June 21, 2024 | High-Dose and Low-Dose Buprenorphine Initiations – Practical tips for the Primary Care Clinician | ME SUD Learning Community



June 21, 2024 | 12:00-1:00pm


The presence of fentanyl and fentanyl analogs in the US drug supply presents new challenges to buprenorphine initiation, including delayed time to induction, a higher risk of precipitated withdrawal with buprenorphine, and idiosyncratic reactions, including intense dystonia and vomiting. At the same time, collaborative decision-making with patients regarding the best strategy and setting for buprenorphine initiation is essential for engagement and successful initiation. This webinar will provide practical tips and tools for the practicing clinician to use for engagement, decision-making, and successful buprenorphine initiation in the outpatient setting.

Learning Objectives:

  1. Provide collaborative decision-making framework for selecting initiation protocol
  2. Review indications, pro, cons and protocols for different types of buprenorphine initiation
  3. Describe use of adjunctive medications during initiation process, with dosing and indications
  4. Review care model for successful outpatient buprenorphine initiations



woman smiling at cameraRachel Solotaroff, MD, MCR

Rachel Solotaroff, MD, MCR is the Executive Clinical Director of Substance Use Disorder Services at Penobscot Community Health Care, where she provides patient care, oversees substance use disorders care delivery in the outpatient setting, and providing medical direction for withdrawal management at New Horizons. Prior to moving to Maine, Rachel served as Chief Medical Officer and then CEO at Central City Concern in Portland, Oregon. Rachel’s interest lies in using a population health framework to address the complex intersection of homelessness and substance use disorders, often accompanied by trauma, social isolation, and mental illness. Rachel is a general internist with additional board certification in Addiction Medicine and holds a Masters in Clinical Research.


Prescribing clinicians and their teams

Continuing Medical Education
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and CCSME. The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

The Maine Medical Education Trust designates this regularly scheduled series for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

*Nurses and Nurse Practitioners will be awarded a certificate of participation with a maximum of 1 AMA PRA Category 1 Credit™.

Contact Hours
1 contact hours for social workers, licensed clinical professional counselors, and behavioral health professionals.
1 Category I contact hours for psychologists. CCSME is a pre-approved sponsor and provider of Professional Education Activities for Psychologists.
1 contact hours for Alcohol and Drug Counselors pending approval by the Maine Board of Alcohol and Drug Counselors
1 contact hours CHES. CCSME is a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc.