Webinar Video Resources
Recording or live stream transmissions of these webinars without the express written consent of the ME SUD Learning Community is prohibited.
Webinars
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Join the ME SUD Learning Community for the November 12, 2024 PMP webinar “Oregon Psilocybin Services: Opening Pathways for Healing and Wellness in Oregon” presented by Angela E. Allbee, MPA
Join the ME SUD Learning Community for the October 29, 2024 PMP webinar “Palliative Care: What it is Now and its Future” presented by Jackie Fournier, NP-C, ACHPN
Drs Benowitz and Pladsen will describe the current HIV cluster in Penobscot County, and the links between HIV and SUD risks. They will describe efforts currently underway to help address HIV testing and treatment in that community, and will describe whey it is important that all providers in Maine have an increased awareness of HIV risks, particularly in those involved with treating individuals with SUD. They will also introduce key concepts of HIV testing and prevention for providers across the state. (11/20/2024)
Join the Maine Behavioral Health Workforce Development Collaborative for the October 24, 2024 presentation “Evidence-Based Practices in SUD” presented by Jonathan Fellers, MD.
Join the Maine Behavioral Health Workforce Development Collaborative for the October 23, 2024 presentation “Methadone and the Oral Cavity” presented by Kristin Bradley, DMD, MPH.
Join the Maine Behavioral Health Workforce Development Collaborative for the October 22, 2024 presentation “Harm Reduction Efforts in Rural Maine” presented by Katherine Whitney, MPH and LeeAnna Lavoie, MPH.
Join the ME SUD Learning Community for the October 4, 2024 webinar “Initiation of Maintenance Medications for Alcohol and Opioid Use Disorders for Nursing” presented by Amelia Hersey, PA-C.
Join the ME SUD Learning Community for the September 13, 2024 webinar “Polysubstance/Complex Withdrawal Management for Nursing” presented by Amelia Hersey, PA-C.
Join the Maine Behavioral Health Workforce Development Collaborative for the October 18, 2024 presentation “Welcoming Spaces: Trauma Informed Care for People with SUD” presented by Jesse Higgins, RN, MSN, PMHNP.
Join the ME SUD Learning Community for the October 8, 2024 webinar “Clinical and Public Health Approaches to Overdose Prevention and Substance Use Care” with Alexander Y. Walley, MD, MSD
https://vimeo.com/1029768208Join the ME SUD Learning Community for the September 24, 2024 presentation “Xylazine: What We Need to Know” presented by Anna McConnell, FNP-BC, and Maggie Zall, CADC
Join the ME SUD Learning Community for the September 19, 2024 presentation “Contingency Management for Stimulant Use Disorder: Why It’s Needed; Key Elements; Evidence of Effectiveness; Implementation Challenges” presented by Richard Rawson, PhD
Join the ME SUD Learning Community for the September 19, 2024 presentation “Contingency Management for Stimulant Use Disorder: Why It’s Needed; Key Elements; Evidence of Effectiveness; Implementation Challenges” presented by Richard Rawson, PhD
Join the ME SUD Learning Community for the August 14, 2024 presentation “Quality Improvement Models to Support Implementation, Improvement and Expansion of MOUD and Evidence Based SUD Practices” presented by Eric Haram, LADC.
Join the ME SUD Learning Community for the July 31, 2024 presentation “Inpatient Treatment of Alcohol Withdrawal Syndrome” presented by Nicolette Centanni, Pharm D, BCPS, BCGP, BCPP.
Join the ME SUD Learning Community for the June 20, 2024 presentation “Pharmacy-Based Buprenorphine Initiation: An Evolving Care Model for Marginalized People” presented by Traci Green, PhD.
Join the ME SUD Learning Community for the July 24, 2024 presentation “Hospital Care of the Opioid Exposed Newborn” presented by Meredith Jackson, MD.
Join the ME SUD Learning Community for the June 5, 2024 presentation “Bipolar and Alcohol Use Disorders – Not a Simple Coincidence” presented by Javier Ballester Gonzalez, MD.
Join the ME SUD Learning Community for the June 4, 2024 presentation “Sublingual Buprenorphine and the Oral Cavity” presented by Kristin Bradley, DMD, MPH.
Recorded on May 29, 2024 for the Maine SUD Learning Community and presented by Paul Joudrey, MD, MPH.
Join the ME SUD Learning Community for the May 23, 2024 presentation “Inpatient Buprenorphine Treatment for Opioid Use Disorder” presented by Nicolette Centanni, PharmD, BCPS, BCGP, BCPP.
Join the ME SUD Learning Community for the May 22, 2024 presentation “How SUD Treatment Providers Can Promote Safe Sleep Massaging” presented by Meredith Jackson, MD; Alane O’Connor, DNP; Kimberly Gosselin, LSW-c, OQMHP; moderated by Lisa Letourneau, MD, MPH.
Join the ME SUD Learning Community for the May 9, 2024 presentation “Buprenorphine Telehealth Audio-only Telehealth to Improve Buprenorphine Access and Linkage to Care” presented by Elizabeth Samuels, MD, MPH, MHS.
Join the ME SUD Learning Community for the May 7, 2024 presentation “It’s Time to Discuss the Elephant in the Room: Childhood Maltreatment and Risk for Alcohol Use Disorder during Adolescence/Young Adult” presented by Elizabeth Lippard, PhD.
Join the ME SUD Learning Community for the May 2, 2024 presentation “Recent Recommendations for Withdrawal Management: A Focus on Alcohol and Opioids
Join the ME SUD Learning Community for the July 18, 2024 presentation “Identifying and Supporting People Impacted by Intimate Partner Violence and Substance Use” presented by Jesse Higgins, RN, MSN, PMHNP.
Join the ME SUD Learning Community for the June 21, 2024 presentation “High-Dose and Low-Dose Buprenorphine Initiations – Practical tips for the Primary Care Clinician” presented by Rachel Solotaroff, MD, MCR.
Join the ME SUD Learning Community for the June 12, 2024 presentation “Harm Reduction and Preventative Care for People who use Drugs” presented by Kinna Thakarar, DO and Hannah Kazal, MD.
Join the ME SUD Learning Community for the June 4, 2024 presentation “Sublingual Buprenorphine and the Oral Cavity” presented by Kristin Bradley, DMD, MPH
Join the ME SUD Learning Community for the May 2, 2024 presentation “Recent Recommendations for Withdrawal Management:
Join the ME SUD Learning Community for Dr. Gilmore Chung’s presentation “Reducing Barriers to Care for Patients with Substance Use Disorders” from April 9, 2024.
Turning Healthcare into Housing: Solutions for Homelessness | Cullen Ryan, Rachel Solotaroff, MD, and Amy West, MSN, FNP-C
Individuals experiencing long-term homelessness are at a higher risk of negative health outcomes. This panel discussion will explore how to address the impact long term homelessness has on patients and what clinicians can do to contribute to better outcomes. The panelists will outline practical tools that have been shown to benefit this population, as well as examine policy initiatives that have shown extremely positive outcomes. Drawing from the panelists’ extensive experience with the population, their expertise can empower providers to address the whole-person needs of their patients.
Objectives:
- Examine the impact long-term homelessness has on a patient’s health.
- Learn practical methodologies and tools to better address the needs of patients experiencing long-term homelessness.
- Explore policies that have successfully addressed the unique needs of this population and analyze ways to incorporate these methodologies into one’s own practice.
- Name effective advocacy to engage your stakeholder to support action.
Data-Driven Decision Making for Patients with OUD and other SUD | Kimberly Fryer, MD, MSCR, Kimberly Johnson, PhD, Victoria Hynes, LCSW, MSW, and Jacob “Gus” Crothers, MD
This presentation will examine the current state of data collection and application for patients with OUD & other SUD. The panelists will highlight how and what information is being collected both locally and nationally. Panelists will also outline responsive efforts, based on this data, to improve retention and outcomes for patients with OUD & other SUD. The panel will describe practical means by which providers can respond to Maine’s SUD data, to try to improve the quality of care for patients.
Learning Objectives:
- Learn the metrics collected for SUD programs and how to use that data in quality improvement efforts
- Examine public health data collection both locally and on a national scale
- Explore data decision making in practice
Opioid Withdrawal for Nursing | Amelia Hersey, PA-C | March 29, 2024
This program will cover the symptoms and management of opioid withdrawal including possible treatment options and how to assess patients using the Clinical Opiate Withdrawal Scale (COWS).
Objectives
- Understand the withdrawal process for opioids
- Feel competent calculating a Clinical Opiate Withdrawal Scale (COWS)
- Identify some treatment options for withdrawal management
Benzodiazepines: Challenges and Solutions | March 19, 2024 | Christopher Blazes, MD
- Participants will be able to list questions they can ask to assess youth for bipolar disorder in the context of an opioid use disorder and/or other substance use disorder.
- Participants will be able to summarize the evidence supporting pharmacologic treatment for youth with co-occurring bipolar disorder and an opioid use disorder and/or other substance use disorder.
Disentangling Co-Occurring Bipolar Disorder in Youth with OUD/SUD | March 13, 2024 | Amy Yule, MD
This presentation will focus on helping clinicians assess youth for bipolar disorder in the context of an opioid use disorder and/or other substance use disorder. Recommendations for medication management for youth with co-occurring bipolar disorder and an opioid use disorder and/or other substance use disorder will also be reviewed.
Objectives
- Participants will be able to list questions they can ask to assess youth for bipolar disorder in the context of an opioid use disorder and/or other substance use disorder.
- Participants will be able to summarize the evidence supporting pharmacologic treatment for youth with co-occurring bipolar disorder and an opioid use disorder and/or other substance use disorder.
New MaineCare Payment Initiatives to Expand Connections for Justice Impacted Individuals: Now and Future! | February 29, 2024 | Loretta Dutill, Kaley Boucher, and Courtney Plasden, DNP, FNP, RN
Join this webinar to hear about exciting justice system initiatives. MaineCare’s pilot incentive program will encourage service providers to connect with individuals being released from incarceration and provide much needed services during a crucial timeframe. Additionally the Office of MaineCare services is pursuing a Section 1115 Re-entry Demonstration that will create the opportunity for individuals who are incarcerated to have access to MaineCare up to 90 days pre-release with a focus on mental health, substance use treatment, and coordination of care.
Objectives:
- Describe the two MaineCare expansion initiatives: Incentive Payment Pilot for Services to Members Post Incarceration and 1115 Re-entry Demonstration for justice impacted populations.
- Discuss the general procedures and timelines for these initiatives.
- Articulate how these initiatives are envisioned to address the needs of justice impacted populations.
Alcohol Withdrawal for Nursing | February 23, 2024 | Amelia Hersey, PA-C
This program will cover withdrawal symptoms and assessment for patients with significant alcohol use histories. It will cover the Clinical Institute Withdrawal Assessment (CIWA) as well as some treatment options for withdrawal symptoms. Lastly, we will discuss red flags/highest concern symptoms and when to escalate care.
Objectives
- Understand the withdrawal process for alcohol
- Feel competent in doing a Clinical Institute Withdrawal Assessment (CIWA)
- Identify red flags for when alcohol withdrawal may be severe and life-threatening
Integrating Peer Support Roles into Interdisciplinary Teams for Substance Use Services | February 15, 2024 | Randy Morrison, MPH, MPPM
When integrated into interdisciplinary teams, peer recovery partners foster connection, engagement, and support with self-directed recovery pathways. This webinar will provide and overview of the peer support role within an integrated team and review the best practices for communicating and collaborating as a team to support patients. We’ll look at how to get your practice started, assess workflows that have been successfully implemented, and address common challenges you might encounter.
Objectives
- Understand the roles and functions of peer support within the team
- Understand documentation standards
- Understand interdisciplinary team communication
Disentangling Co-Occurring Bipolar Disorder in Youth with OUD/SUD | February 13, 2024 | Amy Yule, MD
This presentation will focus on helping clinicians assess youth for bipolar disorder in the context of an opioid use disorder and/or other substance use disorder. Recommendations for medication management for youth with co-occurring bipolar disorder and an opioid use disorder and/or other substance use disorder will also be reviewed.
Objectives
- Participants will be able to list questions they can ask to assess youth for bipolar disorder in the context of an opioid use disorder and/or other substance use disorder.
- Participants will be able to summarize the evidence supporting pharmacologic treatment for youth with co-occurring bipolar disorder and an opioid use disorder and/or other substance use disorder.
A Losing Hand: Gambling Among Patients with OUD | February 2, 2024 | Rick Berman, LPC, CGACII
As Maine has moved to legalize sports gambling, there is a need for treatment providers to become more aware of problem gambling in their clients and its negative effects on OUD treatment success. Rick Berman, LPC, CGACII, a consultant to Oregon and numerous gambling treatment programs, will provide an overview of how to recognize gambling issues and their impact on treatment for opioid use disorder.
Objectives
- Learn how even mild gambling problems reduce the effectiveness of Opioid Use Disorder treatment and are associated with OTP treatment disengagement.
- Learn how to effectively discuss gambling with patients and screen for gambling problems.
Low Barrier Models of Care for Substance Use Disorders | January 22, 2024 | Robert Baillieu MD, MPH, FAAFP
Robert Baillieu MD, MPH, FAAFP will discuss the principles and components of low barrier care, and how low barrier care may be leveraged to overcome substantial gaps in access, while also engaging individuals in treatment.
Objectives
- Participants will gain an understanding of low barrier care and be able to describe its principles and components.
- How low barrier models of care might be leveraged to overcome gaps in access.
- How low barrier models of care engage individuals in services.
Adding Fentanyl Testing to Hospital Toxicology Assays | November 17, 2023 | Alane O’Connor, DNP, Robert Carlson, MD, and Scott Lowell, MHA, MLS (ASCP)
This webinar will provide an overview of the guidance released by the Maine Opioid Response Clinical Advisory Committee to hospital leadership, substance use treatment providers, and pharmacy communities regarding recommendations for adding fentanyl testing to routine hospital toxicology testing. From the guidance document: ‘Despite the increased prevalence of fentanyl and related complications, not all healthcare facilities or providers of laboratory services in Maine currently employ toxicology testing that includes an assay for fentanyl.’ See the link below to read the rest of the statement and recommendations:
Objectives
Presenters will:
- Promote the recommendation of the Maine Opioid Response Clinical Advisory Committee (per the above-linked document) that hospitals add fentanyl testing to their routine toxicology testing panels
- Help to answer questions and clarify any confusion in the hospital, provider, and pharmacy communities about the need to have this type of testing routinely available in hospitals
Treatment Considerations in Patients who have Bipolar Disorder and are Pregnant or Postpartum| January 8, 2024 | Stephanie Nichols, PharmD, BCPP, BCPS, MPH
This session will focus on reviewing bipolar disorder in pregnant and postpartum patients. We will examine the benefits and risks associated with specific mood stabilizers, as well as the potential risks of withholding therapy on the dyad. Additionally, we will delve into the CANMAT bipolar disorder guidelines and the ACOG guidelines for psychiatric care in pregnant and postpartum individuals.
Learning Objectives:
- Analyze the efficacy, risks, and benefits of using or withholding psychiatric medications for bipolar disorder during the prenatal and peripartum periods.
- Evaluate current guideline recommendations and recent literature describing the use of psychiatric medications in pregnant patients with bipolar disorder.
Alcohol Use Disorder and Withdrawal Management | December 15, 2023 | Brain Fuehrlein, MD, PhD
This one-hour training will commence with a basic overview of alcohol use. We will then shift our focus to triaging patients based on risk factor stratification and introduce some fundamental approaches for ambulatory detox management. We will conclude with a clinical discussion of two different cases.
Objectives
- To demonstrate a basic understanding of standard drink sizes and their impact on blood alcohol levels.
- To be able to triage patients who present for alcohol withdrawal management.
- To be able to manage alcohol withdrawal in an ambulatory setting.
Medications for Alcohol Use Disorder | December 5, 2023 | Stephanie Nichols, PharmD, BCPP, BCPS, MPH
Cannabis Use and Psychosis in Adolescents | November 29, 2023 | Amy M. Mayhew, MD, MPH
This presentation will investigate cannabis use among adolescents and the associated risk factors for developing psychotic symptoms or a psychotic illness during adolescence. We will explore the impact of high-potency THC, the common perception of these substances as ‘natural’ and harmless, as well as the dose-dependent relationship between THC use and the development of psychosis.
Objectives
- Evaluate some data about current substance use among adolescents
- Recognize some of the processes that THC and CBD influence natural cannabinoid receptors in the body
- Explore one theory of how THC may create a predisposition to psychosis
- Examine how tobacco and cannabis industries are influencing adolescent behaviors
- Analyze some case examples of cannabis use and development of psychosis and psychotic illness
Cytochrome P Four Who? Demystifying Pharmacokinetic Drug Interactions | Stephanie Nichols, PharmD, MPH, BCPP, BCPP, BCPS, FCCP | November 28, 2023
Do you struggle with knowing if a medication interaction is clinically meaningful? Do you get confused about which medications cause interactions and which are simply along for the ride? This session is devoted to reviewing pharmacokinetic CYP450 enzyme and P-glycoprotein transporter interactions using examples that are medications used for psychiatric and substance use disorders. Learners will leave the session with the ability to describe and evaluate specific medication interactions.
Objectives
- Describe how pharmacokinetic (PK) parameters are used to assess medication interactions
- Describe the CYP450 enzymes including common substrates, inhibitors, and inducers, and the expected timeframe of CYP450 enzyme interactions
- Identify key psych/SUD medications involved in CYP450 enzyme and P-glycoprotein interactions
- Apply PK and medication interaction knowledge to a patient scenario
Alcohol Use During the Perinatal Period | Alane O’Connor, DNP | October 23, 2023
Perinatal substance use is a critical public health concern, and alcohol remains one of the most commonly used substances during pregnancy. Despite the risks of harm from alcohol exposure, patients often encounter mixed messages in the media. In this session, we will review screening tools for alcohol use during pregnancy, as well as the potential fetal impacts of perinatal alcohol use. We will also discuss evidence-based best practices for treating alcohol use disorder during the perinatal period, summarize Maine’s FASD notification requirement, and review strategies for discussing alcohol use with pregnant patients.
Objectives:
- Review validated screening tools for alcohol use disorder during pregnancy, as well as the potential fetal impacts of perinatal alcohol use.
- Discuss evidence-based best practices for the treatment of alcohol use disorder in the perinatal period.
- Summarize Maine’s FASD notification requirement and strategies for discussing alcohol use with pregnant patients.
Understanding the Complex Intersection of Co-Occurring Depression and Substance Use Disorders | Jonathan Fellers, MD, PA, LLC | September 28, 2023
Join us for an insightful presentation that delves into the intricate relationship between co-occurring depression and substance use disorders. This session aims to shed light on the challenges faced by individuals grappling with both conditions simultaneously, providing a comprehensive understanding of their interconnected nature.
Through an evidence-based approach, our speaker will explore the underlying causes, risk factors, and the intricate interplay between depression and substance abuse. Attendees will gain valuable insights into the mutual reinforcement of these conditions, the impact on mental and physical health, and the associated social and economic burdens. The presentation will highlight various treatment approaches, emphasizing integrated interventions that address both depression and substance use disorders concurrently. Attendees will learn about the importance of early detection, screening tools, and comprehensive assessment techniques to develop personalized treatment plans tailored to individual needs.
Objectives
1) Gain awareness about the complex relationship between co-occurring depression and substance use disorders
2) Understand the mutual reinforcement and interconnected nature of these conditions
3) Educate about evidence-based treatment approaches for co-occurring depression and substance use disorders
4) Highlight the importance of integrated interventions and multidisciplinary collaboration in addressing both conditions simultaneously
OUD/SUD and Anxiety | Kevin Simon, MD, MPH | September 14, 2023
This talk delves into the intersection of opioid use disorder/substance use disorder (OUD/SUD) and anxiety in adults. Participants will learn how to differentiate and approach various anxiety types; screen, assess, and address co-occurring OUD/SUD, and understand appropriate pharmacologic management critical to patient care.
Objectives
1. Differentiate between substance-induced anxiety, withdrawal-induced anxiety, and clinical organic anxiousness.
2. Employ effective screening methods to identify co-occurring OUD/SUD in patients presenting with anxiety.
3. Understand the implications and potential interactions of medications prescribed for anxiety when taken in conjunction with medications for opioid use disorder.
Extended-Release Buprenorphine During Pregnancy and Postpartum | Alane O’Connor, DNP | August 23, 2023
The use of extended-release buprenorphine (XRB) is becoming increasingly common in patients with opioid use disorder. There is an ongoing clinical trial examining the safety, efficacy, and pharmacokinetics of XRB in pregnant and postpartum women. We will review the potential use of XRB in pregnant and postpartum patients while awaiting the results from this trial and describe ways in which clinicians can engage in shared decision-making with their patients around whether XRB may be appropriate.
Objectives
1) Describe the basic logistics of acquiring extended-release buprenorphine (XRB) including REMS certification and the MaineCare coverage criteria.
2) Identify pregnant and postpartum patients who may be appropriate for XRB and demonstrate an approach to discussing the potential risks and benefits of its use during the perinatal period.
3) Explain XRB issues that are unique to the perinatal population including medication administration and appropriate monitoring for neonatal opioid withdrawal syndrome.
Bipolar Disorder and SUDs | Stephanie Nichols, PharmD, BCPS, BCPP | June 20, 2023
Join Anna McConnell, FNP-BC, and Kinna Thakarar, DO, for Unsafe Supply: Clinical Practice Implications & Future Directions.
Learning Objectives:
1) Review the epidemiology of overdoses and infectious complications of substance use in Maine
2) Recognize the significance of unsafe supply, with contaminants such as xylazine, and its clinical implications
3) Identify opportunities to advocate for safe supply, such as community drug checking programs
Harm Reduction 2.0 | Unsafe Supply: Clinical Practice Implications and Future Directions | Anna McConnell, FNP-BC, and Kinna Thakarar, DO | June 7, 2023
Join Anna McConnell, FNP-BC, and Kinna Thakarar, DO, for Unsafe Supply: Clinical Practice Implications & Future Directions.
Learning Objectives:
1) Review the epidemiology of overdoses and infectious complications of substance use in Maine
2) Recognize the significance of unsafe supply, with contaminants such as xylazine, and its clinical implications
3) Identify opportunities to advocate for safe supply, such as community drug checking programs
Nicotine Vaping: What Should Providers Tell Their Patients? What about that Cough? | Jonathan Fellers, MD | June 1, 2023
Basic information about the inhalation of vaporized nicotine (vaping) will be provided including the pharmacology, products, epidemiology, and patterns of use. Patients sometimes turn to electronic nicotine delivery systems (ENDS) as a way to decrease or stop smoking. Risks of using ENDS, including nicotine use disorder and EVALI (E-cigarette including cannabis and Vaping Associated Lung Injury) will be described. Counseling approaches for people who use ENDS will be outlined. This presentation will review the current evidence for using ENDS for smoking cessation. A synthesis of evidence-based approaches to smoking cessation will be provided.
Learning Objectives:
- Attendees will be equipped with up-to-date information about evidence-based medication approaches to smoking cessation.
- Attendees will be able to counsel patients regarding the risks of ENDS and the evidence for using ENDS as an approach to smoking cessation.
- Attendees will report an increased awareness of ENDS as a potential cause of pulmonary symptoms in their patients.
Nursing Management of Withdrawal of Alcohol and Opioids | Amelia Hersey, PA-C | May 31, 2023
Nurses and medical assistants are on the front line of managing withdrawal protocols in outpatient and inpatient settings for alcohol and opioids. This program will review assessment scales, tips on identifying symptoms, and high-risk situations. It’s geared towards nurses and medical assistants who are completing the assessment and monitoring of withdrawal symptoms but all professionals are welcome.
Learning Objectives:
As a result of this learning activity, nurses will have gained:
- Knowledge about strategies for keeping patients safe during withdrawal from alcohol and/or opioids.
- Describe ways to use assessment tools for assessing withdrawal from alcohol and opioids.
- Describe the continuum of withdrawal symptoms.
Identify higher-risk symptoms and risk factors. - Describe various medication dosing regimes.
The Invitation to Change Approach | Nicole Kosanke, PhD | May 10, 2023
Join Nicole Kosanke, PhD, to learn about the Invitation to Change Approach which is a practical, compassionate, and skills-oriented program developed for people wanting to help loved ones struggling with substance use. It blends evidence-based principles and practices from Community Reinforcement and Family Training (CRAFT), Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT). Instead of the traditional message to families of “detachment”, this approach emphasizes the idea that people can take care of themselves while simultaneously staying engaged and practicing active strategies to help their struggling loved one. Professionals attending will gain a thorough understanding of the behavioral motivations behind substance use, how to employ motivational strategies that improve communication and promote change, and learn to share this information with the family members and loved ones of people who use substances. Training is accomplished through didactic learning and experiential exercises.
Anxiety and Substance Use Disorders | Petros Levounis, MD, MA | April 13, 2023
In this webinar, Petros Levounis, MD, MA, will highlight the management of anxiety disorders in the context of substance use. Assessment, diagnosis, and treatment options will be discussed, including SSRIs, other antidepressants, benzodiazepines, non-benzodiazepine anxiolytics, and psychotherapy. The presentation will also review management approaches when anxiety symptoms do not respond to initial treatment. At the end of the presentation, clinicians should feel more confident in their ability to effectively diagnose and manage anxiety co-occurring with substance use disorders.
Objectives:
- List three anxiety disorders that commonly co-occur with substance use disorders
- Describe the role of SSRIs and other antidepressants in the management of anxiety disorders
- Explain the appropriate use of benzodiazepines and non-benzodiazepine anxiolytics in the management of anxiety disorders
Enhancing Access to Medications for Opioid Use Disorder for Patients in Hospital Settings | Alane O’Connor, DNP and Rachel Solotaroff, MD | April 4, 2023
Alane O’Connor, DNP, and Rachel Solotaroff, MD, will review the recent guidance document on enhancing access to Medications for Opioid Use Disorder (MOUD) for patients in hospital settings developed by the Maine Opioid Response Clinical Advisory Committee. This will include discussion of the recommendations for a basic level of care for patients with OUD in both Emergency Department (ED) and inpatient hospital settings, as well as recommendations for hospitals with the ability to provide a more advanced level of care. Policy recommendations to support MOUD in the hospital setting will also be addressed.
Objectives:
- Describe expectations for hospitals to provide a basic level of care for patients with OUD in the ED and inpatient hospital setting
- Describe expectations for hospitals able to provide an advanced level of care for patients with OUD
- Identify resources to assist implementation of care for patients with OUD in ED and inpatient and hospital settings
Addiction in LGBTQ+ Communities and Crystal Methamphetamine | Petros Levounis, MD, MA | March 30, 2023
Reflecting sweeping changes in our understanding of gender and sexuality over the past decade, this webinar aims to provide an informative and affirming discussion of addiction treatment for clinicians working with patients of diverse gender and sexual identities. We will focus on the re-emergence of crystal methamphetamine among gay men and discuss culturally sensitive, safe, and effective treatments.
Objectives:
- List the three dimensions of sexual orientation and the three dimensions of gender.
- Analyze the connection between crystal methamphetamine use among gay men and the risk of HIV transmission.
- Describe the Matrix Model of treatment for crystal methamphetamine use disorder.
March 21, 2023 | Justice Involved Individuals with OUD | Alane O’Connor, DNP
Individuals with opioid use disorder (OUD) often intersect with the criminal justice system. Access to medications for opioid use disorder (MOUD) in correctional facilities has historically been limited. Individuals with OUD are at an increased risk of drug overdose death in the weeks following release from correctional facilities. Access to MOUD, while incarcerated, has been shown to improve outcomes and reduce recidivism post-release. Addressing the barriers associated with providing MOUD is critical in expanding access to treatment for incarcerated individuals.
Objectives:
Review post-release outcomes in correctional facilities when MOUD is not available.
- Discuss barriers to implementing MOUD in correctional facilities and understand how treatment reduces the risk of overdose following incarceration.
- Describe outcomes associated with recovery and family treatment courts with a focus on one rural Maine alternative sentencing program.
- Understand the implementation and evaluation of an extended-release buprenorphine pilot for patients with OUD in a rural Maine jail.
March 16, 2023 | Emotionally Reactive or Highly Avoidant: the art of medication management for co-occurring substance use disorder and borderline personality disorder in non-specialty care settings | Hilary S. Connery, MD, PhD
Objectives:
- Participants will learn about community prevalence of co-occurring SUD and BPD in non-specialty care settings and how SUD+BPD impacts patient care outcomes
- Participants will learn the most recent evidence-based medication treatments for BPD, with and without SUD, with special considerations for safe prescribing in the context of active SUD and/or elevated suicide risk
- Participants will be provided brief descriptions of evidence-based psychotherapies for SUD+BPD, along with nationally-available resources for referral and patient/family education
Objectives:
- Identify pharmacology and pharmacokinetic properties of gabapentin that link to key clinical effects
- Describe the prevalence and risk factors of non-prescribed gabapentin use
- Detail clinical outcomes of non-prescribed gabapentin use
March 7, 2023 | Post-Acute and Long-Term Care Facilities: Prescribing and Managing OUD and AUD | Amelia Hersey, PA-C
Self-paced course available for CMEs.
Objectives:
- Adapting outpatient practice to SNF/LTC Facilities
- Basic review of protocols
- Explore applications utilizing case examples
February 1, 2023 | How to Respond Proactively to Patient Behavior in MOUD and Chronic Pain Environments | Eric Haram, LADC
The patient’s journey towards stable management of their chronic pain and/or OUD is a landscape of challenges and opportunities that often exceed our patient’s ability to cope. Planning and responding proactively to behaviors that may impact the safety of the person, program and staff is critical.
Objectives:
- Understand program policies, norms, and contracts that direct patient progress and safety
- Understand the use of patient assessment
- Discuss patient, staff, and program education
- Identify ways to support and reinforce patient psychosocial skill development
December 21, 2022 | Substance Use and Co-occurring Infectious Diseases | Kinna Thakarar, DO, MPH
Learning objectives:
- Recognize the interplay between Infectious Disease and Substance Use disorder epidemics
- Identify opportunities to incorporate recommended screening into practice settings
Urine Toxicology Testing in Substance Use Disorder Treatment | December 12, 2022 | Dr. Alane O’Connor, DNP
Self-paced course available for CMEs
Urine toxicology testing can be a useful tool in clinical decision making when caring for patients with substance use disorders. It is critical for providers to be familiar with the pros and cons of various types of testing and to be skilled in interpreting the results.
Objectives:
- Review essential concepts in urine toxicology testing including testing methods, specimen validity measures, windows of detection and cut-off concentrations.
- Discuss toxicology testing in the context of substance use disorder treatment including monitoring for prescription medication use and/or returns to use as well as how to talk with patients about drug testing.
- Learn how to interpret urine toxicology results including unexpectedly positive/negative specimens.
- Examine strategies for caring for special populations including those who are engaged with the child welfare and criminal justice systems.
Cannabis and Cannabis Use Disorder: Updates for Clinicians on a Complex Topic | December 6, 2022 | Kevin M. Gray, M.D., Professor of Psychiatry and Behavioral Sciences, Medical University of South Carolina
Dr. Gray will provide a general overview of the complex and evolving context for cannabis use. The talk will then focus on cannabis use disorder (CUD) and its clinical implications. An overview of evidence-based psychosocial strategies will be followed by a summary of findings to date on candidate pharmacotherapies for CUD. Dr. Gray will then provide perspective on the incorporation of evidence-based CUD treatment practices in challenging clinical scenarios, including co-occurring opioid use disorder and mental health disorders.
Objectives:
- Summarize current knowledge regarding cannabis-related benefits and harms
- Describe evidence-based psychosocial treatments for cannabis use disorder
- Indicate candidate pharmacotherapies being examined for cannabis use disorder
Harm Reduction | 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
What does this mean to ME: Legal Issues and Prescribing | 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
- Objectives:
Improve understanding and familiarity with documentation and other tools to manage legal risk in view of current law enforcement activity involving opioid prescribing practices. - Learn the basic requirements associated with Maine’s opioid prescribing statute and rules.
- Learn the basic legal and regulatory requirements associated with Maine’s Prescription Monitoring Program.
- Objectives:
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? This session will bring together psychiatry and addiction medicine physicians to explore this clinical question. We will present clinical advice about diagnosis, review literature about pharmacologic treatment, and bring experience and evidence together to discuss common clinical questions on this topic.
Goals
1. Raise awareness of the complexity of ADHD dx
2. Understand evidence for treatment of adult ADHD alone and with SUD
3. Understand the harms of treatment of adult ADHD
Objectives
1. Identify considerations in enhancing specificity of making an ADHD diagnosis in adults
2. Describe the evidence for benefit of treatment of adult ADHD, and the limitations of that evidence
3. Outline potential harms of stimulant therapy
Universal Screening, Brief Intervention and Referral to Treatment: SBIRT within Primary Care | 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.
Objectives:
- Describe screening and engagement
- Identify strategies to engage individuals in care discussion
- Discuss tips to support shared decision making
Methadone Transition to Bupenorphine | 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
When a Patient with Chronic Pain Loses their Provider: Compassionate, Evidence-Based Responses | November 2, 2022 | Elisabeth Mock, MD, MPH and Noah Nesin, MD
Self-paced course available for CMEs
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?
Cannabis Research: Complexities and Priorities| 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
Illicit Drug Supply 2022: More potent methamphetamine forms and mixtures of fentanyl, and the “Xines” and “Xenes”| 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.
Contingency Management: An Essential Treatment Approach for Individuals with Stimulant Use Disorder | 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.
Ambulatory Alcohol Withdrawal Management | 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.
Medications and Treatment of Alcohol Use Disorders | 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
Update on 2022 PMP Enhancements | September 29, 2022 | Elisabeth Fowlie Mock, MD
Self-paced course available for CMEs
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
Medications for Youth with an OUD and Other Treatment/Recovery Considerations | September 20, 2022 | Amy Yule, MD
This presentation will discuss youth/adolescents with OUD and co-occurring mental health disorders, trauma, and/or ADHD, review the three types of MOUD that can be used for youth with a main focus on buprenorphine, and review developmental considerations and approaches to treatment and recovery.
Learning objectives:
- describe the three FDA-approved medications for OUD, their actions, induction, and dosing in the youth/adolescent population
- identify the developmental aspects of treatment and recovery approaches when caring for the youth/adolescent population
- discuss trauma-informed care and the importance of addressing co-occurring psychiatric disorders when engaging with the youth/adolescent population.
Delivering XR Buprenorphine in Maine Practice | 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
Complex Persistent Opioid Dependence | 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
Opioid Health Home (OHH) New Adopted Rule – MaineCare Services | 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
Comorbidities in Psychiatry: Prescribing Pearls | 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.
Buprenorphine and Pain | 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
Early Recovery: Shifts in Focus | 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.
Peer Support Roles in Primary Care: How does it work? | 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.
Principles in Pain Care: Guiding Mood, Movement and Rest | 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.
Changing the Risks of Benzodiazepines across the Lifespan | 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
New Strategies to Initiate Buprenorphine Therapy: Microdosing and Macrodosing | June 14, 2022 | Stephanie Nichols, PharmD, BCPS, BCPP
Self-paced course available for CMEs
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
Best Practice of the Use of Extended-Release Buprenorphine and Naltrexone | 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).
Data Collection: Assessing the Complex Patient | 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.
Benzodiazepines: Challenges and Solutions | ME SUD Learning Community
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.
Join the ME SUD Learning Community for the May 7, 2024 presentation “It’s Time to Discuss the Elephant in the Room: Childhood Maltreatment and Risk for Alcohol Use Disorder during Adolescence/Young Adult” presented by Elizabeth Lippard, PhD.
Join the ME SUD Learning Community for the May 9, 2024 presentation “Buprenorphine Telehealth Audio-only Telehealth to Improve Buprenorphine Access and Linkage to Care” presented by Elizabeth Samuels, MD, MPH, MHS
Join the ME SUD Learning Community for the May 22, 2024 presentation “How SUD Treatment Providers Can Promote Safe Sleep Massaging” presented by Meredith Jackson, MD; Alane O’Connor, DNP; Kimberly Gosselin, LSW-c, OQMHP; moderated by Lisa Letourneau, MD, MPH
Join the ME SUD Learning Community for the May 23, 2024 presentation “Inpatient Buprenorphine Treatment for Opioid Use Disorder” presented by Nicolette Centanni, PharmD, BCPS, BCGP, BCPP.
Join the ME SUD Learning Community for the June 5, 2024 presentation “Bipolar and Alcohol Use Disorders – Not a Simple Coincidence” presented by Javier Ballester Gonzalez, MD.