You are visiting us from Virginia. You are located in HHS Region 3. Your Center is Central East ATTC.

Buprenorphine Initiation in the Age of Fentanyl




As the illicit opioid supply includes more and more fentanyl, there have been increasing concerns about increasing rates of buprenorphine initiation precipitating opioid withdrawal. This session will describe why we believe this is happening, how common it is, and buprenorphine initiation strategies to support patients in avoiding precipitated withdrawal.




  • Describe the challenges of buprenorphine initiation in the fentanyl era.
  • Name three potential approaches to buprenorphine initiation.
  • Counsel on reducing fentanyl-related harms.




Trainer, Elizabeth Salisbury-Afshar, MD, MPH

Elizabeth Salisbury-Afshar, MD, MPH is an Associate Professor in the Departments of Family Medicine and Community Health and Population Health Sciences at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin. She is the Program Director of the Preventive Medicine Residency and core Faculty for the Addiction Medicine Fellowship. Dr. Salisbury-Afshar is board certified in family medicine, preventive medicine/public health and addiction medicine and her expertise lies at the intersection of these fields. Her work has focused on expanding access to evidence-based substance use disorder treatment and harm reduction services. Past public health roles include serving as Medical Director of Behavioral Health Systems Baltimore, Medical Director at Heartland Alliance Health (a healthcare for the homeless provider in Chicago), and Medical Director of Behavioral Health at the Chicago Department of Public Health. Dr. Salisbury-Afshar received her Medical Degree from Rush University Medical College and her Master’s in Public Health from John Hopkins Bloomberg School of Public Health.



The Great Lakes A/MH/PTTC is offering this training for individuals working in HHS Region 5: IL, IN, MI, MN, OH, WI. This training is being provided in response to a need identified by Region 5 stakeholders.

April 20, 2023
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