This Clinical Pearls session consists of three, 15-minute presentations about unique psych pharmacy patient cases and/or clinical challenges. Each presentation will be recorded, and the three combined sessions are available for 1.0 hour of ACPE credit.
The Role of Buprenorphine in Restless Legs Syndrome, presented by Alissa Scalise, PharmD, BCPS, BCPP
- Describe the role of opioids in treatment of Restless Legs Syndrome (RLS).
- Explore two patient cases and identify the benefit of buprenorphine in the treatment of restless legs syndrome.
Summary: Restless Legs Syndrome (RLS) is a challenging neurologic condition that is treated with commonly used CNS pharmacotherapeutics. Opioid therapy has been used for many years for RLS, but many providers are hesitant given the opioid epidemic. Recent guidelines were released by the American Academy of Sleep Medicine with changes to the treatment algorithm have adjusted the place in therapy for dopamine agonists, a commonly known mainstay of RLS treatment. The importance of opioid therapy in RLS treatment will be highlighted in this clinical pearl, along with a patient case describing how buprenorphine can be a safe alternative to full agonist opioid therapy, highlighting another important clinical use of this important medication.
Pee Attention!: Interpreting Fentanyl Urine Drug Tests, presented by Roisin Sabol, PharmD
- Recognize limitations of immunoassay tests to screen for fentanyl use.
- Discuss how to interpret quantitative fentanyl tests using patient-specific considerations.
Summary: Nearly 70% of drug overdose deaths in the United States in 2023 involved fentanyl, underscoring the importance of continued harm reduction efforts to combat the opioid crisis. Urine drug monitoring can be a valuable source of objective information about fentanyl exposure, but this is contingent on appropriate use. As immunoassay and quantitative drug tests are increasingly used in clinical settings, accurate interpretation is essential. Understanding fentanyl’s unique pharmacokinetic and pharmacodynamic properties is foundational to recognizing the complexities and limitations of fentanyl urine drug tests.
Monitoring Methadone: Beyond the EKG, presented by Zoe Karavolis, PharmD, MPH, BCPP, CPH
- Describe methadone pharmacology and therapeutic drug monitoring.
- Review clinical implications for methadone therapeutic drug monitoring and limitations of split dosing.
Summary: Methadone is a first-line treatment option for opioid use disorder; however, it presents significant dosing challenges based on its pharmacokinetic and pharmacodynamic principles. Serum methadone monitoring has been proposed as a tool to guide the interpatient variability that exists with dosing. To date, there is limited literature to support the use of methadone serum monitoring. This clinical pearl will review the clinical implications and potential role for methadone serum monitoring in clinical practice.
Target Audience
If you are a pharmacist, nurse practitioner, or other health care professional involved in the comprehensive medication management of individuals living with mental health and/or substance use disorders, we invite you to participate in this online course.
Course Requirements
To receive ACPE credit for this session, you must:
- Register for this course.
- Review the full content of the activity and reflect upon its teachings.
- Complete the evaluation at the end of the activity.
- Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.
Faculty Information
View biographical information
Alissa Scalise, PharmD, BCPS, BCPP
Clinical Pharmacist Practitioner – Pain/Neurology VISN1 Clinical Resource Hub
VA Connecticut Health Care System
West Haven, CT
Alissa Scalise graduated from Western New England University, College of Pharmacy & Health Sciences with her PharmD in 2016. She completed PGY1 Pharmacy and PGY2 Psychiatric Pharmacy Residencies at Providence VA Medical Center (PVAMC) in Providence, Rhode Island. She is currently a Board Certified Psychiatric Pharmacist and Board Certified Pharmacotherapy Specialist and maintains an Adjunct Assistant Professor Position at the University of Rhode Island College of Pharmacy.
Dr. Scalise continued her career after residency as a Multispecialty Clinical Pharmacist Practitioner at PVAMC. She was their Neurology Clinical Pharmacist Practitioner, while she also supported substance use disorders in an interprofessional model and was also an early adopter of buprenorphine prescribing for Pain. She also had a role in Internal Medicine where she supported Consult & Liaison Psychiatry services. In 2022 she transitioned to the facility’s Pain Management, Opioid Safety, and PDMP Coordinator where she maintained a small practice in Neurology and Pain before transitioning to her current role as a Pain and Neurology Clinical Pharmacist Practitioner, a role which serves rural Veterans across New England in a predominately telehealth model. Other highlights include integral involvement in quality improvement and access to medications and vaccinations for patients with neurological and specialty conditions. She also serves nationwide VA workgroups in Neurology and Headache Pharmacotherapy.
Dr. Scalise’s interest includes thoughtful applications of Central Nervous System pharmacotherapy across disciplines. Special focus areas are chronic pain, neurodegenerative and neuromuscular diseases, movement disorders, and headaches. She strives to highlight the significant role pharmacists, specifically Psychiatric Pharmacists, can play in neurology and pain clinics nationwide.
Roisin Sabol, PharmD
Advanced Fellow in Addiction Treatment, VA Pittsburgh Healthcare System;
Clinical Pharmacist – Ambulatory Addiction Medicine Services, University of Pittsburgh Medical Center Western Psychiatric Hospital
Pittsburgh, PA
Roisin Sabol, PharmD (she/her) is an Advanced Fellow in Addiction Treatment at the Center for Health Equity Research and Promotion (CHERP) at VA Pittsburgh Healthcare System. Dr. Sabol earned her PharmD with a concentration in Psychiatric Pharmacotherapy from the University of Pittsburgh School of Pharmacy in April 2022, followed by 2 years of clinical residency training in Pharmacy Practice and Psychiatric Pharmacy at VA San Diego Healthcare System. As a pharmacist-researcher in training, her current work includes understanding factors that contribute to inequities in treatment quality for substance use disorders and improving outcomes after within-setting transitions of care.
Dr. Sabol also provides clinical care at VA Pittsburgh and UPMC Western Psychiatric Hospital. Her primary practice settings include ambulatory substance use disorders clinics and a primary care-based buprenorphine for chronic pain clinic.
Outside of work, Dr. Sabol enjoys exploring new dog parks with her pup, Melvin, and frequenting local bakeries in search of the city’s best donut.
Zoe Karavolis, PharmD, MPH, BCPP, CPH
Clinical Psychiatric Pharmacist
Alcohol, Drug, and Addiction Treatment Program McLean Hospital
Belmont, MA
Zoe Karavolis, PharmD, MPH, BCPP, CPH earned her PharmD and MPH from Northeastern University in Boston, Massachusetts. She completed her PGY1 and PGY2 Psychiatry residency training at UPMC in Pittsburgh, Pennsylvania. She now works as a clinical psychiatric pharmacist in the Alcohol, Drug, and Addiction Treatment Program at McLean Hospital where she is a crucial member of a multidisciplinary team ensuring optimal medication management for an inpatient dual diagnosis unit. She also serves as the Site Coordinator of the hospital’s Naloxone Program and is a substance use disorder clinical expert for Mass General Brigham Health System-wide initiatives. Her clinical interests include harm reduction and health disparities in substance us disorder treatment.
Continuing Education Credit and Disclosures
Activity Dates: 04/29/2025 - 04/29/2028
ACPE Contact Hours: 1
ACPE Number: 0284-0000-25-018-H01-P (Knowledge)
Nursing Credit Reminder: Note that ACPE credit is accepted for ANCC Certification Renewal and AANPCB advanced practice provider content. For specific questions related to your organization's acceptance of ACPE continuing education units, please contact your organization directly.
The American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
AAPP owns the copyright, is licensed or has received permissions for use of, or is otherwise permitted to use copyrighted materials within any CPE activity. Authors and speakers are required to obtain necessary copyright permissions for content in CPE activities. AAPP complies with copyright laws and regulations.
View disclaimer and disclosure of off-label use
Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information). The opinions expressed in the educational activity do not necessarily represent the views of AAPP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
View fair balance and integrity statement
It is the policy of AAPP to ensure independence, balance, objectivity, scientific rigor, and integrity in continuing education activities. Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer’s package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Fair balance is achieved through ongoing and thorough review of all materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by AAPP for any product or manufacturer identified.