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The Fourth Wave: Fentanyl and the Overdose Crisis

Sponsored by: California Department of Health Care Services (CA DHCS), Opioid and Stimulant Implementation Support-Training and Technical Assistance (OASIS-TTA)-MAT Expansion Project, UCLA Integrated Substance Abuse Programs (UCLA ISAP), Pacific Southwest Addiction Technology Transfer Center (PSATTC), HHS Region 9, & Opioid Response Network STR-TA


Course Description

This session will address “The Fourth Wave” of the opioid epidemic, including recent data on rising mortality due to fentanyl alone and in combination with methamphetamine. The rise of polysubstance use, including the use of the so called “goofball,” has implications for morbidity and mortality and raises the complexity of treatment. Treatment options, including use of medications, will be discussed. The session will also cover harm reduction strategies including naloxone, drug surveillance, and drug checking. This session will also include training on how to use fentanyl test strips, as part of a comprehensive public health and harm reduction strategy. Fentanyl test strips are a practical and effective tool for people who use drugs as means to encourage overdose risk education and reduce risk of death. Training will include discussion on distribution, limitations, sourcing, messaging amongst other considerations in the application and administration of use.

Launch Date: November 12, 2021


At the conclusion of the training, participants will be able to:

1. Recall the history, epidemiology and use patterns of two (2) drug classes, including synthetic opioids and stimulants.
2. Explain two (2) poly-drug use patterns involving synthetic opioids and methamphetamines and develop treatment strategies.
3. Propose three (3) harm reduction measures to prevent overdose deaths due to synthetic opioids.
4. Identify two (2) steps required when testing drug supply using Fentanyl Test Strips.

CME Statements:

The training course meets the qualifications for the provision of two (2.0) continuing medical education credits/contact hours (CMEs/CEHs).

Continuing Education:

The training course meets the qualifications for the provision of two (2.0) continuing education credits/contact hours (CEs/CEHs).

Estimated time to complete the course:

This course should take approximately hours to complete.

Cost: Free

Disclosure statements:

Dan Ciccarone, MD, MPH – University of California, San Francisco

DISCLOSURES: Dr. Ciccarone is on the Scientific Advisory Board of Celero Systems and an expert witness in federal opioid litigation for Motley Rice LLC. All of the relevant financial relationships listed have been mitigated.

Amanda Cowan, MS – CLARE|MATRIX

DISCLOSURES: Reported no relevant financial relationships with commercial entities.


Dan Ciccarone, MD, MPH – University of California, San Francisco

Amanda Cowan, MS – CLARE|MATRIX

December 10, 2021
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