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Case Challenges in Opioid Use Disorder: Use of Medications in Treatment

  • Authors: Joshua D. Lee, MD, MSc
  • CME / CE Released: 12/17/2018; Reviewed and Renewed: 12/29/2020
  • Valid for credit through: 12/29/2021
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Target Audience and Goal Statement

This activity is intended for psychiatrists, primary care physicians, nurse practitioners, physician assistants, nurses, and other clinicians who manage patients with opioid use disorder.

The goal of this activity is to help clinicians recognize and effectively treat opioid use disorder (OUD) using available medication therapies.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Use of medications for the management of OUD
  • Have greater competence related to
    • Diagnosis of OUD
    • Development of a recovery plan for OUD that utilizes medications as a part of therapy



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Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


  • Joshua D Lee, MD, MSc

    Associate Professor
    NYU Langone Health
    New York, New York


    Disclosure: Joshua D. Lee, MD, MSc, has disclosed no relevant financial relationships.


  • Marcello Morgan, MD, MPH

    Scientific Director, Medscape, LLC


    Disclosure: Marcello Morgan, MD, MPH, has disclosed no relevant financial relationships.

  • Beverly Caley, JD

    Freelance Writer


    Disclosure: Beverly Caley, JD, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

  • Amy Bernard, MS, BSN, RN-BC, CHCP

    Lead Nurse Planner, Medscape, LLC


    Disclosure: Amy Bernard, MS, BSN, RN-BC, CHCP, has disclosed no relevant financial relationships.

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In support of improving patient care, Medscape, LLC 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.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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    For Nurses

  • Awarded 1.0 contact hour(s) of continuing nursing education for RNs and APNs; 1.0 contact hours are in the area of pharmacology.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

Follow these steps to earn CME/CE credit*:

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Case Challenges in Opioid Use Disorder: Use of Medications in Treatment

Authors: Joshua D. Lee, MD, MScFaculty and Disclosures

CME / CE Released: 12/17/2018; Reviewed and Renewed: 12/29/2020

Valid for credit through: 12/29/2021



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  17. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. Training Materials and Resources. Accessed September 13, 2018.
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  20. Lee JD, Nunes EV, Jr., Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet. 2018;391:309-318.
  21. Kenney SR, Anderson BJ, Bailey GL, Stein MD. The relationship between diversion-related attitudes and sharing and selling buprenorphine. J Subst Abuse Treat. 2017;78:43-47.
  22. US Food and Drug Administration webpage. Approved risk evaluation and mitigation strategies. Accessed December 28, 2020.
  23. Weinstein ZM, Kim HW, Cheng DM, et al. Long-term retention in Office Based Opioid Treatment with buprenorphine. J Subst Abuse Treat. 2017;74:65-70.
  24. Vivitrol [package insert]. Waltham, MA: Alkermes, Inc.; 2015.
  25. Bisaga A, Mannelli P, Sullivan MA, et al. Antagonists in the medical management of opioid use disorders: historical and existing treatment strategies. Am J Addict. 2018;27:177-187.
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  27. Cornish R, Macleod J, Strang J, Vickerman P, Hickman M. Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database. BMJ. 2010;341:c5475.
  28. Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550.
  29. Nunes EV, Gordon M, Friedmann PD, et al. Relapse to opioid use disorder after inpatient treatment: Protective effect of injection naltrexone. J Subst Abuse Treat. 2018;85:49-55.
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  31. National Institute on Drug Abuse. Effective treatments for opioid addiction. Updated November 2016. Accessed August 22, 2018.
  32. Knudsen HK, Studts JL. Physicians as Mediators of Health Policy: Acceptance of Medicaid in the Context of Buprenorphine Treatment. J Behav Health Serv Res. 2018.
  33. Krawczyk N, Feder KA, Fingerhood MI, Saloner B. Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U.S. national sample. Drug Alcohol Depend. 2017;178:512-518.
  34. Krupitsky E, Nunes EV, Ling W, Illeperuma A, Gastfriend DR, Silverman BL. Injectable extended-release naltrexone for opioid dependence: a double-blind, placebo-controlled, multicentre randomised trial. Lancet. 2011;377:1506-1513.
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  38. Friedmann PD, Dunn KE, Nunes EV, O'Brien CP. Effectiveness, Implementation and Real-World Experience with Extended-Release Naltrexone (XR-NTX): A Special Issue of JSAT. J Subst Abuse Treat. 2018;85:31-33.
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