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Dartmouth College

AXL: Advanced Opioid Use Disorder X-waiver Team Learning Collaborative - Long-Term OUD Medication Management

Dartmouth College via Independent


Dartmouth Health Continuing Education for Professionals Home, AXL: Advanced Opioid Use Disorder X-waiver Team Learning Collaborative - Long-Term OUD Medication Management, 9/1/2021 8:00:00 AM - 9/1/2024 9:00:00 AM, This series is designed to increase treatment capacity for opioid use disorders by training more prescribers to be able to treat substance or opioid use disorders.

Content includes:
  • Demonstrate the importance of retention on MOUD
  • Describe patient characteristics who are at risk for dropout
  • Consider possible interventions to increase retention
  • Review considerations in stopping MOUD
  • Explain the RDD trial

Dr. Matis Shulman is a clinician-scientist with a research focus on opioid use disorders clinical trials and the use of technology to enhance implementation, quality improvement and treatment delivery. He is currently a co-investigator on the leadership team of two large multi-site opioid use disorder treatment trials funded through the National Institute of Health HEAL initiative. The first considers interventions to improve retention on medications for opioid use disorder and tracks outcomes in individuals who chose to discontinue medications for opioid use disorder. The second trial tests the effectiveness and implementation of a rapid approach to detoxification for induction onto long acting injectable naltrexone.  

Along with his work in clinical research Dr Shulman is actively involved in efforts to increase awareness and treatment quality for substance use disorders. He frequently lectures for both lay and clinical audiences and is on the advisory board of the Communities Confronting Substance Abuse organization (CCSA). He facilitates the CCSA support group for individuals with loved ones and family members suffering from substance use disorders.

Learning Outcome(s)
Participants will be able to identify at least three evidence-based strategies that are designed to enhance the clinical team-based care of patients with substance or opioid use disorders treatment.

The activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for this activity have reported NO financial relationship(s)* with ineligible companies**. 

* A “financial relationship" includes employee, researcher (named as the PI), consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and/or an ownership interest (not including stocks owned in a managed portfolio).

** An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Bibliographic Resources
Wakeman SE, Larochelle MR, Ameli O, et al. Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. JAMA Network Open. 2020;3(2):e1920622-e1920622.
Arthur Robin Williams, M.D., M.B.E. ,, Hillary Samples, Ph.D. ,, Stephen Crystal, Ph.D. ,, Mark Olfson, M.D., M.P.H. Acute Care, Prescription Opioid Use, and Overdose Following Discontinuation of Long-Term Buprenorphine Treatment for Opioid Use Disorder. American Journal of Psychiatry. 2020;177(2):117-124.
Liebschutz JM, Crooks D, Herman D, et al. Buprenorphine Treatment for Hospitalized, Opioid-Dependent Patients: A Randomized Clinical Trial. JAMA Internal Medicine. 2014;174(8):1369-1376.
Gryczynski J, Mitchell SG, Jaffe JH, O'Grady KE, Olsen YK, Schwartz RP. Leaving buprenorphine treatment: patients' reasons for cessation of care. Journal of substance abuse treatment. 2014;46(3):356-361.
Williams AR, Barbieri V, Mishlen K, et al. Long-term follow-up study of community-based patients receiving XR-NTX for opioid use disorders. The American Journal on Addictions. 2017;26(4):319-325.
National Institute of Health National Library of Medicine. Starting Treatment With Agonist Replacement Therapies (START). Accessed June 2, 2021.
Hser YI, Saxon AJ, Huang D, et al. Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial. Addiction. 2014;109(1):79-87.
Shulman M, Luo SX, Campbell ANC, et al. Secondary Analysis of Pain Outcomes in a Large Pragmatic Randomized Trial of Buprenorphine/Naloxone Versus Methadone for Opioid Use Disorder. J Addict Med. 2020;14(5):e188-e194.
Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. J Med Econ. 2018;21(2):127-134. J Consult Clin Psychol. 2014;82(6):964-972.
Haight BR, Learned, S.M., Laffont, C.M., Fudala, P.J., Zhao, Y., Garofalo, A.S.,, Greenwald MK, Nadipelli, V.R., Ling, W., Heidbreder, C. and Andersen, J.L.,. Efficacy and safety of a monthly buprenorphine depot injection for opioid use Disorder a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet. 2019;393(10173):778-790.
Lofwall MR, Walsh SL, Nunes EV, et al. Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs Daily Sublingual Buprenorphine With Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial. JAMA Internal Medicine. 2018;178(6):764-773.
Vanderplasschen W, Wolf JRLM., Rapp, R., Hesse, M.,. Case management for persons with substance use problems. Adiktologie 2005;7(4):430-443.
Goodnough A. This Addiction Treatment Works. Why Is It So Underused? New York Times. Oct. 27, 2020, 2020.
Maricich YA, Bickel WK, Marsch LA, Gatchalian K, Botbyl J, Luderer HF. Safety and efficacy of a prescription digital therapeutic as an adjunct to buprenorphine for treatment of opioid use disorder. Curr Med Res Opin. 2021;37(2):167-173.
Christensen DR, Landes RD, Jackson L, et al. Adding an Internet-delivered treatment to an efficacious treatment package for opioid dependence. J Consult Clin Psychol. 2014;82(6):964-972.
DeFulio A, Rzeszutek MJ, Furgeson J, Ryan S, Rezania S. A smartphone-smartcard platform for contingency management in an inner-city substance use disorder outpatient program. J Subst Abuse Treat. 2021;120:108188.
National Institute on Drug Abuse. Optimizing Retention, Duration, and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy (NIH HEAL Initiative). Accessed June 2, 2021.


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