Out With the Old and In With the New: Removal of the X-Waiver and the Role of the Psychiatric Pharmacist

Registration Options

Activity Dates: 04/28/2025 - 04/28/2028

Session Time and Location

Date: Monday, 04/28/2025

Time: 3:10 PM (view in the schedule)

Room: Regency AB-L4

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.

Session Summary

Step into a new era of opioid use disorder treatment with the removal of the X-Waiver and discover the expanded opportunities for psychiatric pharmacists. This session will explore the significant changes to buprenorphine prescribing brought about by the Mainstreaming Addiction Treatment Act and highlight the pivotal roles psychiatric pharmacists can play in managing this treatment. Learn innovative strategies to develop a psychiatric pharmacist practice model that optimizes buprenorphine management and improves outcomes for patients battling opioid use disorder.

Course Requirements

To receive ACPE credit for this session, you must:

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Register for this course.
Review the full content of the activity and reflect upon its teachings.
Complete the post-test at the end of the activity no later than the closing activity date.
Complete the evaluation at the end of the activity.
If necessary, complete the post-test retest no later than the closing activity date.
Receive a passing grade (70%).
Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.

Your ACPE credit will be submitted directly to CPE Monitor within 48 hours of successful completion of the exam and of the evaluation form if you have provided the relevant information in your profile.

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Faculty Information

Michelle Geier, PharmD, BCPP, APh, FAAPP
Damian Peterson, PharmD, BCPP, BCPS, APh

View biographical information

Michelle Geier, PharmD, BCPP, APh, FAAPP
Psychiatric Clinical Pharmacist
San Francisco Department of Public Health
San Francisco, CA

Michelle Geier is a psychiatric clinical pharmacist for San Francisco Department of Public Health (SFDPH). She is currently deployed as a disaster service worker for SFDPH as the Substance Use Services Pharmacy Lead to address the local opioid overdose crisis. In her usual roll, she manages a caseload of psychiatric and substance use disorders clients under a collaborative practice agreement at a county mental health clinic that predominantly serves people experiencing homelessness on admission and dual diagnosis. She oversees substance use disorder clinical services at our county mental health and substance use disorders pharmacy that serves approximately 1200 people with opioid use disorder annually. She participates in multiple quality improvement committees for the health plan that is responsible for all Medicaid beneficiaries with a serious mental illness in San Francisco county. I serve as the Residency Program Director for our PGY2 in psychiatry.

Damian Peterson, PharmD, BCPP, BCPS, APh
Psychiatric Clinical Pharmacist
San Francisco Department of Public Health
San Francisco, CA

Damian Peterson is a psychiatric clinical pharmacist for the San Francisco Department of Public Health (SFDPH). Four days of the week he travels between various supportive housing buildings outreaching clients and providing low-barrier psychiatric and substance use disorder treatment. His typical case load is about ~60 clients that he sees once per week, distributed between 20+ different buildings. One day per week he sees clients at a drop-in urgent care clinic that predominantly serves people experiencing homelessness.

Damian is also involved in many initiatives to improve substance use disorder care for clients in San Francisco. He serves as the buprenorphine subject matter expert for the cities coordinated overdose response team, maintains the buprenorphine treatment guidelines for the city, and helps to develop policies & procedures to improve the quality of care provided for opioid use disorder.

Learning Objectives

Describe the role of psychiatric pharmacists in improving access to buprenorphine for patients with opioid use disorder.
Apply the PRECEDE planning model to development of a psychiatric pharmacist practice managing opioid use disorder.
Use the PROCEED model to evaluate a new psychiatric pharmacist practice managing opioid use disorder.

Continuing Education Credit and Disclosures

Activity Dates: 04/28/2025 - 04/28/2028
ACPE Contact Hours: 1
ACPE Number: 0284-0000-25-010-H04-P (Application)
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.

ACPE The American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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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.

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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.

Meeting Essentials