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    specialty pharmacy training, delivered in our convenient & on-demand format



    SASP 2

    Background

    At some point, everyone ponders whether the “War on Drugs” will ever end? Didn’t the “Just Say No” campaign eradicate addiction, drug overdoses, and drug diversion? When should healthcare professionals expand their respective knowledge base on substances of abuse? Just. Say. NOW.

    Faculty

    Mark GarofoliMark Garofoli PharmD, MBA, BCGP, CPE

    Module 1: Just Say Know – A Review of Substances of Abuse / 1.0 hour
    Spelling matters. Just Say No? Perhaps, Just Say KNOW! Substances will change controlled substances classes in the future, just as ethyl alcohol had in the past, but their respective pharmacology remain the same. Because of this, we, as healthcare professionals, need to provide impactful patient care with expanded knowledge of substances of abuse. In this program, we will review a multitude of substances of abuse, broken down into therapeutic classes and subclasses, with particular attention to structural nuances, clinical pearls, mechanisms of action, dosages, and interactions. This dynamic discussion will provide a broader depth of knowledge than the average clinician is ever armed with for patient care, while serving as the introduction for the much more comprehensive Substances of Abuse Specialty Pharmacist Certificate. Just Say NOW.

    Module 2: Drug Pricing and Policy / 1.0 hour
    Join us for a dynamic review of substances of abuse utilization, market, and policy trends from across the globe. Healthcare professionals continually need to be up-to-date with all levels of policy and law, particularly pertaining to substances of abuse that are also available as prescription medications. It is in the best interest of pharmacists looking to provide the highest quality patient care to stay abreast of common legal drug misuse/abuse and illicit drug market trends. The crossroads of legal medications and illegal drugs can sometimes even be the same chemical, yet with incredibly different pricing, policy, and patient care aspects to consider.

    Module 3: Hallucinogens / 2.0 hours
    If it’s natural, it must be safe, right? Can you name a few dozen hallucinogens? Do you know what the various types or subgroups of hallucinogens are? This dynamic discussion on hallucinogens will provide perspective on how to organize dozens of hallucinogens by mechanism of action. It will also help the pharmacy practitioner with utilizing knowledge of expected duration of hallucinogenic effects, drug interactions, and various clinical pearls to help inform patient care efforts. This program will clear any distorted vision (pun intended) of the pharmacology of hallucinogens.

    Substances of Abuse Specialty Pharmacist Module 4: Stimulants / 1.0 hour
    Join Dr. Mark Garofoli for a “stimulating” discussion of substances that raise alertness—stimulants—which share the same illicit distribution networks as illicit opioids. Methamphetamine (meth) and cocaine utilization has actually remained at a consistently moderate to high level over the past few decades but was lost in conversation due to the sensationalization of the opioid crisis. Additionally, there is a decent amount of overlap and confusion between some hallucinogens and stimulants, since there are substances within both categories of substances of abuse that are almost identical in structure, yet, unique in effect. This discussion of the various stimulants that are utilized, misused, and abused across the globe can help to broaden your view of these substances of abuse (hopefully without even dilating your pupils)!

    Module 5: Nicotine / 1.0 hour
    Every U.S. Surgeon General has proclaimed smoking cessation to be the single most important effort to discuss with patients. Some may even venture to say that nicotine, a not so perfectly legal substance, may be the most addictive substance known to mankind. Fast forward from the Big Tobacco days of yore to our current society experiences, which now include e-cigarette and vape utilization. To get one’s heart pumping as much as nicotine can, one can ponder the question of whether vaping can, or should, be utilized as smoking cessation. To answer this question and countless others, we, as healthcare professionals, truly need to understand the mindset of someone choosing to smoke tobacco or vape, along with the products being utilized and the available cessation agents, to ultimately even attempt to have continual and impactful conversations with our patients. Join Dr. Mark Garofoli for a professional discussion on all forms of nicotine available today to finally clear the smoke on how to best improve and save the lives of our patients!

    Module 6: Cannabis and Cannabinoids / 1.0 hour
    Medical marijuana, recreational marijuana, weed, hemp, cannabis, cannabinoids, CBD, THC—when will the madness end or begin?

    Cannabis has been around for centuries and has recently reignited public discussion of its safety, efficacy, legality, and access. Public opinion and policy regarding cannabis has continually shifted across the globe for some time now. With that in mind, do you have any “budding” questions?

    This discussion will dive deeper into the weeds to provide a “higher education” of clinically practical knowledge, specifically, mechanisms of action, dosages, prescription and general products, effects, clinical applications, side effects, and drug interactions. In other words, all things cannabis, with a respect for the pharmacology.

    Module 7: Opioids / 1.0 hour
    The world has dealt with opioids in some way, shape, or form for centuries and will continue to do so for centuries to come. However, many mistakenly consider the recent opioid crisis to be the only incident of its kind in history.

    The first wave of the current opioid crisis observationally involved prescription opioids (whether attained via prescription or illicitly), the second wave involved heroin, and the third wave involves fentanyl and its analogs. Along the way, there are numerous other “natural” and “synthetic” opioid substances that ebb and flow in popularity across the globe. Healthcare professionals should be able to identify any and all opioid substances, while also taking those substances into consideration during clinical conversations when reviewing for therapeutic considerations, such as drug interactions. Join Dr. Mark Garofoli for a dynamic discussion of the most sensationalized substances on our planet: opioids.

    Module 8: GABA-Related Sedatives / 1.0 hour
    GABA, GABA, GABA. What’s all this GABA about?

    If a substance exhibits a mechanism of action involving the GABA receptors and channels, should it be expected to have an abuse potential, and further, should it automatically be a controlled substance right alongside benzodiazepines (benzos), ethyl alcohol, and some seizure medications (in other words, a decent group of sedatives)?

    Then again, just because a substance is a controlled substance, that doesn’t necessarily mean outright avoidance should be practiced within patient care either. Still, for substances like “roofies” or “the date-rape drug”, the balance between appropriate utilization and major safety concerns is a little more one-sided. Join Dr. Mark Garofoli for a thorough review of all sedatives provoking their action with GABA receptors and channels.

    Module 9: Alcohol and Inhalants / 1.0 hour
    Drug overdoses account for the loss of 100,000 lost American lives annually, while alcohol-related deaths mirror those staggering numbers, even though ubiquitously available for anyone at least 21 years old.

    As the “poster child” for the subjectivity of laws regarding substances of abuse through its shift from being legal, to prohibition, and then back again, alcohol truly begs one to ponder our overall “war on drugs”. To round off this program, the discussion will also venture into the concept of inhalants that are abused across the globe on a daily basis, with particular attention to what we, as healthcare professionals, need to know to best educate our patients and possibly even save a life. Join Dr. Mark Garofoli for a glass-half-full approach to drastically helping patients either with alcohol use disorder or even managing occasional alcohol use with other medications or substances of abuse.

    Module 10: Drug Diversion Best Practices / 2.0 hours
    How can I best help my patient while navigating the abundance of federal and state laws dictating how I practice? Will I lose my license? Just how far is too far?

    No one ever enjoys the answer to difficult patient care scenarios being the cookie-cutter response: it differs patient to patient. Yet, just how does one make recommendations to provide patient care while still adhering to the “corresponding responsibility” of prescribers and dispensers and accounting for reasonable patient variations? Well, as always, an ounce of prevention (education) is worth a pound of treatment (patient care). Join Dr. Mark Garofoli for a dynamic discussion on drug diversion best practices (DEA Red Flags, PDMPs, Urine Drug Monitoring, etc.) along with best practices in patient education and treatment selection.

    Module 11: Opioid Antagonists / 1.0 hour
    Naloxone saves lives by reversing opioid overdose respiratory depression, but it is not the only opioid mu-receptor antagonist available. Also, the actual administration of naloxone typically takes seconds, yet the additional clinical and situational information associated with it takes much longer to unpackage. Thus, this program will review the signs and symptoms of opioid overdose, the FDA-approved opioid overdose respiratory depression reversal products, the opioid overdose respiratory depression reversal medication administration guidelines, and general important pharmacological characteristics of the opioid antagonist’s naloxone, naltrexone, and nalmefene. Join Dr. Mark Garofoli for a dynamic discussion on just how to save a life!

    Module 12: Substance Use Disorder (Addiction) / 1.0 hour
    Every 6 minutes in our country, a person dies from prescription drug overdose, while every 30 minutes a child is born dependent (not addicted!) upon opioids. How do we, as healthcare professionals, offer non-stigmatic patient care and help to move society in the right direction? Addiction, classified as substance-use disorder, is likened to an iceberg or a weed because the issues beneath the surface are typically more complicated than what is viewed from the surface. Thus, in this discussion, we will review the core concepts and understandings of substance use disorder (addiction). So, join Dr. Mark Garofoli for a conversation on addiction that will be sure to impact your patient care, maybe your own opinions, and perhaps even your holiday family meal conversations!

    Module 13: Medication-Assisted Treatment (MAT) / 1.0 hour
    Heroin was developed and intended to address morphine addiction, and methadone and buprenorphine aim to address heroin and/or fentanyl (or really any opioid) addiction. Still, each pharmacological entity certainly comes with its own pitfalls. In this discussion, we will review the key clinical practice concepts and patient counseling points stemming from the pharmacology of the medication-assisted treatment options of buprenorphine, methadone, and naltrexone. All MAT, as with all medications in general, are continually improving and savings lives, yet each come with their own baggage. Thus, we, as healthcare professionals, need to continually educate ourselves and each other in this realm.





    Program Description

    This 15-hour specialty certificate, consisting of 13 activities/modules, will be an in-depth exploration of substances of abuse including dynamic pharmacology aspects for all healthcare professionals to immediately utilize to improve their own respective patient care.

    Some important notes to remember regarding the Substances of Abuse Specialty Pharmacist (SASP) Certificate:

    • Registration costs $189 for members, $289 for non-members.
    • Once you have completed the specialty certificate, you are eligible to claim a sharable digital badge. Learn more about badges here.
    • This program's final exam consists of 50 unique multiple-choice questions.
    • You have only three (3) attempts to pass the final exam.
    • You may not leave the final exam in the middle and return at a later time.
    • The final exam has no time limit; however, we recommend that you write the answers down in case you lose your Internet connection or get interrupted while taking the exam.
    • You will earn continuing education credit as you complete each activity, totaling 15 credits upon final completion
    • You will have 12 months to complete the specialty certificate before it expires from your account.
    • This specialty certificate is NOT accredited for pharmacy technicians or nurses.
     

    Requirements

    Substances of Abuse Specialty Pharmacist 2023 Update