REVIEW COURSE ATTENDEES RECEIVE 25% OFF - Use the promo code located in your syllabus when checking out to take advantage of this special deal!

Looking to stay engaged and expand your ASAM Review Course experience? This six-webinar series will offer an additional, in-depth look at some of the most popular sessions from the ASAM Review Course in Addiction Medicine. 

Each webinar will be an hour long, with 30-45 minutes of lecture on the topic of the week and the rest saved for audience questions. Questions have been collected in advance from participants of the 2018 Review Course and all attendees will have the opportunity to submit questions during the live webinar!

All webinars will be recorded and available to watch for registrants unable to attend live. 

Additional Resources

Additional Board Exam Preparation resources and tools are also available.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 6 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 6 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 6 AMA PRA Category 1 Credit(s)™ for completing this course.

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The ASAM CME Committee and Reviewers Disclosure Listing

  The ASAM Review Course Program Planning Committee Disclosure Listing

The ASAM Review Course Faculty Member Disclosure Listing

Overview

The ASAM Review Course in Addiction Medicine is widely recognized as the essential primer for physicians and clinicians preparing for a career in addiction medicine, as well as for primary care providers who wish to increase their skills in identifying and managing patients whose medical problems are caused or exacerbated by substance use disorders.

The course offers two and a half days of sessions which are mapped to the addiction medicine exam blueprint of topics for the exam and features an outstanding faculty. Over 600 professionals attend this popular course each time it is offered. ASAM’s Review Course has had a major impact on advancing a common base of scientific knowledge among physicians and other healthcare professionals.

Learning Objectives

Upon completion, participants should be able to:

1. Demonstrate practical knowledge on the neurobiology of addiction and articulate its activity in terms useful in a clinical setting
2. Describe the effects of alcohol, tobacco and other drugs in both tolerant and non-tolerant individuals
3. Describe the process for diagnosing addiction and differentiating the symptoms of addiction from those of other medical or psychiatric disorders
4. Explain the various pharmacologic and psychosocial treatments for addictive disorders and describe the factors that should be considered in selecting a treatment modality to match the needs of a specific patient
5. Describe the precipitants of relapse and current evidence-based practices to prevent and manage relapse

Additional Resources

Additional Board Exam Preparation resources and tools are also available.

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The ASAM CME Committee and Reviewers Disclosure Listing

ACCME Accreditation Statement:

The American Society of Addiction Medicine is accredited by the Accreditation Council for
Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement:

The American Society of Addiction Medicine designates this live activity for a maximum of 20.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Academy of Family Physicians: 

This Live activity, The 2018 ASAM Review Course in Addiction Medicine & Pre-Courses, with a beginning date of 07/25/2018, has been reviewed and is acceptable for up to 27.50 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABAM Transitional Maintenance of Certification Program (Tmoc)

This course has been approved by The American Board of Addiction Medicine (ABAM).  Physicians enrolled in the Transitional Maintenance of Certification (Tmoc) Program can apply a maximum of 20.5 AMA PRA Category 1 Credits™

American Psychological Association (APA)

The American Society of Addiction Medicine (ASAM) Continuing Medical Education (CME) has been approved for renewal of certification by the APA College of Professional Psychology. ASAM CME credits may be applied toward the APA’s “Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders.”

Continuing Education Credits (CEUs)

Non-physician participants will receive a certificate of attendance upon completion of the activity and an online evaluation confirming their participation. Participants should submit his/her certificate of attendance to their professional organization/institute.

CME Committee Members

• Catherine Friedman, MD, FASAM, Chair
• R. Jeffrey Goldsmith, MD, DLFAPA, DFASAM
• Adam J. Gordon, MD, MPH, FACP, DFASAM
• Zwaantje Hamming, FNP-C, CARN-AP
• Noel Ilogu, MD, MRCP, FASAM
• Herbert L. Malinoff, MD, FACP, DFASAM
• Edwin A. Salsitz, MD, DFASAM

Staff - Sandy Metcalfe; Arlene Deverman, MA, CAE, CFRE; Marcia Jackson, PhD

CME Committee, Program Planning Committee and Faculty Disclosure Information

In accordance with the disclosure policies of the American Society of Addiction Medicine (ASAM) and the Accreditation Council for Continuing Medical Education (ACCME), the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. These polices include resolving all conflicts of interest between the CME Committee, planning committee and faculty, and commercial interests that might otherwise compromise the goal and educational integrity of this activity. All planning committee members and faculty participating in the activity have disclosed all relevant financial relationships with commercial interests. The ASAM CME Committee has reviewed these disclosures and determined that the planning committee and faculty relationships are not inappropriate in the context of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 20.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 20.5 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 20.5 AMA PRA Category 1 Credit(s)™ for completing this course.

Upon completion, participants should be able to:

1. Demonstrate practical knowledge on the neurobiology of addiction and articulate its activity in terms useful in a clinical setting.
2. Describe the effects of alcohol, tobacco and other drugs in both tolerant and non-tolerant individuals.
3. Describe the process for diagnosing addiction and differentiating the symptoms of addiction from those of other medical or psychiatric disorders.
4. Explain the various pharmacologic and psychosocial treatments for addictive disorders and describe the factors that should be considered in selecting a treatment modality to match the needs of a specific patient.
5. Describe the precipitants of relapse and current evidence-based practices to prevent and manage relapse.

The ASAM Review Course in Addiction Medicine provides an up-to-date review of the core content of addiction medicine for:

• Physicians preparing for the ABPM Board Certification/Recertification Examination in addiction medicine
• Addiction specialists seeking a "refresher" course that incorporates recent developments in addiction science and practice
• Non-specialist physicians and other healthcare professionals needing the knowledge to identify and manage problems related to substance use disorders for their patients 

The misuse of extended-release and long-acting (ER/LA) opioids is a major public health problem. Centers for Disease Control and Prevention reported the following:

• From 2000 to 2015 more than half a million people died from drug overdoses.
• 91 Americans die every day from an opioid overdose.

The CO*RE/ASAM Pain Management and Opioids: Balancing Risks and Benefits addresses the opioid public health crisis. This comprehensive course was developed by renowned experts from Collaborative for REMS Education (CO*RE) and incorporates all six units outlined in FDA blueprint for safe opioid prescribing. The updated course also provides necessary context for safe opioid prescribing by discussing biopsychosocial aspects of pain, the newest clinical guidelines on the treatment of chronic pain, and state policies about prescribing opioids.

Learners will be able to:

1. Accurately assess patients with pain for consideration of an opioid trial
2. Establish realistic goals for pain management and restoration of function
3. Initiate opioid treatment (IR and ER/LA) safely and judiciously, maximizing efficacy while minimizing risks
4. Monitor and re-evaluate treatment continuously; discontinue safely when appropriate
5. Counsel patients and caregivers about use, misuse, abuse, diversion, and overdose
6. Educate patients about safe storage and disposal of opioids
7. Demonstrate working knowledge and ability to access general and specific information about opioids, especially those used in your practice.

CME Information and Disclosure Listing

The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. ASAM has been awarded the highest level of Accreditation with Commendation by the ACCME as a provider of continuing medical education.  

The American Society of Addiction Medicine designates this live activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

In accordance with the disclosure policies of the American Society of Addiction Medicine (ASAM) and the Accreditation Council for Continuing Medical Education (ACCME), the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. These policies include resolving all conflicts of interest between the Medical Education Council, the CME Committee, program planning committees and faculty, and commercial interests that might otherwise compromise the goal and educational integrity of the activity. All program planning committee members and faculty participating in the activity have disclosed all relevant financial relationships with commercial interests. The ASAM CME Committee has reviewed these disclosures and determined that the program planning committee and faculty relationships are not inappropriate in the context of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.  

ASAM CME Committee

Program Planning Committee

Faculty

  ASAM CME Committee Reviewers

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 2.5 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 2.5 AMA PRA Category 1 Credit(s)™ for completing this course.

Acknowledgement

Presented by ASAM, a member of the Collaborative on REMS Education (CO*RE), 10 interdisciplinary organizations working together to improve pain management and prevent adverse outcomes.

RPC Commercial Support Disclosure Statement

This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies. Please see this link for a listing of the member companies. This activity is intended to be fully compliant with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration.

This course is not intended to advocate for the use of ER/LA Opioids, but to ensure proper education about safe prescribing practices should a medical provider determine that ER/LA Opioids are the best course of treatment.

The ASAM Board Examination Study Tool (BEST) helps prepare physicians for the ABPM certification/re-certification examination utilizing an interactive and engaging format. 

This powerful study tool includes: 

1. Bank of 600 self-assessment questions reviewed for accuracy by addiction medicine experts
2. Content derived from the ABPM Exam Blueprint for effective study guidance
3. Excerpts and highlights from ASAM’s Essentials of Addiction Medicine and Principles of Addiction Medicine
4. Glossary of important terms and definitions
5. Additional resources recommended by Review Course faculty and experts for each topic
6. 12 CME Credits upon completion
7. Fully searchable functionality and content
8. Access to the BEST 24/7 online at ASAM's e-Learning Center

Live attendees of the 2018 ASAM Review Course in Addiction Medicine in Dallas, TX receive the 2018 BEST complimentary with registration. 

Additional Board Exam Preparation resources and tools are also available.

Goals and Objectives

Upon completion of this education activity, participant should be able to:

• Differentiate between important terms and definitions in the field of Addiction Medicine.
• Distill knowledge on key points from the text, the Principles of Addiction Medicine, 5th edition and course slides
• Appraise addiction patient cases and respond accurately to questions about next steps and treatment options.
• Employ knowledge gained in the educational sections of the BEST to respond accurately to self-assessment questions.

Participants of the 2018 ASAM Review Course in Addiction Medicine and other physicians who are preparing for the ABPM Certification Exam in Addiction Medicine.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 12 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 12 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 12 AMA PRA Category 1 Credit(s)™ for completing this course.

Overview

The ASAM 49th Annual Conference is the nation’s premiere conference on the latest science, research, best practices and innovations in addiction medicine. The 2018 program includes more education offerings such as; seven concurrent sessions offerings at a time instead of six, three pre-conference courses instead of two.  There will also be three Plenary Sessions that include the popular Opening Plenary Session and Policy Plenary Session and new this year the National Perspectives Plenary Session moderated by the ASAM president with leaders from national federal agencies. There will be other exciting changes to provide learning in a more interactive, casual and fun environment. 

Learning Objectives

At the conclusion of the conference, participants should be able to:

• Identify and describe the new developments affecting the science, policy, and clinical practice of addiction medicine.
• Compare presented clinical guidelines/best practices with the participant's current practice and identify strengths or gaps.
• Analyze new research and science to develop practical applications for treatment or further research.
• Explain recent or upcoming policy changes and identify implications or areas for provider involvement.
• Create a network of professionals or a set of resources that can be used to support the participant's practice.

Accreditation Council for Continuing Medical Education (ACCME)

The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The ASAM 49th Annual Conference - Innovations in Addiction Medicine and Science

The American Society of Addiction Medicine designates this enduring material for a maximum of 64.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABAM Transitional Maintenance of Certification (Tmoc)

This course has been approved by the American Board of Addiction Medicine (ABAM).  Physicians enrolled in the ABAM Transitional Maintenance of Certification (Tmoc) Program can apply a maximum of 64.5 AMA PRA Category 1 Credit(s)™ for completing the The ASAM 49th Annual Conference – Innovations in Addiction Medicine and Science.

American Psychological Association (APA)

The American Society of Addiction Medicine (ASAM) Continuing Medical Education (CME) has been approved for renewal of certification by the APA College of Professional Psychology. ASAM CME credits may be applied toward the APA’s “Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders.”

Continuing Education Credits (CEUs)

Non-physician participants will receive a certificate of attendance upon completion of the activity and an online evaluation confirming their participation. Participants should submit his/her certificate of attendance to their professional organization/institute.

CME Committee Members

• Catherine Friedman, MD, FASAM, Chair
• R. Jeffrey Goldsmith, MD, DLFAPA, DFASAM
• Adam J. Gordon, MD, MPH, FACP, DFASAM
• Zwaantje Hamming, FNP-C, CARN-AP
• Noel Ilogu, MD, MRCP, FASAM
• Herbert L. Malinoff, MD, FACP, DFASAM
• Edwin A. Salsitz, MD, DFASAM

Staff - Sandy Metcalfe; Arlene Deverman, MA, CAE, CFRE; Marica Jackson, PhD

CME Committee, Program Planning Committee and Faculty Disclosure Information

In accordance with the disclosure policies of the American Society of Addiction Medicine (ASAM) and the Accreditation Council for Continuing Medical Education (ACCME), the effort is made to ensure balance, independence, objectivity, and scientific rigor in all educational activities. These polices include resolving all conflicts of interest between the CME Committee, planning committee and faculty, and commercial interests that might otherwise compromise the goal and educational integrity of this activity. All planning committee members and faculty participating in the activity have disclosed all relevant financial relationships with commercial interests. The ASAM CME Committee has reviewed these disclosures and determined that the planning committee and faculty relationships are not inappropriate in the context of their respective presentations and are not inconsistent with the educational goals and integrity of the activity.

Who Should Attend:

• Physicians and Clinicians
• Researchers and Academics
• Counselors and Students
• Other Health Care Professionals 

dedicated to increasing access and improving the quality of addiction treatment and care.

(1.0 CME) In this conference recording from the 2018 Annual Conference, you will learn about how emergency department (ED) visits for opioid overdose have increased dramatically over the last several years, mirroring trends in overdose related mortality (1). In Indianapolis alone, our ambulance service—Indianapolis Emergency Medical Services—responded to over 2,000 opioid overdoses in 2016 and are on track to outpace that in 2017. Many local public health and safety agencies have championed increased access to naloxone and participated in trainings making it more widely available and accepted by first responders and community members (2). In Indianapolis, we created project POINT to help link those surviving an opioid overdose with the highest quality emergency care including warm hand offs to on-going treatment. Methods: We convened a group of experts and key stakeholders in our hospital system/community and undertook a quality improvement process to improve the care of overdose survivors while in the ED and through their transition to longitudinal care. Results: We developed a set of core ED services and a plan to implement each of them. Core ED services included: 1) brief assessment by a specialty trained outreach team member (ideally a recovery coach), 2) rapid HIV/hepatitis C testing, 3) naloxone teaching and provision, 3) harm reduction counseling, 4) referral to appropriate next level of care and 5) rapid ED follow up focused on recovery support, increasing/supporting motivation and overcoming logistical barriers. We also created a network of providers who were willing and able to accept our referrals and worked with them to optimize the referral process. 

Conclusions: With the growing opioid epidemic, EDs and EMS systems are looking for novel and effective ways to reduce mortality and help bridge patients into recovery. EDs and EMS systems are used to working at all hours, in austere conditions with complex and often critically ill patients. We offer an expansive and largely untapped network of providers which could be brought to bear on this epidemic. Project POINT is one example of how the ED can help drive incremental change—even in areas of the country where access to high quality MAT is limited.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn about more about treating youth with opioid addiction through cases and controversies. Young people are disproportionately affected by the current opioid epidemic, with catastrophic consequences for youth and their families. Despite the urgent need, there is a lack of consensus about treatment approaches for youth. Many practitioners have questions, and struggle with this “mysterious” and difficult to engage population. This workshop will feature an interactive, case-based format. Workshop leaders will present 4-5 cases with background and treatment course, each punctuated by “what would you do next…” management questions for guided discussion at several pivotal decision points in the course. Cases are chosen to reflect real world concerns and clinical conundrums, key learning objectives, practice debates and controversies. 

The goal is to engage participants in a lively conversation about developmentally-informed strategies, approaches, and treatment options in the treatment of this critical target population. 

Featured cases

• 18 M at 5th episode of residential detoxification who has been unable to sustain continuing outpatient care despite previous course of buprenorphine.
• 19 F who becomes pregnant during treatment with extended release naltrexone.
• 20 M in outpatient treatment, abstinent from opioids on buprenorphine, but struggling with cocaine and other non-opioid substances, opposes communication with family.
• 17 F who presents in crisis to residential treatment seeking detoxification, and struggles with the process of decision making around recommendations for and choice of relapse prevention medications (buprenorphine vs extended release naltrexone).
• 18 M with sickle cell anemia with repeated relapses despite multiple treatment levels of care, including multiple attempts at outpatient buprenorphine treatment under various programmatic conditions.

The case discussions will cover a range of questions, including: 

1. developmentally specific approaches to treatment of adolescents and young adults with OUDs; 
2. use of relapse prevention medication (MAT) in youth; 
3. the role of families, when and how to involve them; 
4. confidentiality; use of various levels of care; 
5. the impact of other substance use disorders (primarily cannabis and alcohol); 
6. delivery models for medications and psychosocial treatment modalities; and others.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that, marijuana is an illegal drug in most countries around the globe, however efforts to legalize marijuana in a number of countries are gaining momentum. Addiction physicians are consequently are more involved in public policy debates on the subject. This symposium will provide an overview of global developments pertinent to marijuana legalization and decriminalization efforts and the central role of addiction physicians in the respective public policies. The increasing use and abuse of marijuana around the globe raises questions about the impact of this substance on communities, and the role of addiction physicians in influencing public policies. Questions about the safety, toxicity, addictive potential, gateway effects of marijuana are now being fiercely debated, as states in the USA (Colorado and Washington) are legalizing marijuana, and other countries are considering decriminalizing i.e. Uruguay. Furthermore, the "medical" use of marijuana is being permitted by some US states and nations (i.e. Canada). 

The symposium speakers:

1. Dr. Gregory Bunt will discuss decriminalization v. legalization of marijuana, 
2. Dr. Susan Weiss will discuss cannabis policy developments at home and abroad, and 
3. Dr. Kevin Sabet will cover international and global consequences of legalization of marijuana.In brief, the symposium will provide the participants an important historical and international perspective on marijuana use, abuse and dependency, and the relationship addiction physicians can establish with the public, policymakers and governmental authorities. In addition, an Audience Response System will be utilized to evaluate controversial opinions of participants and facilitate vigorous audience participation.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABPM Maintenance of Certification (MOC)

The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.

ABAM Transitional Maintenance of Certification (tMOC)

This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn about the publication Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder (OUD) and Their Infants – a comprehensive Clinical Guide on managing optimal OUD care and treatment developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). This Clinical Guide meets an urgent need among healthcare professionals who treat women with OUD and children exposed to substances by providing reliable information that can be applied in clinical practices to achieve positive outcomes for both mother and infant. It contains an introduction to the guide and fact sheets that include clinical scenarios, clinical action steps, supporting evidence, clinical considerations, and web resources. 

The factsheets are organized into three sections: 

• Section I – Prenatal Care (Factsheets #1–8)
• Section II – Infant Care (Factsheets #9–13) 
• Section III – Maternal Postnatal Care (Factsheets #14–16) 

The Clinical Guide is based on the recommendations published in Advancing the Care of Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: A Foundation for Clinical Guidance. 

This workshop will be moderated by Melinda Campopiano, MD, Medical Officer for SAMHSA’s Center for Substance Abuse Treatment. She and three members from the RAND/UCLA Appropriateness Method (RAM) expert panel will discuss treatment recommendations from the Clinical Guide. Audience members will have the opportunity to ask questions about the recommendations and the clinical care for pregnant and parenting women with OUD.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that the hallmark of addiction is loss of control and ongoing compulsive substance use despite negative consequences, and is underscored by significant difficulty in executive functioning and organization. As such, especially early on in care or at a time of relapse, highly structured treatment modalities and scheduling are unrealistic for many at best, and potentially lethal for others at worst. If late or missed appointments result in longer waits or missed opportunities for care, or substance use results in discharge from care or referral to a higher level of care when the patient is either not able or ready to make such a change, the result can be no level of care. Despite the prescription drug monitoring program, misuse deterrent opioid formulations, expanded education efforts for safe pain prescribing and SUD screening and management, increased buprenorphine trainings and expanded waivers, the substance use disorder treatment gap remains and the opioid overdose epidemic continues to soar. The landscape of the opioid epidemic has changed even more dramatically with fentanyl and carfentanyl, requiring more readily available care, and flexible care models to help keep people engaged in care, while we work with them through the natural history of substance use disorder. By partnering with them in this manner, we help keep patients alive, lower their risk of ongoing serious health complications or overdose, and increase their chances of continuing to engage in meaningful treatment; we collaborate with them in the practice of harm reduction.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that the question of how to craft curricula to engage residents on Substance Use Disorders topics is both difficult and urgent.  It is difficult because there is a paucity of research on the efficacy of various didactic formats to guide us towards solutions; urgent because we are increasingly identifying knowledge gaps among residents in critical SUDs topics. Using as a model the new Substance Use Disorders Theme Block from the MGH Internal Medicine residency, this workshop seeks to spark discussion among educators about best practices for the creation and implementation of new SUDs-focused curricula for millennial learners. Through group discussions, video review of sessions, and microskills teaching, facilitators will explore how educators can expand the diversity of didactic formats, integrate Buprenorphine waiver training, and include peer-developed and peer-delivered content in their SUDs curricula. Throughout the session, participants will be exposed to different ways of gathering real-time and actionable feedback from residents. 

The workshop begins with a brief interactive review of literature on the impact of different didactic formats on medical student and resident engagement and confidence, and explores the different didactic formats used in the MGH SUDs Theme Block--rapid-fire cases, simulation, skills workshops, peer mini-lectures. This is followed by small group discussions, with the goal of identifying barriers and benefits to implementing similar formats at one's home institution. After observing video of a peer-delivered session, a larger group discussion will address the three domains of resident/learner engagement--content creation, collaborative learning, and peer coaching—with associated examples of innovations in the MGH model to address these domains. Facilitators will unpack how Buprenorphine waiver training was delivered to all categorical and primary care residents in the MGH SUDs Theme Block. Finally, teaching micro skills that were highlighted by resident feedback will be reviewed in small group sessions.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn from an attorney from the Disability Rights Section in the U.S. Department of Justice’s Civil Rights Division will present on “Opioid Use Disorders and the Americans with Disabilities Act: Eliminating Discriminatory Barriers to Treatment and Recovery.” Among the topics discussed will be the Civil Rights Division’s response to the opioid epidemic; an Americans with Disabilities Act (ADA) overview; the ADA’s application to and protections for people with substance use disorders and opioid use disorders; and how to file a complaint about disability discrimination with the Department.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that physician burnout and suicide rates are at their highest levels and steadily climbing. Workload, electronic medical records, decreased time with patients and poor work-life balance have all be proposed as possible contributors to the epidemic of physician burnout. In contrast, physicians have the same rates of mental illness (such as depression and anxiety) and substance abuse as the general population. However, the substance physicians tend to abuse are alcohol and prescription medications (v.s. illicit substances for the general pop). With all of these factors colliding into "Physician Health," it is no surprise that physician well-being committees are commonly tasked with assessing a "troubled physician".  Burnout and suicide are not limited to seasoned members of the field of medicine. Medical students and residents have burnout levels as high as 50%. We are just now starting to uncover the epidemic of medical student and resident suicide rates.  An intensive diagnostic evaluation of a physician is a repetitively new concept. Prior to the 1990's Physicians were confronted and in many cases forced into treatment. Currently, the practice is to encourage a physician suspected of having a substance abuse, mental health or behavioral problem into a minimum 72 hour diagnostic evaluation to uncover whether or not they need treatment.  Physicians face similar barriers to treatment as the general population such as shame. However, they also face barriers such as fear of losing their careers, losing medical malpractice coverage, losing credentialing/hospital privileges and more if they are diagnosed with mental illness or substance abuse.  Therefore, the delivery and quality of a diagnostic evaluation and treatment and monitoring for a physician are critical. Our workshop will cover the current healthcare environment and the epidemiological and other risk factors that physicians face. We will discuss the process of intervention and what to do when a colleague, staff member or resident/medical student is suspected of being impaired. In great detail we will cover the process of evaluating a physician from a multi-disciplinary approach. We will discuss the treatment process of when a healthcare provider (a colleague, staff member or resident/medical student) needs treatment including the intensity of treatment, levels of care, medication vs. non-medication treatment options, time needed off of work and other important considerations. Finally, in great detail we will cover the process of ongoing monitoring to assure the healthcare provider is safe to return and to continue to practice after receiving treatment. We will provide an interactive experience for the audience to help them incorporate a better understanding of both physician health and thorough treatment into their practice or into the medical institution. Legal consideration and concerns will be discussed and best practices will be provided.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that buprenorphine became available for the treatment of opioid dependence in the United States in 2002. The accompanying regulations also allowed that the treatment be done outside of Opioid Treatment Programs (OTPs) or methadone clinics in a variety of settings including office-based providers and various types of outpatient programs by physicians (and now advanced providers) who obtain X-waiver certification. While it is clear that buprenorphine is an effective treatment for patients with opioid dependence with retention in treatment, reduction in illicit opiate use, decreases in craving and improvements in function on a variety of levels supported as evidence-based outcomes various issues come up in prescribing patients buprenorphine. Some physicians ignore the problems and others have zero tolerance for any deviations from what is expected. In this workshop two physicians with many years’ experience from outpatient treatment programs, Emergency Departments, detoxification units and hospital settings as well as primary care practice, will present and moderate case-based discussions in addressing complex issues in buprenorphine prescribing. These issues include running out of medication early or encounters with patients who report lost or stolen medications. What does one do when the urine has been adulterated or substituted or does not show any buprenorphine? How should one optimally approach patients that are using other substances such as alcohol, cocaine, marijuana or prescription sedatives and benzodiazepines when prescribed buprenorphine? These issues are discussed and often debated yet typically don’t come to easy resolution. The authors of this workshop will present and moderate discussion for various cases and provide examples of and support for approaches for challenging patient encounters that providers prescribing buprenorphine are confronted with. The format is through moderated case discussion and the audience will be encouraged to present their thoughts and responses for discussion during this session as well. Where available references to support decision making and to clarify pharmacologic, toxicologic and forensic principles, such as interpretation of drug testing results, will be provided. Cases will also serve to reinforce basic addition medicine competencies in these areas though interactive discussion and presentation rather than didactic lecture.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that general medical settings are opportune for the identification and initiation of addiction treatment. There is strong evidence for delivering primary care-based alcohol and tobacco screening, brief interventions, and referrals to higher levels of specialty addiction treatment, providing integrated psychiatric, addiction, and general medical treatment, and additional evidence that addiction pharmacotherapies and outpatient psychotherapies can be feasibly delivered in a variety of general medical settings. Collaborative care models have been long-demonstrated to improve depression treatment outcomes in primary care, and there is emerging evidence that these models have applicability to opioid and alcohol use disorders. Population-based chronic disease management is characterized by longitudinal care delivery, integrated and coordinated primary and specialty care, explicitly supported and seamless transitions between care intensities and settings, evidence-based care plans, and the availability of subspecialty expert care. The implementation of an integrated system of care may overcome the barriers to the effective application of chronic disease management for addictive disorders. The existing healthcare system has significant fragmentation, overall access problems, and specific inaccessibility to highly effective addiction treatments. Building an integrated system of care within existing healthcare enterprises requires addressing these factors. Within this context, addiction medicine clinicians often encounter barriers and facilitators associated to the delivery of addiction treatment in general medical settings, particularly with patients with co-occurring addiction and other psychiatric conditions. 

This session will briefly review the evidence of collaborative care and other integrated care models for addiction medicine clinicians in the general medical setting-based treatment of addiction. The panelists will review the real-world barriers and facilitators to the identification of addiction and initiation of addiction treatment in these settings. The majority of the session will engage workshop participants in a facilitated discussion, where participants will be asked to reflect upon their institutional climates and identify key opportunities for collaborative care in their institutional settings. Participants will be split into small groups where they will be asked to develop and discuss a personal strategy for enriching their own institutional practices and promote the integration of addiction treatment into general health systems. The session will conclude with a large group reflection on the knowledge learned, skills acquired, and inventory of attitudes.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that while the federal government has taken some steps to improve access to and the quality of addiction treatment in recent years, many states also have been busy passing a flurry of laws and writing regulations related to addiction prevention, treatment, and recovery. States hit hard by the opioid overdose epidemic have established Task Forces, declared states of emergency, applied for federal waivers to transform their Medicaid programs, issued naloxone standing orders, and established countless other policies to reduce opioid prescriptions, promote harm reduction strategies, fund treatment, or regulate addiction treatment services. Each state has taken a different approach, but some trends have emerged, allowing for a comparative analysis of policies’ effectiveness and predictions for what policy changes clinicians can expect at home. 

This Policy Plenary will:

1. Feature state policy experts and officials who will discuss state-level strategies to improve addiction medicine quality and access;
2. Highlight examples of policies that have worked well and those that have had unintended consequences, and 
3. Help equip attendees to be effective advocates for good addiction policies in their states.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1 CME) In this conference recording from the 2018 Annual Conference, you will learn about recent trends in youth smoking and alternate tobacco product use. Behind the steady decrease in traditional cigarette smoking rates in adolescents and young adults hides a new pattern of tobacco and nicotine addiction. E-cigarettes, hookahs, ‘poppers’ (the combination of tobacco and marijuana), and chewable forms of tobacco are increasingly popular among today’s youth, with evidence showing that e-cigarettes are attracting a group of young smokers who most likely would have otherwise never smoked. Less studied and unequally regulated when compared with traditional cigarettes, these alternate tobacco forms present both a challenge and an opportunity for clinicians and policymakers. This session will offer a comprehensive perspective on adolescent and young adult smoking in North America. It will aim to uncover and explore some of tobacco’s newer and alternate forms while highlighting important associations with other substance such as marijuana, and co-morbid medical and mental health conditions. Building on the presenters’ experience with in-patient and outpatient primary, secondary and tertiary care adolescent and young adult populations, the interactive nature of this workshop will allow participants to share challenges and examples from their own practice. Attendees will also have the opportunity to develop new skills and approaches for tobacco prevention and cessation with youth in a rapidly evolving context. This highly interactive workshop will combine short lectures, case simulations and small group discussions. The first part of the workshop will highlight new and emerging forms of tobacco as well as current challenges associated with youth tobacco consumption. Presenters will share compelling new data and evidence on the topic. The second part of the workshop will consist of an interactive presentation including small group discussions about approaches to tobacco prevention and cessation specifically adapted for adolescents and young adults. The third portion of the workshop will consist of case discussions integrating elements from the first two sections of the workshop in a small group discussion format allowing exchange of best practices. Workshop presenters will complement small group presentations with key findings and recommendations from the literature. The workshop will conclude with a large group debrief where participants will have the opportunity to share, comment and ask questions about the case scenarios discussed or other aspects of the workshop.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of <<NUMBER OF CREDITS>> AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn what immediate access clinical care looks like, as seen through The Massachusetts General Hospital Bridge clinic; a multidisciplinary, immediate access low threshold transitional clinic which has provided over 4039 visits to 460 patients since opening in 2016. We offer medication management, recovery coaching and optional peer-support and psychoeducation groups to individuals unable to access care in the community. The primary goal is to engage people by “meeting them where they are," and to initiate pharmacotherapy, followed by stabilization and eventually linkage to community based treatment. Flexible drop-in scheduling is critical to our model. Half of all visits are not scheduled ahead and 80% of patients have at some point utilized same day appointments while 63% have utilized walk in services. The 30 day readmission rate for Bridge Clinic patients who have had a recent inpatient stay is only 10.4 %. This clinic also serves in a complementary role to an inpatient addiction consult team (ACT), the emergency department, the obstetrics department, as well as all outpatient departments. The Bridge Clinic provides a "consult and return model" for complex patients cared for in the MGH primary care clinics who need stabilization in a low threshold environment, as well as to mentor newly waivered buprenorphine providers and trainees. 

This focus session will describe the need for such models of care, lessons learned, review of outcomes and the nuts and bolts needed to start and run this type of clinic model, providing attendees with concrete tools to start their own Bridge Clinic.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1 CME) In this conference recording from the 2018 Annual Conference, you will learn about the origins, prevalence, known pharmacology, and harmful clinical effects of fentanyl, fentanyl analogs, and other novel non-fentanyl opioids, as well as the treatment response including naloxone dosing. 

We are presently in the midst of a massive opioid epidemic, partly due to a recent increase in heroin adulterated with fentanyl and its analogs.(Rudd 2016) Deaths from heroin overdoses began to rise in 2009 with overdoses associated with synthetic analogs rapidly increasing since 2013.(Rudd 2016;Peterson 2016) Although fentanyl was the initial adulterant found during the present epidemic, multiple other analogs such as carfentanil, acetylfentanyl, and butyrylfentanyl, as well as other non-fentanyl-derived opioids such as U-47700 are increasingly found in the heroin supply.(Lucyk 2017) There were eight seizures involving acetylfentanyl in 2013 with the number rising to 2001 in 2015.(Prekupec 2017) In addition to their increased prevalence, these analogs are incredibly potent. As an example, carfentanil is 10,000 times more potent than morphine and 100 times more so than fentanyl.(Wax 2003) The pharmacokinetics of novel fentanyl analogs such as their duration of effect or the amount of naloxone required for reversal is not well described in the published literature. As such, this makes it difficult to understand the potential effects on patients who are exposed to these opioids. While little is available in the peer-reviewed literature, much is written in the lay press regarding purported toxicity from ambient secondary exposures to healthcare providers and law enforcement officers. Many of these reports about first responders describe toxicity from routes of exposure that are pharmacologically implausible and portray symptoms inconsistent with an opioid overdose. Unfortunately, these sensationalistic reports rapidly disseminated leading to increasing concern and potentially poorly informed and dangerous decision-making about first responder and healthcare workers’ safety. Given the prevalence and morbidity of these agents, testing our patients for fentanyl has increased relevance, and rapid immunoassays are under development. Although advanced laboratory testing can identify some fentanyl analogs, this is expensive, not widely available, and not sufficiently rapid to impact patient care. Rapid testing may be beneficial to public health and law enforcement officials when identifying outbreaks and to improve risk communication. Clinical benefit, however, is unclear given the need to generally make decisions prior to the results returning. Our focus group plans to discuss what is known about these novel opioids and their impact on both clinical care and public health concerns

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of <<NUMBER OF CREDITS>> AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that, on a typical day in 2015, there were more than 4.7 million adults under community supervision and thousands of others awaiting trial in the community. An additional 2.2 million were incarcerated. With so many of those passing through the criminal justice system having a substance use problem, there are many millions of opportunities each year to reduce problematic substance use and promote public health and safety, almost all of which are missed. What should police officers, judges, and probation officers do when they believe reducing the substance use of individuals they encounter would benefit the user and/or society more generally? 

This workshop, based on a chapter in the forthcoming ASAM textbook Principles of Addiction Medicine, will highlight innovative ideas for reducing the substance use of individuals who are under criminal justice supervision and review evidence on the effectiveness of such programs. We will begin with a discussion of the role of contingency management in reducing substance use, with a special focus on Physician Health Programs. In addition to reviewing evidence on the use of positive incentives in treatment and non-treatment settings, the workshop will also discuss a different—but theoretically consistent—approach involving frequent substance testing with swift, certain, and proportionate sanctions for violating judicial orders to abstain from consumption (e.g., 24/7 Sobriety). We will also discuss the pathways to treatment via criminal justice agencies ranging from drug courts to the oft-discussed Portuguese model that diverts those arrested for possessing small amounts of drugs to a “Commission for the Dissuasion of Drug Addiction” that is outside of the criminal justice system. We will not argue that one or the other of these approaches is the most effective or cost-effective; that would require randomized controlled trials and even then some approaches would work better for particular individuals. Rather, we view the collection as proof of the fallacy inherent in debating the merits of prison vs. treatment, and as an inspiration for those seeking to invent and evaluate additional creative implementations of the basic concept of contingency management.

ACCME Accreditation Statement

The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.