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Substance Use Disorder Pharmacotherapy: Buprenorphine Practice After the X-Waiver

  • 76 minutes
  • 40 slides
What we'll cover
  • 0:00 What Changed, What Didn't
  • 10:00 Access Gains And Persistent Gaps
  • 18:00 Patient Selection And Readiness
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What you'll take away

Practical shifts you can apply this week

  • Identify Federal Changes After Elimination

    Know which rules changed, which did not, and where state or institutional policy still shapes practice.

  • Compare Buprenorphine Workflows After Policy Shift

    See how office, ED, hospital, and telehealth pathways differ so teams can reduce delays and handoff gaps.

  • Apply Induction Principles Across Starts

    Match standard, high-dose, or low-dose starts to opioid exposure, withdrawal risk, and care setting.

  • Diagnose Common Implementation Failures

    Spot where diversion fears, weak follow-up, or fuzzy roles quietly derail treatment before it starts.

  • Draft A Post-X-Waiver Practice Protocol

    Leave with a practical framework for same-day access, safer documentation, and clearer team ownership.

Agenda

What we'll cover

  1. 0:00

    What Changed, What Didn't

    The MAT Act ended the waiver, not the need to follow DEA, state, and institutional rules.

  2. 10:00

    Access Gains And Persistent Gaps

    Why prescribing is easier on paper than in practice, especially when staffing and stigma linger.

  3. 18:00

    Patient Selection And Readiness

    Assessment that focuses on withdrawal risk, opioid pattern, treatment goals, and informed consent.

  4. 28:00

    Induction Options That Fit Reality

    When to use standard, high-dose, or low-dose starts, and how to handle precipitated withdrawal.

  5. 40:00

    Care Settings And Workflow Design

    Build practical pathways for ED, hospital, primary care, and telehealth follow-up.

  6. 49:00

    Risk, Safety, And Misuse

    Address overdose, sedatives, urine testing, PDMP checks, and diversion without punitive drop-off.

  7. 56:00

    Playbook, Recap, And Q&A

    Choose one bottleneck, assign an owner, and leave with a draft protocol or metrics plan.

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