Opioid Agonist Therapy 101 Introduction to Clinical Practice November 20 & 21

This workshop will arm you with new knowledge and skills around opioid addiction and
the resources available to support this vulnerable patient population; it is a prerequisite
training requirement in order to prescribe or dispense methadone and buprenorphine/
naloxone in Manitoba.

Overall Learning Objectives:

At the conclusion of this workshop, participants will:

1) Describe the prerequisite knowledge required to initiate and monitor patients on methadone and/or buprenorphine/naloxone. (CanMED Roles: Medical Expert, Scholar)
2) Be able to demonstrate basic decision making skills essential to providing or dispensing safe and effective opioid agonist therapy (CanMED Roles: Medical Expert, Professional, Collaborator)
3) Discuss the role of sensitivity, understanding, and commitment in the delivery of addiction medicine in clinical or pharmacy practice.(CanMED Roles: Professional, Communicator, Health Advocate)

Specific Learning Objectives:

At the conclusion of this workshop, participants will be able to:

1) Identify opioid use disorder (neuroanatomy and pathophysiology of the brain’s reward system, typical clinical presentations, typical behaviours, DSM-5 criteria). (Medical Expert, Scholar)
2) Explain the model of addiction as a chronic disease, requiring long term management by health care professional(s) as well as mental health, spiritual and social support. (Medical Expert, Collaborator, Health Advocate)
3) Perform a comprehensive assessment of an individual with opioid use disorder and select appropriate treatment options. (Medical Expert, Communicator, Professional)
4) Recognize the unique pharmacology of methadone and buprenorphine/naloxone and participate effectively in prescriber – pharmacist collaborative care. (Medical Expert, Collaborator, Professional)
5) Identify potential and actual drug interactions. (Medical Expert)
6) Select an appropriate methadone induction dose and manage initial methadone induction, dose adjustments and early stabilization issues appropriately. (Medical Expert, Professional)
7) Assess a patient’s appropriateness for carry doses, including frequent reassessment and as-needed adjustments to carry status.8) Discuss important issues in the maintenance phase of treatment, including urine toxicology, prolonged QT, split dosing, smoking cessation support and withdrawal of treatment. (Medical Expert, Professional)
8) Discuss issues in maintenance phase: urine toxicology, QT prolongation, split dosing, smoking cessation, withdrawal of treatment (Medical Expert, Health Advocate)
9) Identify special considerations in the treatment of pregnant women with opioid use disorder, in the ante-natal period, during labour and post- partum, including breast feeding. (Medical Expert, Health Advocate, Communicator)
10) Examine neonatal opioid withdrawal and recognize how treatment decisions may impact withdrawal severity and overall maternal/neonatal outcomes. (Medical Expert, Health Advocate)
11) Examine the role education and advocacy plays in promoting improved neonatal/maternal outcomes and strengthening the family unit. (Health Advocate, Scholar, Communicator)
12) Discuss special issues in the management of individuals with opioid use disorder and concurrent major psychiatric disorders. (Medical Expert, Collaborator, Professional)
13) Discuss special issues in the management of individuals with opioid use disorder and concurrent acute, chronic, and post-operative pain. (Medical Expert, Collaborator)
14) Identify special considerations in the management of individuals with opioid use disorder and hepatitis C and/or HIV. (Medical Expert, Collaborator, Health Advocate)
15) Identify special considerations in the management of individuals with opioid use disorder who are indigenous and/or from indigenous communities. (Health Advocate, Communicator, Professional)
16) Formulate a practical approach to managing insomnia in the patient with opioid use disorder. (Medical Expert, Professional)
17) Discuss important safety considerations and formulate a practical approach to managing individuals with opioid use disorder who also abuse alcohol. (Medical Expert, Professional, Health Advocate)
18) Discuss important safety considerations and formulate a practical approach to managing individuals with benzodiazepine use and/or with complex polypharmacy. (Medical Expert, Professional)
19) Distinguish different models of service delivery in opioid agonist therapy including the comprehensive care model, private clinic model, community clinic model and family practice model. Compare and contrast the strengths and weaknesses of each model. (Medical Expert, Scholar, Collaborator, Leader)
20) Implement and integrate safe preparation, documentation, and dispensing of methadone and buprenorphine/naloxone into pharmacy practice. (Medical Expert, Professional, Collaborator, Leader)

Day 1 Agenda November 20, 2025

0800-0820 Check In and Coffee

0820-0845 Orientation to the Workshop (Includes Pre-Test – will be emailed)

0845-0910 Round Table Introductions

0910-0940 A Review of Opioid use disorder and emerging inpatient and community disease patterns

0940-1040 Treatment approaches – the evidence and how it informs local practice (includes discussion on abstinence vs. harm reduction, naloxone and psychosocial support groups)

1040-1055 Coffee Break (provided)

1055-1205 From Initiation to the Maintenance Phase: Dose adjustments, Urine toxicology, Carries, Split dosing, Management of Concurrent alcohol abuse, and Insomnia

1205-1235 Pharmacology of methadone and buprenorphine/naloxone and prescriber-pharmacist collaborative care      

1235-1305 Lunch break

1305-1350 The Comprehensive Patient Assessment

1350-1415 Key Practice Supports and the Prescribing Approval Process

1415-1445 Benzodiazepines and opioid agonist treatment: A practical approach to care

1445-1500 Break

1500-1550 Break-out session # 1 (Pharmacists Breakout Room) Integrating Opioid Agonist Therapy into Pharmacy Practice – Part 1: Examining the Current Guidelines

1500-1550 Break-out session # 1 (Prescribers Breakout Room) Standardized patient interviews

1550-1630 Break-out session # 2 (Prescribers & Pharmacists) Case discussion and role play

Day 2 Agenda November 21, 2025

0800 – 0820         Check in & Coffee

0820 – 0855          Reflections from day 1 & Lindy’s Tool  

0855 – 0935          Withdrawal of Treatment                  

0935 – 1005         Special Considerations: HIV and Hep C in the context of Opioid Agonist Treatment

1005 – 1050         Polypharmacy and over-the-counter medication use

1050 – 1105         Break

1105 – 1155         Special Considerations: Pregnancy

1155 – 1255         Opioid Agonist Treatment and Co-occurring Psychiatric Disorders: A 45-minute primer (Prescribers Breakout Room)

1155 – 1255         Breakout session # 3 (Pharmacists Breakout Room) Integrating Opioid Agonist Therapy into Pharmacy Practice – 

                               Part 2: Witnessed Ingestion.                                                                               

1255 – 1325         Lunch break

1325 – 1410         Special Considerations: Indigenous Health and Opioid Agonist Treatment.

1410 – 1440         Special Considerations: Acute, Chronic, and Perioperative Pain in the Context of Opioid Agonist Therapy

1440 – 1455         Break

1455 – 1550         Break-out session # 4 (Pharmacists) Integrating Opioid Agonist therapy into Pharmacy Practice –   

                                Part 3: Special Situations

1455 – 1550         Break-out session # 4 (Prescribers) Standardized patient interviews

1550 – 1620         Breakout session # 5 (Prescribers & Pharmacists) Case discussion and role play

1620 – 1630         Post-test (link will be emailed); Day 2 Evaluation Forms (emailed)
Wrap up

Prior to attending this workshop participants are required to complete the following prerequisite readings listed below:

Methadone Maintenance Treatment: Client Handbook REVISED; Can be found at:

Making the Choice, Making it Work – Booklet

The College of Physicians & Surgeons of Manitoba publication, Manitoba Opioid Agonist Therapy Recommended Practice Manual. Please note, this manual is in development and provides recommendations for both buprenorphine/naloxone and methadone; published chapters are available at the OAT Recommended Practice Manual page for review while awaiting the completed manual. Please read all chapters posted on this webpage.

The College of Pharmacists of Manitoba guidelines: Opioid Agonist Therapy Guidelines for Manitoba Pharmacists (OAT Guidelines) (required reading for pharmacists only); Can be found at:

OAT Guidelines for Manitoba Pharmacists

General Inquiries or questions regarding the workshop can be directed to your Regulatory Body:

Marina Reinecke MBChB, CCFP (ISAM Certified), Medical consultant, CPSM
MReinecke@cpsm.mb.ca or 204 294 2162

Diana Heywood RN MN, Practice and Standards Consultant, CRNM
dheywood@crnm.mb.ca or 204 784 6467

Kim McIntosh, B.Sc.(Pharm), Assistant Registrar – Qualifications and Practice Development, CPhM
kmcintosh@cphm.ca or 204-233-1411 ext 230

Registration:

Physicians: $1250.00
Pharmacists: $400.00
Residents: $500.00
Nurse Practitioners: $500.00
Physician Assistant: $400.00
Clinical Assistant: $400.00
Other Nursing Profession: $400.00
Other Health Professions: $350.00

Cancellation Policy

Cancellation Policy
In accordance with CPD Medicine policy:

• More than 14 days’ notice: A refund will be issued, minus a 20% administrative fee (up to a maximum of $200).
• Less than 14 days’ notice: No refund will be provided.

Special refund requests may be submitted to the event coordinator for consideration by the Scientific Planning Committee Chair or the Program Director.