Best Practices for Improving SUD/OUD Treatment in the Fentanyl Era

 Maple Hill Farm Inn and Conference Center |  June 14, 2023  |  8:00AM- 4:00PM

Agenda and Handouts

8:10 – 8:10

Overview of the day

Why this Work is Important

Alane O’Connor, DNP

8:10 – 9:05  

AM Keynote

Buprenorphine Initiations in the World of Fentanyl

With the majority of the drug supply containing fentanyl, what are the strategies for high and low-dose inductions in the inpatient setting? Dr. Weinstein will explore ways to safely transition our patients onto buprenorphine, given the potential risks. She will highlight what we know and the directions of future research for inpatient and outpatient buprenorphine induction.

Zoe Weinstein, MD, MS

9:05 – 9:15


9:15 – 9:45

Interactive Panel Discussion

Exploring the Opioid Clinical Committee’s (Opioid CAC) Guidance Documents

An exploration of two Opioid CAC Guidance documents to guide our practices by panelists.

  • Ensuring Access to Medications for Opioid Use Disorder (MOUD) in Hospital Settings
  • Draft Ambulatory withdrawal and care for OUD/AUD/Other SUDs

Rachel Solotaroff, MD, Alane O’Connor, DNP, and Kelley Harmon, DO

9:45 – 10:15

Table Top Discussions

How do I Step It Up?

10:15 – 10:30


10: 15 – 10:30

Breakout A


Addiction Recovery Support Services: Rationale and Science

During the past 50 years in the United States, we have learned a great deal about the causes, prevalence, clinical course, and impact of alcohol and other drug use disorders, including that these disorders tend to have a long course. Even when individuals achieve initial remission, the risk for recurrence of the disorder can remain elevated for several years. This presentation will provide a brief contextual overview of what has been learned during the past 50 years of addiction science, which has led to the emergence and growth of new models of extended recovery support services demonstrating effectiveness and cost-effectiveness in facilitating long-term remission and stable recovery.

John Kelly, Ph.D. (pre-recorded video) and facilitators Rachel Solotaroff, MD, and Amanda Thompson

Breakout B

Carriage House

Partnering with Corrections

Come learn about substance use disorder treatment in Maine jails and prisons. Presenters will review related literature as well as their own experiences of successes and challenges in delivering SUD treatment in correctional settings. Presenters will also discuss successful diversion programs, including pretrial/community corrections supervision rather than detention.

Alane O’Connor, DNP, Melissa Caminiti, MPH, RN, and Elizabeth Simoni, JD

Breakout c

Gathering Place

Ambulatory Withdrawal Management and Identifying Risk for Withdrawal

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 Consideration also will be given to the risk of other drugs including opioids in alcohol withdrawal management.

Nicholas Piotrowski, MD, FASAM

11:30 – 12:45

Lunch and Reflections

Recovery Reflections

Gordon Smith, Esq., Brittany Reichmann, and Arthur Padilla

12:45 – 1:45

PM Keynote

Contingency Management: Experiences with Implementation

Dr. Baldwin will discuss START (Stimulant Treatment and Recovery Team), an innovative, low-barrier treatment program that utilizes contingency management for the treatment of stimulant use disorder. She will discuss how the team designed and implemented the program and suggest helpful tips for implementing a contingency management program in other settings.

Marielle Baldwin, MD, MPH

1:45 – 1:55


1:55 – 2:55

Breakout A


Implementing Peer Recovery as Part of the Clinical Team

The integration of a peer support role within SUD treatment programs can have a profound positive effect on team dynamics and patient outcomes. In this session, we’ll discuss peer support model fidelity, role clarity, and strategies to successfully integrate the role on multidisciplinary teams, including supervision and communication recommendations.

Amanda Thompson

Breakout B

Carriage House

Enhancing Access to Extended-Release Buprenorphine for Patients with Opioid Use Disorder (Opioid CAC Guidance Document)

Come learn how to utilize extended-release buprenorphine (XRB) when caring for patients with OUD. We will discuss clinical indications including XRB dosing and administration, XRB operational considerations including REMS certification as well as ordering, storing, and billing for the medication. Finally, we will discuss Mainecare’s XRB clinical criteria and related suggested workflows.

Alane O’Connor, DNP, Kristen Silvia, MD, and Anne Marie Toderico, PharmD

Breakout C

Gathering Place

Treating Adolescents with Substance Use Disorders in Maine

Join Deborah Hagler, MD, and Jonathan Fanburg, MD, as they discuss an overview of what is currently happening regarding adolescent Substance Use Disorders (SUD) screening, prevention, and treatment in Maine, things to consider as an adult provider treating adolescents, and challenges that are specific to treating adolescents with a SUD in Maine (attention will be given to treatment of adolescents using opioids). There will be time at the end to ask questions and share challenges you might be facing when it comes to treating adolescents.

Deborah Hagler, MD, MPH, FAAP, Jonathan Fanburg, MD, MPH, and Adrienne Carmack, MD

2:55 – 3:05


3:05 – 4:05

Video and Discussion

What We Do Matters: Addressing Stigma in Health Care Towards People Who Use Substances

This session will feature a documentary-style video to reveal the expressions and impact of stigma towards people with substance use disorders when they seek healthcare. A brief discussion will follow the video to promote further processing of the material presented.

Kristen Silvia, MD, and Andrea Truncali, MD, MPH, with reflective panel Amanda Thompson and Eric Haram

4:05 – 4:10

Evaluation and Close


Alane O’Connor, DNP