Resources Library

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Stephanie Nichols, PharmD, MPH, BCPP, BCPP, BCPS, FCCP | November 28, 2023 Do you struggle …

November 29, 2023 | Amy M. Mayhew, MD, MPH This presentation will investigate cannabis use …

December 5, 2023 Presented by: Stephanie Nichols, PharmD, BCPP, BCPS, …

Alcohol use disorder (AUD) is a disease that affects one in seven people. 1  And …

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Greetings, colleagues! In the era of fentanyl, we wonder, is more buprenorphine better? Or does …

The Maine Organizational Management module allows chief medical officers, medical directors, and other medical supervisors …

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The Maine Prescription Monitoring Program (PMP) utilizes specialty-specific clinical thresholds as a component of the …

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Managing Legacy Patients on Controlled Substances: Compassionate, Evidence-Based Responses | June 27, 2023 | Noah …

Webinar Medication Deprescribing and Chronic Pain Care | July 11, 2023 | Eva Quirion, NP, …

Webinar Colorado’s Experience with Cannabis: A Public Health Perspective| July 25, 2023 | Richard Holdman, …

Webinar PMP Tools to Improve Controlled Substance Prescribing | June 6, 2023 | Elisabeth Fowlie …

Webinar Safe and Effective Opioid Practices in the Hospital: Pharmacy Perspective | August 8, 2023 …

Webinar Strategies for Solving the Opioid Epidemic and Treatment of Acute Pain | August 15, …

Webinar Legal Issues and Controlled Substance Prescribing: How to Make It Work for ME | …

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Adolescent and Young Adults Project …

The revised 2023 Fourth Edition of The ASAM Criteria is soon to be released. This …

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Learn more about …

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Participants will review current opioid overdoses driven by fentanyl and xylazine, adverse and long-term effects …

Xylazine causes really bad skin ulcers when injected, even beyond the site of injection, like …

A cutting agent making its way into the drug supply. Contamination with xylazine increases risk …

The Maine Office of Behavioral Health’s Prescription Monitoring Program periodically review prescribing patterns of all …

What is Xylazine?
− A non-opioid agent that the FDA originally approved in 1972 as a sedative and analgesic for use in veterinary medicine (not FDA approved for use in humans)
− Acts as a central alpha-2-adrenergic receptor agonist in the brainstem (like clonidine)
o Rapid decrease in the release of norepinephrine and dopamine in the central nervous system (CNS)
o May also bind to other CNS receptors

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State of Maine Opioid Response …

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December 21, 2022 | Kinna Thakarar, DO, MPH Learning objectives: Recognize the interplay between Infectious …

November 30, 2022 | Kinna Thakarar

Learning objectives:

Review harm reduction approaches
Understand the roles of syringe service programs
Understand how to incorporate harm reduction principles in your current work with people who use drugs

December 6, 2022 | Kevin M. Gray, M.D., Professor of Psychiatry and Behavioral Sciences, Medical …

December 12, 2022 | Dr. Alane O’Connor, DNP Urine toxicology testing can be a useful …

Diagnosis and Treatment of ADHD in Adults with Substance Use Disorder: Applying Evidence to a Common Clinical Quandary | November 10, 2022 | Andrea Truncali, Lauren Moran, and Margaret Chaplin

Diagnosis and treatment of adult ADHD is on the rise. Patients with substance use disorder are thought to be disproportionately affected by ADHD but how safe is, and what impact does the pharmacologic treatment have?

NEJM Knowledge+ Pain Management and Opioids consist of 62 in-depth, case-based scenarios developed by practicing …

November 3, 2022 | Jonathan C Fellers, MD

Learning objectives:

Understand the pharmacologic differences between buprenorphine and methadone
Describe 2 strategies for switching between buprenorphine and methadone
Discuss informed consent and considerations for patients

November 14, 2022 | Ben Townsend and Elisabeth Fowlie Mock
This program will review current legal requirements for Maine opioid prescribers and the possible effects of current law enforcement activity

November 9, 2022 | Eric Haram, LADC

Universal screening and brief intervention and referral for substance misuse within primary care settings is a foundation activity soon to be required under PCPlus. This program will review the nuts and bolts to help providers implement this evidence-based practice. Screening tools to be highlighted include CRAFFT, DAST, AUDIT, 4Ps.

Technical Assistance,
Guidance Documents,
Handouts,
Recorded Webinars/ Online trainings,
Patient Handouts

General Educational Guidelines from the Maine Substance Use Disorder Learning Community Faculty
Eva Quirion, FNP, Ph.D., with contributions from Andrea Truncali, MD, MPH, Jonathan Fellers, MD, Stephanie Nichols, PharmD, BCPS, BCPP
https://mesudlearningcommunity.org/

General Educational Guidelines from the Maine Substance Use Disorder Learning Community Faculty
Jonathan Fellers, MD, with contributions from Eva Quirion, FNP, Stephanie Nichols, PharmD, BCPS, BCPP, https://mesudlearningcommunity.org/

General Educational Guidelines from the Maine Substance Use Disorder Learning Community Faculty
Jonathan Fellers, MD, with Stephanie Nichols, PharmD, BCPS, BCPP
https://mesudlearningcommunity.org/

Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leaders
Christine Munroe, DO
Director at the Recovery Center
Eric Haram, LADC, Haram Consulting LLC.

Recorded on April 27, 2022 for the Maine SUD Learning Community
Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leaders Andrea Truncali, MD, MPH, and Christine Wyman, LCSW, LADC, CCS

Talks with Dr. Lisa Letourneau and Randy Morrison, Director of Peer Services at Maine Health

Recorded on May 20, 2022 for the Maine SUD Learning Community. Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leader Kinna Thakarar, DO, MPH.

Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leader Kendra Emery, DO, Medical Director of Integrated Medication-Assisted Treatment (IMAT) and Department Chair of Family Medicine.

Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leader Eva Quirion, NP

Promising Practice Series: 30-minute Talks with Dr. Lisa Letourneau and Maine leaders | Jacob Crothers, MD and Rhonda P. Selvin, FNP

June 23, 2022 | Jonathan Fellers, MD

Learning objectives:

Explore the indications and treatment frame for the use of benzodiazepines
Understand the risks of benzodiazepines, including higher risk situations such as comorbidity
Discuss strategies for deprescribing benzodiazepines

November 2, 2022 | Elisabeth Mock, MD, MPH and Noah Nesin, MD
What are the best actions to take when patients with chronic pain in a community suddenly lose their provider? Patients on high dose opioids often have difficulty finding new providers. What resources are available to support prescribers in such a transition?

November 1, 2022 | Susan R.B. Weiss
The presenter will clarify cannabis, cannabinoids, and the endocannabinoid system. After examining the evolving landscape and the effects of long-term cannabis use, the public health impacts of cannabis will be discussed.

Objectives

Understand cannabis, cannabinoids, and the endocannabinoid system
Discuss the evolving landscape of cannabis use
Examine long term health effects of cannabis
Discuss the public health impact of cannabis

October 25, 2022 | Richard Rawson, PhD

An undeniable fact of the 2022 illegal drug supply is that it is changing rapidly and it is much more lethal. Methamphetamine with far greater purity and potency and fentanyl mixed into “heroin” cocaine and meth, fentanyl pressed into a variety of pill forms, and potent drugs including xylazine (a veterinary tranquilizer) and isotonitazene a potent opioid are now part of the drug landscape.

Learning objectives:

Understand the new street drug supply to provide effective overdose care and treatment.

October 18, 2022 | Richard Rawson, PhD

Contingency Management (CM) is a powerful behavioral strategy that has repeatedly been demonstrated to reduce stimulant use by individuals with Stimulant Use Disorder. Use of CM outside of the VA has been rare due to regulatory and funding obstacles. However, CM is cited in the 2022 National Drug Plan as a priority treatment to address the treatment needs of individuals with cocaine and methamphetamine use disorder. Delivery of an effective, evidence-based CM protocol that is in compliance with federal guidelines requires careful development of a training and implementation plan. The presenter will present the steps and key components of the CM protocol and implementation plan being used in California in the first large scale implementation of CM outside the VA.

October 11, 2022 | Nick Piotrowski, MD, FASAM, Medical Director, Addiction Psychiatry, MBH

Many patients can receive treatment for alcohol withdrawal safely in the community with the support of a primary care provider. This program will provide an overview of key elements and safety considerations of ambulatory alcohol withdrawal management programs.

Objectives:

Describe the role of ambulatory alcohol withdrawal management in the ASAM continuum of care.
Name 4 essential components of an ambulatory alcohol withdrawal management program.
Outline advantages and disadvantages of using benzodiazepines for ambulatory alcohol withdrawal management.

October 4, 2022 | Sephanie Nichols, PharmD MPH and Eric Haram, LADC

Objectives:

Understand prescribing and treatment for Alcohol Use Disorder
Describe ways to engage with patients when discussing unexpected information

October 4, 2022 | Mark Sullivan

Learning Objectives:

Learn the prevalence of Opioid Use Disorder (OUD) in patients treated with long-term opioid therapy (LTOT) for chronic pain
Understand the difference between OUD and Complex Persistent Opioid Dependence among patients on LTOT
Learn how to manage Complex Persistent Opioid Dependence
Differentiating Dependence from Opioid Use Disorder Maine

September 29, 2022 | Elisabeth Fowlie Mock, MD

Multiple enhancements to the Maine PMP in 2022 will further its mission “to promote the public health and welfare and to detect and prevent substance misuse.” Tune in to learn about PMP tools to enhance patient safety and how to ensure documentation of your compliance with the 2016 Chapter 488 law. Dr. Mock has been serving as the Clinical and Policy Advisor to the PMP since January 2022.

Objectives:

Use the PMP as a tool for patient safety
Evaluate PMP check workflows
Understand the ‘Overdose Risk Score’
Review new PMP functionalities

September 29, 2022 | Elisabeth Fowlie Mock, MD

Multiple enhancements to the Maine PMP in 2022 will further its mission “to promote the public health and welfare and to detect and prevent substance misuse.” Tune in to learn about PMP tools to enhance patient safety and how to ensure documentation of your compliance with the 2016 Chapter 488 law. Dr. Mock has been serving as the Clinical and Policy Advisor to the PMP since January 2022.

Objectives:

Use the PMP as a tool for patient safety
Evaluate PMP check workflows
Understand the ‘Overdose Risk Score’
Review new PMP functionalities

September 27, 2022 | Eva Quirion, NP, PhD

Explore the delivery of XR buprenorphine with a focus on practical issues. Challenges and successes of the use of the XR buprenorphine will be highlighted.

Learning objectives:

Assess patients for XR buprenorphine
Describe induction and delivery (practice tips on injection)
Name challenges and success with the use of XR buprenorphine

September 14, 2022 | Kaley Boucher

The program will review the recent changes to the Opioid Health Home (OHH) model and regulation. The new updates provide increased flexibility and care coordination across programs. The changes will be highlighted and there will be opportunities for questions and answers.

Objectives:

Describe the various tiers of the Opioid Health Home model
Highlight changes from the previous MaineCare OHH regulations
Identify the advantages of value-based payment models

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August 24, 2022 | Dr. Laurie Deerfield

This presentation will assist prescribers in their conceptualization and understanding of different diagnostic categories and ways psychiatric presentations may overlap to guide their choice of agents to treat complex medical psychiatric and substance issues appropriately without exacerbating other comorbid issues. Topics will include the how fentanyl influences those decisions, tips on reading confirmation substance testing, and ways to avoid precipitated withdrawal and the phenomenon known collectively as “restless leg syndrome.” Topics will include treating substance use disorders and anxiety, depression, and bipolar spectrums as well as depressive disorder sub types among others as time allows.

August 9, 2022 | Stephanie Nichols, PharmD, BCPS, BCPP, FCCP

This session will review the interface and nuances of the use of buprenorphine in a person with pain. We will review multiple angles, including both the treatment of acute and chronic pain in a person receiving buprenorphine for OUD and the use of buprenorphine to treat pain (with or without OUD).

Learning objectives:

Compare and contrast the various formulations of buprenorphine including consideration of FDA indication, route of administration, and dose
Identify the clinical result of using buprenorphine in a person who is opioid naive and in a person who is currently using other medical or nonmedical opioids
Describe the efficacy and clinical pearls associated with the use of buprenorphine patch and transmucosal forms for analgesia in a person with and without OUD
Identify emerging and best practices regarding treatment of acute and chronic pain in a person receiving buprenorphine for OUD

July 27, 2022 | Todd Mandell, MD

The early recovery period is critical to supporting ongoing recovery efforts. There are many pitfalls, with continued disruption of sleep, mood fluctuations and changing ways to care for yourself. Dr. Mandell will explore these areas providing tips about when and what might be helpful for pharmacological and treatment considerations.

Learning objectives:

Participants will be able to assist patients with the identification of post-withdrawal symptoms and refer for management.
Participants will be able to provide patients with education and skills regarding affect management as it pertains to recovery.
Participants will be able to address within their scope of practice issues such as overall well-being and self-care including healthy nutrition and sleep hygiene.

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June 14, 2022 | Stephanie Nichols, PharmD, BCPS, BCPP

This session will review the initiation of buprenorphine for OUD using the microdosing and macrodosing approaches. We will review why these emerging approaches are preferable to traditional approaches, the supporting evidence, and the practical pearls for implementation.

Learning Objectives:

Describe microdosing and macrodosing approaches to buprenorphine initiation
Recall the evidence supporting each of these approaches
Discuss practical pearls regarding these approaches when applied to patient care

June 29, 2022 | Eva Quirion, NP, PhD

How best to assess pain to offer non-opioid medication and non-medication treatments based upon the patient needs will be explored. Pertinent to this assessment is learning how to distinguish between peripheral pain and centralized pain.

Learning objectives:

Assess patients with chronic pain to offer non-opioid medications and non-medication treatments based on patient needs.
Distinguish between peripheral pain and centralized pain in order to identify treatments most likely to be helpful.

July 12, 2022 | Carol Squires, Dr. Kristine Silvia, Michael Niles, and Randy Morrison

Peer recovery partners in primary care foster connection, engagement, and support with self-directed recovery pathways. The panel will discuss their journey working together in primary care settings – what’s worked, lessons learned, how they collaborate as a team to support patients. The panel will consist of a physician, clinician, and peer support staff who have created this type of partnership.

Learning objectives:

Discuss peer support roles in primary care settings.

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May 4, 2022 | John Mariani, MD

The presenter will explore the promising and best practices on the use of XR Buprenorphine and naltrexone. The ways the medications can be delivered and practical issues of certification in the SUBLOCADE REMS program, storage, and administration will be discussed.

Learning objectives:

Assess which patients are appropriate for treatment with the extended release (XR) formulation of Buprenorphine and Naltrexone.
Familiarize with the induction and monitoring processes for XR Buprenorphine and XR Naltrexone. Familiarize with delivery, storage, and administration (including certification in the Sublocade REMS Program).

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April 5, 2022 | Todd Mandell, MD, FASAP

The presenter will explore how to assess and use evidence based resources and tools to begin to identify the interrelations between SUD and psychiatric conditions to direct treatment approaches. Interactive case studies will be used for discussion.

Learning objectives:

Identify ways that SUD can mimic functional psychiatric conditions.
Complete an HPI with a focus on the reasons that brought the patient to seek treatment.
Identify a plan to utilize evidence based resources/tools as part of their assessment process.

Purpose:
To describe best practice for navigating prescriptions when patients are unable to present to the
office for prescription refills due to residential treatment.

Purpose:
To describe the purpose of the Witnessed Daily Dosing within the Bridge Clinic and related
protocols for treating patients.

Purpose:
To describe the purpose of the Telehealth Witnessed Daily Dosing within the Bridge Clinic and
related protocols for treating patients.

Purpose:
To describe the purpose of the Bridge Clinic Program and related protocols for treating patients.

Purpose:
To manage a patient who has overdosed or is near overdose safely, while minimizing PCHC and staff
liability. We want to ensure that all patients are treated as they wish, while also maintaining their
safety and the safety of the clinic

About the CTN DI Initiative
The CTN Dissemination Initiative aims to reduce the gap that exists between the publication of research on treatment of substance use disorders and implementation in clinical practice. It incorporates collaboration among clinicians, researchers, and experienced trainers to develop user-friendly tools and products to facilitate the adoption of research-based interventions into clinical settings. Explore this page for more information about the different components of the CTN Dissemination Initiative.

DESCRIPTION
Item Number: SA5829

This toolkit has been developed specifically for pediatric, primary care, and other health professionals treating adolescents and young adults within their medical practice. It provides guidance in regard to the medical, psychological, and social needs of adolescents and young adults with opioid use disorders, thereby improving physical and mental health outcomes. It has been developed to help primary care and pediatric health providers advance the clinical interventions by offering developmentally appropriate screening, treatment engagement, and coordinated care. A specific focus on evidence-based practices includes Medication for Opioid Use Disorder (MOUD) guidance and resources to support these clinical interventions.

Welcome to HCVGuidelines.org
The AASLD and IDSA in partnership with the panel have created an updated web experience to facilitate easier and faster access to this important resource. Please select a patient profile from the menu above, click on a guidance section below, or use the search box to begin.

Simplified HCV Treatment Algorithm for Treatment-Naive Adults With Compensated Cirrhosis
Who Is NOT Eligible for Simplified Treatment
Patients who have any of the following characteristics:

Current or prior episode of decompensated cirrhosis, defined as Child-Turcotte-Pugh (CTP) score ≥7 (ascites, hepatic encephalopathy, total bilirubin >2.0 mg/dL, albumin ≤3.5 g/dL, or INR ≥1.7)
Prior hepatitis C treatment
End-stage renal disease (ie, eGFR <30 mL/min/m2) (see Patients with Renal Impairment section) HIV and/or HBsAg positive Current pregnancy Known or suspected hepatocellular carcinoma Prior liver transplantation (see HCV guidance for treatment recommendations for these patients)

The Matrix Model provides a framework for engaging stimulant (e.g., methamphetamine and cocaine) abusers in treatment and helping them achieve abstinence. Patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become familiar with self-help programs. Patients are monitored for drug use through urine testing.

Resources for Substance Use Disorder and Opioid Misuse Prevention, Treatment, and …

TRAININGS & EVENTS We bring audiences quality continuing education with expert, nationally recognized trainers. Our …

Who We Are The Co-Occurring Collaborative Serving Maine advocates for best practices, encourages professional development, …

Alcohol Use in Adolescence Adolescents use alcohol more than any other drug, including tobacco and …

Youth Peer Support Statewide Network now accepting referrals for youth peer support! Maine Behavioral Healthcare …

Implementation RCORP-Implementation will advance RCORP’s overall goal by strengthening and expanding SUD/OUD prevention, treatment, and …

MaineMOM aims to improve care for pregnant and postpartum people with opioid use disorder and their infants by integrating …

You are invited to take a complimentary self-paced course in Telehealth and Substance Use Disorder (SUD) Treatment and …

We will develop the Treating Addiction in Rural Areas ECHO as part of HRSA’s Telehealth Technology-Enabled Learning …

UNH is a Project ECHO® Hub led by the NH Citizens Health Initiative, a program …

The Systems Improvement and Innovation Responsive Grants (SIIRG) program provides funding for organizations working to …

BANGOR, Maine, Nov. 10—An innovative program expanding low-barrier treatment for opiate use disorder—potentially serving thousands …

The Maine Association of Psychiatric Physicians (MAPP) is the Maine District Branch of the American …

Sample Tip Sheet content: Choose one or a small number (< 5) of behaviors to …

An up to date list of Publications and Digital Products from …

This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration …

AGENCY: Office of the Secretary, Department of Health and Human Services. ACTION: Notice. SUMMARY: The …

Facts About Buprenorphine   FDA approved for Opioid Use Disorder treatment in an officebased setting. …

Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings This resource provides information …

Sample spread sheet : OHH Attestation for Service/Billing Month of 6/21/19-7/20/19 Organization Name Enter attestation …

Sample spreadsheet: NOTES: ** These services may be delivered face-to-face, via phone or other media, …

Health Homes Health Homes, Behavioral Health Homes, and Opioid Health Homes The three health home …

EVIDENCE BASED CLINICAL MODULES Alosa Health produces educational materials on common primary care topics that …

We are the world’s leading research and educational center of excellence on PTSD and traumatic stress. …

Benzodiazepines Overview Continuing to renew benzodiazepine (BZ) prescriptions to certain subgroups of your patients with …

VHA Pain Management Opioid Safety – Clinical Tools his section provides links to a variety …

VHA Pain Management For Providers Chronic pain is among the most common, disabling, and costly …

Instructions: Fill in the mg per day* for whichever opioids your patient is taking. The web page …

AMDG agency medical directors’ group “A collaboration of state agencies, working together to improve health …

Helping patients by helping providers. UVM CORA’s mission is to expand addiction-treatment capacity in HRSA-designated …

Reports, recorded webinars and events for rural providers and health, behavioral health and substance use …

New Online Course: Contingency Management for Healthcare Settings Publication Date: Apr 30, 2020 Share This! …

The Addiction Files Darlene Petersen, MD and Paula Cook, MD 37 episodes Darlene Petersen MD …

The Shatterproof Addiction Stigma Index Shatterproof and The Hartford co-developed the Shatterproof Addiction Stigma Index …

Peer Recovery Center of Excellence The Peer Recovery Center of Excellence is a peer-led national …

About the MHTTC Network   Years of research and knowledge of evidence-based practices show that …

LGBTQ+ Behavioral Health Equity Center of Excellence The Center of Excellence on LGBTQ+ Behavioral Health …

At the Recovery Research Institute (RRI), we present the evidence about addiction treatment and recovery. …

PCSS is a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) …

Pain Treatment Guidelines Introduction For the past few decades, a conceptual shift has taken place …

Opioid Response Network The Substance Abuse and Mental Health Services Administration (SAMHSA) funded the State …

New England PTTC   The New England Prevention Technology Transfer Center, administered by AdCare Educational Institute of …

New England MHTTC   The core mission of the New England MHTTC is to use …

About the ATTC Network Who We Are The ATTC Network is an international, multidisciplinary resource …

The National Network to Eliminate Disparities in Behavioral Health (NNED) is a network of community-based organizations focused …

National Institute on Drug Abuse NIDA is the lead federal agency supporting scientific research on …

National Hispanic and Latino MHTTC   Our mission is to provide high-quality training and technical …

Training Guide GETTING OFF RIGHT: A SAFETY MANUAL FOR INJECTION DRUG USERS Introduction Disclaimer: This …

Opioid Response Governor Mills is committed to combatting the opioid crisis and protecting Maine families. …

Substance Use Disorder Treatment Resources and Training With the understanding that substance use disorder (SUD) …

About OPTIONS The Overdose Prevention Through Intensive Outreach Naloxone and Safety (OPTIONS) initiative is a …

MICIS   MICIS, the Maine Independent Clinical Information Service, is an innovative educational outreach program …

Maine Drug Data Hub The Maine Drug Data Hub is a collaboration between several state …

Prescription Monitoring Program The Prescription Monitoring Program (PMP) is a secure database that is used …

Governor Mills Opioid Response Summit & Seminars are part of the state’s strong commitment to …

Process for Updating the Opioid Prescribing Guideline The draft 2022 CDC Clinical Practice Guideline for …

Safer Prescribing Saves Lives: Opioid Prescribing Guideline Chronic pain is common, multidimensional, and individualized. Treatment …

The MMA-CQI Learning Lab has been designed to support health care practitioners and professionals, and …

Our vision is that all people who use drugs will have access to evidence-based treatment …

Boston Medical Center (BMC) Office Based Addiction Treatment (OBAT) Training and Technical Assistance (TTA) Expanding …

Who is AAFP? Our mission is simple: Strengthen family physicians and the communities they care …

INTRODUCTION Chronic pain is common in the U.S., with anywhere from 11% to 40% of …

Agency for Healthcare Research and Quality: A Profile The Agency for Healthcare Research and Quality …

The ATTC Network is an international, multidisciplinary resource for professionals in the addictions treatment and …