamson, P.(2012). Adverse drug reactions in children--a systematic review. PloS one, 7(3), e24061.https://doi.org/10.1371/journal.pone.0024061

Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., Ferri, M., &Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ (Clinical research ed.), 357,j1550. https://doi.org/10.1136/bmj.j1550

Woody, G. E., Poole, S. A., Subramaniam, G., Dugosh, K., Bogenschutz, M., Abbott, P., Patkar, A., Publicker, M., McCain, K., Potter, J. S., Forman, R., Vetter, V., McNicholas, L., Blaine, J., Lynch, K. G., & Fudala, P. (2008). Extended vs short-termbuprenorphine-naloxone for treatment of opioid-addicted youth: a randomized trial. JAMA, 300(17), 2003–2011. https://doi.org/10.1001/jama.2008.574

Zee, A. V. et al. (2009). The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy. National Library of Medicine. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

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Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Alan R. Schroeder, MD
Clinical Professor
Stanford University

Course Director and Reviewer

Nothing to disclose

Lee Trope, MD
MD
Santa Clara Valley Medical Center

Faculty

Nothing to disclose

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Nothing to disclose

Olivera Marsenic Couloures, MD
LPCH

Planner

Nothing to disclose

Lane Donnelly, MD
University of North Carolina

Planner

Nothing to disclose

Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Ingrid Garnica, Other
Stanford Pediatrics

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Ownership-BioSkryb Genomics

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MD, MSCE, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford School of Medicine

Planner

Nothing to disclose

Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose