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  • Opioid Misuse, Overdose, and Suicide: Correlates and Intervention Strategies (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about opioid use and chronic pain as risk factors for suicide and/or overdose risk from this conference recording from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:


    According to 2016 NSDUH, 2 million adults (aged 18 or older) met criteria for an opioid use disorder (OUD) and 42,000 of overdose deaths are attributable to opioids. In the same year, an estimated 1.3 million adults attempted suicide. It is estimated that over 11million US adults experience daily pain. Various studies have concluded that depression and pain frequently co-occur and increase the risk for suicidal behaviors/suicide or overdose. However, the intersection among these conditions is often complex and contributions not well established. Furthermore, in the context of chronic pain or OUD, determining the cause of death as either a drug overdose or suicide is a challenge due to the entwined nature of these conditions. However, the evidence base to inform clinicians in the selection and sequencing of effective treatment strategies is limited. In this symposium, we propose to characterize these populations and disentangle some of these complex associations among chronic pain, opioid misuse/OUD, and risk for suicide and overdose.  The talks will highlight the correlates and risks in patients exposed to prescription opioids as well as those who have OUD. Content also includes some suggestions for methods to identify key risk, and provide a review of the evidence for prevention interventions to reduce suicide, factors in these populations. The final speaker will review the literature on effective treatments for OUD and Depression and discuss its potential for lowering OD/suicide risks.   
    1.) Recognize the prevalence and correlates of opioid use and chronic pain as risk factors for suicide and/or overdose risk
    2.) Identify ways to identify these risk factors and become familiar with prevention interventions to reduce the risk for suicide
    3.) Review the existing literature on combining or integrating depression and OUD treatments with the aim of lowering risk for overdose or suicide.




    Geetha Subramaniam

    MD., DFAPA, DFAACAP

    Dr. Subramaniam is the Deputy Director of the Center for Clinical Trials Network, at NIDA. In this role, she has been instrumental in developing research projects in a variety of topic areas, including addressing the prevention of substance abuse in adolescents, prevention and intervention of prescription stimulant misuse in youth. Previously, she was a full-time faculty member in the Division of Child Psychiatry at Johns Hopkins School of Medicine and the Associate Medical Director of Mountain Manor Treatment Center, Baltimore, MD, where she led clinical trials with adolescents with SUD and served as a preceptor to residents and fellows. She distinguished herself as a clinical and research expert in the assessment and treatment of adolescents and young adults with opioid use disorders. She is ABPN certified in General, Child, and Adolescent, and Addiction Psychiatry and a Distinguished Fellow of both the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.

    Martin D. Cheatle

    PhD

    Dr. Martin Cheatle, Clinical Psychologist, Director, Behavioral Medicine at Penn Pain Medicine Center earned his PhD in psychology at Princeton University. He completed his clinical internship at the University of Pennsylvania, School of Medicine and founded the Orthopaedic Pain Center at PENN. Currently he is Director of Behavioral Medicine at the PENN Pain Medicine Center and Director, Pain and Chemical Dependency Research at the Center for Studies of Addiction, University of Pennsylvania. He is an Associate Professor of Psychiatry, Perelman School of Medicine, University of Pennsylvania.  Dr. Cheatle specializes in the evaluation and treatment of chronic pain disorders from a biopsychosocial perspective and has been involved in extensive research including a NIH funded 5-year longitudinal study of the development of addiction in patients initiating prescription opioid therapy for chronic pain and as PI of a currently funded NIH/NIDA grant assessing phenotypic and genotypic markers of prescription opioid abuse.  His main focus of research is pain management and addiction in vulnerable populations (HIV/AIDS, psychiatric patients) and pain and suicidal ideation and behavior. 

    Mark Ilgen

    PhD

    Mark A. Ilgen, Ph.D. is a clinical psychologist, a professor of psychiatry, and an investigator with the VA Center for Clinical Management Research (CCMR) at the VA Ann Arbor Healthcare System. Much of his current work focuses on improving treatment outcomes for patients struggling with substance use disorders and complicated co-occurring problems, particularly chronic pain, other psychiatric disorders, and suicide risk. In working with adults who have drug and alcohol problems, his goal is to help them reverse the course of addiction as quickly as possible to minimize the damaging effects on other areas of their lives. For individuals grappling with both addiction and chronic pain, Dr. Ilgen has developed an intervention that can help address both problems and also minimize the treatment challenges that opioids, cannabis and alcohol often present for this population. He is in the process of conducting research to determine the potential effectiveness of this intervention. Dr. Ilgen is also keenly interested in evaluating addiction treatment approaches to identify the factors most important to patient motivation, quality of life during treatment, and outcomes. He is also the principal investigator of a study to better understand marijuana use for pain management and the potential implications for patient outcomes as well as health policy.

    Richard Ries

    MD, F.A.P.A., F.A.S.M

    RICHARD K. RIES, MD Professor, Director, Addictions Division Department of Psychiatry and Behavioral Sciences University of Washington School of Medicine Seattle, Washington Richard K. Ries, MD, is Professor of Psychiatry, and Director of the Addictions Division in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle, Washington, and Director of the Addiction Treatment services at Harborview Medical Center in downtown Seattle. Dr. Ries received his undergraduate degree from Stanford, medical degree from Northwestern Medical School and completed his psychiatric residency at the University of Washington, Seattle, where he was Chief Resident. Dr. Ries is board-certified in Psychiatry by the American Board of Psychiatry and Neurology with Added Qualifications in Addiction Psychiatry, and the American Board of Addiction Medicine. A Distinguished Fellow of the American Psychiatric Association and a Fellow of the American Society of Addiction Medicine, he is on the editorial board and a reviewer for several scientific journals and has been involved with numerous research grants from the National Institute of Health. In addition he has been active in both studying and treating persons with opioid use disorders, with involvement in SAMHSA grants and the Harborview Addictions program opioid treatment tracks. He has been senior editor of the key reference text: Principles of Addiction Medicine (editions IV and V, published by the American Society of Addiction Medicine, and a noted expert in the field of Addictions, Suicide and other Co-occurring Disorders.

    Edward Nunes

    MD

    Dr. Nunes is a Professor of Psychiatry, and Principal Investigator of the Greater New York Node of the National Institute on Drug Abuse (NIDA) clinical Trials Network as well as other NIDA funded studies on behavioral and medication treatments for substance dependence and related psychiatric disorders. Interests and ongoing studies include treatments for cocaine dependence in general, heroin and other opioid dependence, for nicotine dependence in general, and for addicted patients with co-occurring psychiatric disorders including depression, and post-traumatic stress disorder. Types of treatment under study include medication treatments (naltrexone, buprenorphine, mirtazapine) as well as behavioral and psychotherapeutic approaches and computer-delivered treatments. Dr. Nunes also studies the challenges involved in implementing evidence-based treatments for substance use disorders in real-world community-based treatments settings. Dr. Nunes also serves on the American Board of Addiction Medicine, Co-Chair of the Columbia/ New York State Psychiatric Institute's Institutional Review Board, and has been appointed to the National Advisory Council on Drug Abuse.

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • An Assertive Approach for Youth OUD: Family Engagement and Medication Home Delivery (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about clinical models for the treatment of youth with opioid use disorders from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:


    Young people are disproportionately affected by the current opioid epidemic, with catastrophic consequences for youth and their families. But adolescents and young adults with OUD generally have poor engagement in care, and worse treatment outcomes than older adults. Fewer than 25% of adolescents with OUD receive any relapse prevention medication.  Despite the clear and urgent need, there is still a lack of research and clinical consensus on youth-specific treatment models. In particular, while we have evidence for effectiveness of medications, we have little evidence for the most effective delivery models for these medications. We have a long way to go in optimizing engagement and retention. Assertive interventions, including home delivery of medication,s have had a role in overcoming barriers to retention and adherence in numerous chronic relapsing-remitting illnesses, including Assertive Community Treatment (ACT) for severe and persistent mental illness.  This session will feature an innovative approach to treatment for high-severity OUD in youth, including assertive outreach, family engagement and home delivery of relapse prevention medications. The session will begin with a description of the intervention. Family engagement empowers families, providing guidance for monitoring and improving adherence for youth in treatment. Confidentiality is sometimes seen as a barrier, and young adults may have developmentally normative resistance to involving their families. But respecting the emerging autonomy of youth and including families are not incompatible with one another. In fact, treatment of youth proceeds best as a collaboration among youth, parents and the treatment team. Additionally, clinic-based treatment can present barriers to treatment access. Home-based services, including monthly administration of extended release naltrexone or extended release buprenorphine, have the potential to overcome many of these barriers. By literally meeting youth and families where they are, in their homes, we may be able to engage and retain youth that are not be likely to succeed in clinic-based settings. The workshop will continue with an interactive discussion of cases vignettes that illustrate the non-linear clinical courses characteristic of this patient population, the decision points in clinical trajectories, and the conundrums in management. There will be a particular focus on practical clinical strategies in leveraging family involvement. Finally, the session will summarize results to date in evaluating the model. Our small published case series (Vo et al , 2017) showed promising results with an increase in retention and number of doses received, compared to a historical comparison group of clinic-based treatment as usual. In an interim analysis of the first 25 subjects in a randomized trial currently underway, preliminary results show that the intervention group had a significantly greater mean number of doses over the first 3 months (2.5 doses) compared to the usual care control (0.3 doses). The intervention group also had a lower rate of OUD relapse (27%) than the control group (91%). There will also be ample opportunity throughout for Q&A and discussion.  



    Learning Objectives:


    1.) Describe limitations to clinic based clinical models for the treatment of youth with opioid use disorders 
    2.) Describe developmental vulnerabilities of youth that act as barriers to access, engagement and retention
    3.) Describe approaches to overcoming barriers to care for youth with OUDs 


    Marc J. Fishman

    MD, DFASAM

    Marc Fishman MD is board certified in addiction psychiatry and addiction medicine. A faculty member of the Johns Hopkins University School of Medicine, he is Medical Director and CEO of Maryland Treatment Centers, a regional behavioral health care provider, with inpatient and outpatient facilities for adolescents and adults. His clinical specialties include treatment of drug-involved and dual-diagnosis adolescents, opioid dependence in adolescents and adults, and co-occurring disorders. He has been principal investigator or collaborator for several NIDA- and CSAT-funded projects to improve and evaluate adolescent treatment, as well as pharmacotherapy trials in adults. He is the author of numerous articles and book chapters on addiction treatment, and lectures widely on a variety of topics including adolescent treatment, youth opioid treatment, placement and treatment matching strategies. Dr. Fishman served as a co-editor for the most recent editions of ASAMs Patient Placement Criteria, leading the adolescent section, and served as the chief editor for the ASAM PPC Supplement on Pharmacotherapies for Alcohol Use Disorders. He is the chair of the Adolescent Committee for ASAM. He is a Past President of the Maryland Society of Addiction Medicine.

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Talk Amongst Yourselves: Case-based Discussions on Buprenorphine Treatment Challenges (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about overcoming common barriers to prescribing buprenorphine from this conference recording from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:


    Of the 70,237 drug overdoses in 2017, the majority were related to opioids. In response to the worsening opioid epidemic, the Department of Health and Human Services expanded buprenorphine prescribing privileges to include Nurse Practitioners and Physician Assistants and increased prescribing limits for physicians in 2016. However, even among physicians who already have DATA 2000 waivers, up to 40 percent have never prescribed buprenorphine. In order to increase access to this essential treatment for patients across the country, we must motivate waivered providers from all specialties to prescribe. Research with physician prescribers has identified numerous barriers to buprenorphine prescribing including provider attitudes, payment issues, lack of education and lack of structural support. These barriers occur at patient, provider and systems levels. Case-based experiential learning can address these barriers and empower interdisciplinary clinicians to effectively provide buprenorphine. In a 90 minute workshop, a multidisciplinary panel from the Substance Use Warmline will lead brief didactics and facilitate case reviews for three challenging scenarios in opioid use disorder management. Attendees will participate in small group case reviews of the following cases: 1) chronic pain and mental health 2) pregnancy and postpartum 3) polysubstance use. Groups will be guided to address patient, provider and systems level approaches to management for each case. Peer support resources and clinical tools will be discussed and shared as part of each case. Finally, the panel will review lessons learned in how to build a successful buprenorphine practice.


    Learning Objectives:

    1.) Utilize evidence-based practice and clinical tools to overcome common barriers to prescribing buprenorphine in a variety of healthcare settings
    2.) Analyze real cases to identify opportunities for skills-building in patient, provider and system domains 
    3.) Build confidence among buprenorphine prescribers and inspire non-prescribers to consider applying for their DATA 2000 waiver 


    Rebecca L S Martinez

    MS, RN, FNP-C

    Rebecca Martinez is a family nurse practitioner who works at the intersection of HIV prevention, primary care and substance use disorder management. She's jazzed to be part of an interdisciplinary team of providers on the Substance Use Warmline at the UCSF Clinician Consultation Center, where she provides clinical support to the inspiring healthcare workers across the country who are doing their best to manage patients with substance use.

    Hannah Snyder

    MD

    Assistant Clinical Professor at University of California San Francisco
     

    Erin R. Lutes

    MS, RN, PHN, CNS

    Erin R Lutes is a Clinical Nurse Specialist and Public Health Nurse specializing in HIV/AIDS. She provides expert consultation on HIV prevention and substance use disorders to clinicians across the United States with the Clinician Consultation Center based at the University of California, San Francisco. She also works for the San Francisco Department of Public Health as a Registered Nurse in primary and urgent care, serving populations impacted by substance use disorders, mental health, homelessness and HIV. In addition, she is adjunct faculty at Samuel Merritt University for students placed at an outpatient treatment facility for Native Americans. She is a US Albert Schweitzer Fellow for Life.

    Elizabeth Gatewood

    DNP, RN, FNP-C, RN, CNE

    Elizabeth Gatewood is an Associate Clinical Professor. She has been teaching for the past five years in the Family Nurse Practitioner program at UCSF. She has maintained a practice where she precepts students. Her clinical practice is at Family Health Center at Zuckerberg San Francisco General Hospital, the catchment hospital for uninsured or underinsured in the public health department. There she integrates treatment of substance use disorder into her primary care practice. 

    Jacqueline P. Tuisky

    MD

    Jacqueline Peterson Tulsky, MD is a Professor of Medicine, Emeritus at UCSF in the HIV, Infectious Disease and Global Medicine Division at Zuckerberg San Francisco General Hospital (ZSFGH), the SF County safety net hospital.  She is faculty on the Clincians Consultation Center, Substance Use Warmline, a  program of  the UCSF Dept of  Family and Community Medicine at ZSFGH.  Dr. Tulsky is Boarded in Intermal Medicine and  Board hopeful  in  Addiction Medicine.   

    Triveni Defries

    MD, MPH

    Triveni DeFries, MD, MPH,  is an internist and current Primary Care Addiction Medicine fellow at University of California, San Francisco/San Francisco General Hospital. Prior to fellowship, she was practicing with the Indian Health Service in the Navajo Nation. Her interests include addiction medicine, primary care transformation, trauma informed care, immigrant health and native health.

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Cannabis Today: Not Your Parent’s Pot (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about effects related to cannabis from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    Americans’ views and perceptions of cannabis are changing. This is evidenced by recent legislation: nine states and the District of Columbia legalized recreational (adult-use) cannabis while 13 others decriminalized it, 30 states legalized medical cannabis, and in 16 states cannabidiol (CBD) is legal. As the laws and penalties surrounding cannabis relax, assumptions regarding its safety also change. As an example, the Monitoring the Future study demonstrates a decreasing perception of harm that is correlated with increasing use of cannabis in junior high and high school aged students. This is unfortunate as the National Academy of Sciences found that cannabis can negatively affect memory and learning and impair academic achievement. Another consequence of legalization is the increasing concentration of tetrahydrocannabinol (THC) in available products. While historically cannabis contained approximately 3% THC and had limited clinical consequences beyond euphoria, THC concentrations of 20% or more are now available. Edible products, such as cookies, also contain unexpectedly high quantities of THC and non-commercial products, such as "wax," may have a concentration as high 98%. This has led to an increasing number of adverse medical consequences and emergency department (ED) visits for intoxication, something that almost never occurred in the past. In particular, there is a growing concern for unintentional exposure in the pediatric population. Additionally, reports of cannabis associated psychosis, cannabis withdrawal, cannabinoid hyperemesis syndrome, and motor vehicle collisions due to cannabis intoxication are increasingly prevalent. The recognition and management of cannabis related complications are essential in order to provide appropriate clinical management and reduce harms. One reason for increased access to cannabis is the potential medicinal benefit. Cannabis as well as CBD are purported to treat a multitude of conditions including glaucoma to seizures to pain. While CBD has demonstrated some promise in treating rare childhood seizure disorders, as evidenced by the recent approval of Epidiolex(R), the literature supporting medicinal cannabis is limited. Cannabis is also suggested to be a potential solution to the opioid crisis due to its postulated analgesic effects. Importantly, the reported association of a decrease in opioid prescribing, use, or overdose has not been causally implicated and is inconstant across studies. In this session, we shall review the increasing number and variety of ED visits and acute medical conditions associated with cannabis use. We shall discuss the diagnosis and treatment of intoxication as well as the treatment of other effects related to cannabis use, including unintentional pediatric exposures. Lastly, we shall discuss the convergence of medical cannabis, cannabis legalization for recreational or adult-use, and the opioid epidemic, and what effect, if any, cannabis has had on opioid prescribing and overdoses.  

    Learning Objectives:


    1.) Describe the epidemiology of health effects from cannabis use
    2.) Recognize and understand the management of cannabis related complications including accidental pediatric ingestions (e.g. children/toddlers) and cannabinoid hyperemesis syndrome
    3.) Explore the interactions of medical cannabis and the opioid epidemic



    Evan S. Schwarz

    MD

    Dr. Evan Schwarz is an Associate Professor of Emergency Medicine and the Medical Toxicology Section Chief at the Washington University School of Medicine. Additionally, he is board certified in Addiction Medicine. He directs the medical toxicology and addiction medicine consultation service as well as their outpatient clinic and organized the Emergency Department buprenorphine treatment program. In addition to his work responsibilites, he is a member of the board of directors for the American College of Medical Toxicology and the President of the Missouri College of Emergency Physicians. He was appointed to the Opioid Advisory Committee through Missouri HealthNet and the Department of Social Services and is a physician consultant for Missouri’s State Targeted Response. 

    JoAn Laes

    MD

    JoAn Laes, MD, Attending Physician, Division of Addiction Medicine, Hennepin County Medical Center, Minneapolis, MN; Core Medical Toxicology Faculty, Minnesota Poison Control System, Minneapolis, MN; Medical Director, Mission Detox Center, Plymouth, MN and 1800 Detox, Minneapolis, MN, ASAM Medical Toxicology workgroup Chair.Dr. Laes' practice is focused on inpatient addiction medicine and toxicology consultation and outpatient treatment of opioid and other substance use disorders. She is board certified in Internal Medicine, Addiction Medicine, and Medical Toxicology. She completed internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota.

    Ross Sullivan

    MD, FASAM

    Dr. Sullivan completed his medical school education at SUNY Upstate Medical University. After, he entered and finished a residency in Emergency Medicine at the same hospital.  Dr. Sullivan then completed a medical toxicology fellowship at the SUNY Upstate Poison Control Center and SUNY Upstate Emergency Department. Dr. Sullivan is also board certified in Addiction Medicine. 

    Dr. Sullivan is currently the medical director of medical toxicology and the fellowship director of the medical toxicology fellowship. He also is the director of the Upstate Emergency Medicine Opioid Bridge Clinic, as well as the medical director for Syracuse Behavioral Health.

    Dr. Sullivan has several publications related to overdose and addiction, including “Cardiac conduction disturbance after loperamide abuse”, “Synthetic Cannabinoid Withdrawal”, and  “Baclofen overdose mimicking brain death”.

    Dr. Sullivan currently is a member of the Medical Advisory Panel to OASAS (NYS Office of Alcoholism and Substance Abuse Services), the NYS -DOH buprenorphine work group, and Co-Chair of the Health Care Provider subcommittee of the Onondaga County Task force. 

    Lewis S. Nelson

    MD

    Dr. Nelson is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is board certified in emergency medicine, medical toxicology, and addiction medicine. He is a member of the Board of Directors of the American Board of Emergency Medicine and the Accreditation Council for Continuing Medical Education, and a Past-President of the American College of Medical Toxicology. He is an editor of the textbook Goldfrank’s Toxicologic Emergencies and on the editorial boards of several journals. He provides direct clinical care to patients in the ED and through the New Jersey Poison Information & Education System. His areas of specific expertise include the consequences of opioids, alternative (to opioid) pain management strategies, emerging substances of abuse, and medication safety.  

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Motivational Interviewing: Beyond the Foundation (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about motivational interviewing in clinical practice from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    For those who attended the ASAM motivational interviewing course or those with an existing foundation in motivational interviewing, this session will build upon participants’ existing familiarity with the core concepts and skills of MI through advanced practice of several key areas.  We will practice advanced focusing skills, such as agenda mapping, core skills for evocation including ways to elicit from patients and selectively reinforce change talk during common challenging clinical situations.  For planning, we will practice ways to know how and when to transition to planning, and how to best accomplish this process consistent with the spirit of MI.  The focus of this workshop will be non-didactic, interactive small group practice designed to strengthen participants’ ability to apply the spirit of motivational interviewing in their clinical practices.  The spirit of motivational interviewing " compassion, acceptance, evocation, and partnership" serves as a fundamental framework for communicating with patients and can be essential to avoid fatigue, burn out, and unprofessionalism when working with patients who experience suffering and are ambivalent about change. This workshop will support enhanced clinician competence using motivational interviewing and improved clinical performance working with patients trying to change behaviors. This session addresses addiction medicine patient care competencies by evoking participant’s own behaviors to collect a history, explain an addiction diagnosis consistently with the spirit of MI, and to offer addiction treatment to patients based on a mutually agreed upon plan based in the spirit of MI. Opportunities for participants to enhance these skills within the spirit of motivational interviewing will be provided. The core competency most relevant to this session is interpersonal skills and communication, given that participants will strengthen participant’s ability to communicate with patients based on medical and public health understanding of drug use and addiction, in a manner that is respectful and non-judgmental, their use of motivational strategies to support change, their understanding of their role as a member of a care team and communicate effectively and respectfully with co-care providers, their identification and addressing of the potential barriers to effective communication, and their navigation of cultural barriers. At the conclusion of this workshop, clinicians will have enhanced competence using motivational interviewing and will be able to improve their performance working with patients trying to change problematic behaviors.

    Learning Objectives:


    1.) Apply the spirit of motivational interviewing when working with patients ambivalent about change.
    2.) Use the frame of the four metaprocesses of MI to identify and selectively reinforce change talk elicited during challenging clinical situations. 
    3.) Co-create a practical framework for supporting themselves and their colleagues to maintain balance in coping with distress, suffering and difficulty in clinical practice



    Brian Hurley

    MD, MBA, DFASAM

    Dr. Brian Hurley is an addiction psychiatrist and Medical Director for Co-Occurring Disorder Services for the Los Angeles County Department of Mental Health (LACDMH), supporting the identification and management of co-occurring substance use among patients with mental illness served by LACDMH. He is an assistant professor of Addiction Medicine at UCLA. 

    Brian serves as the Treasurer and is a Distinguished Fellow of the American Society of Addiction Medicine. Brian joined ASAM in 2002 as a first year medical student, and has served on the ASAM Board of Directors in various capacities since 2003. Brian previously served as chair of ASAM’s Membership Committee and Physicians-in-Training Committee and is formerly ASAM’s alternate delegate to the American Medical Association. Brian additionally served on the EVP/CEO search committee in 2010 that led to Penny Mill’s selection as ASAM’s current EVP/CEO. He has additional served in various roles for the Massachusetts Society of Addiction Medicine, New York Society of Addiction Medicine, and California Society of Addiction Medicine.

    Brian completed the Robert Wood Johnson Foundation Clinical Scholars Program at the University of California, Los Angeles (UCLA), and was previously a Veterans Administration National Quality Scholar at the VA Greater Los Angeles Healthcare System. He completed residency training at the Massachusetts General Hospital and McLean Hospital, where he was Chief Resident in Addiction Psychiatry and addiction psychiatry fellowship training at Bellevue Hospital and the New York Veterans Administration. Brian is a graduate of the Keck School of Medicine and Marshall School of Business of the University of Southern California. He was a 2012 American College of Psychiatrists Laughlin fellow, a 2010-2013 American Psychiatric Association (APA) Public Psychiatry Fellow, and a 2015-2017 Group for Advancement of Psychiatry Fellow. Brian has previously served on the Board of Trustees of the APA.

    Carla Marienfeld

    MD

    Carla Marienfeld, MD, is an addiction psychiatrist and an Associate Clinical Professor of Psychiatry at University of California San Diego. Clinically, she focuses on the treatment of patients with substance use disorders and co-morbid psychiatric conditions. She previously worked at a large outpatient addiction treatment program serving over 5000 patients. Her academic interests focus on implementation research and large-data health outcomes for patients with substance use disorders. She attended Baylor College of Medicine in Houston, TX, where she completed the International Health Track, served nationally on the Board of Trustees of the American Medical Student Association (AMSA), and earned Alpha Omega Alpha (AOA) Medical Honors Society and Honors distinction. During psychiatry residency at Yale, she served as chief resident, a National Institute of Drug Abuse R25 Research Fellow, and as the resident representative to the Accreditation Council for Graduate Medical Education (ACGME), while also earning several awards and fellowships. She completed a fellowship in Addiction Psychiatry at Yale. During residency and her early faculty years, she founded and led the Yale Global Mental Health Program. She served as the site training director for the Yale New Haven Hospital Addiction Psychiatry Fellowship and supervised and taught medical students for psychiatry, residents for global mental health, and fellows for addiction psychiatry. She has come to UCSD to help in the development and implementation of a new Addiction Recovery and Treatment Program and a new Addiction Psychiatry Fellowship.

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Perinatal Substance Use: From Research to Practice to Public Health (1.5 CME)

    Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about pregnant and parenting women with substance use disorder from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:


    Early identification and timely treatment of substance use disorder (SUD) in pregnancy is a priority for women, families, clinicians and society. Common goals include prevention of illness progression, education regarding best care practices, and improved access to comprehensive treatment. Provision of compassionate care includes appropriate pharmacotherapy as well as safeguards against discrimination and stigmatization. Validation of this care model and approach through research will help build a stronger evidence base for effective policies and care delivery strategies in the future. As the social and health repercussions of SUD during pregnancy grow heavier, necessary interventions along the continuum of prenatal and postpartum care are gaining in urgency for programming, policy and research focus. The panel will discuss substance use disorder treatment during pregnancy and in the postpartum period. Evidence-based management approaches for opioid use disorder, benzodiazepine use disorder, contraceptive practices, and overdose prevention will be provided. Perinatal, postpartum, neonatal, public health and research perspectives will be condensed, with the aim to translate data into a practical clinical guide. Mishka Terplan will discuss maternal mortality and overdose prevention through a public health lens highlighting fatal and non-fatal postpartum overdose in relationship to pharmacotherapy, and provide suggestions for improving postpartum and lifecourse care. Hendree Jones will present research data on contraception practices and address induction techniques for treating pregnant and parenting women with buprenorphine. Tricia Wright will discuss buprenorphine dosing in pregnancy and beyond, with focus on pharmacokinetics and evidence-based recommendations in the prenatal and postpartum care. Vania Rudolf and Jim Walsh will address challenges and practical considerations for benzodiazepine use disorder and summarize treatment benefits for optimizing maternal and neonatal outcomes.  

    Learning Objectives:

    1.) Upon completion, participants will be able to identify current national data, trends and significant gaps in access to care for pregnant and parenting women with substance use disorder.
    2.) Upon completion, participants will gain knowledge of maternal mortality, postpartum overdose and appreciate ways to improve lifecourse care. They'll identify practical considerations and benefits of contraception practices.
    3.) Upon completion, participants will be able to understand buprenorphine induction and pharmacokinetics. They will be able to summarize recommendations for benzodiazepine use disorder to optimize maternal and neonatal outcomes.


    Vania Rudolf

    MD, MPH, FASAM

    Dr. Rudolf is board certified in addiction medicine and family medicine. She received her medical degree from Sofia Medical University and completed residency in family medicine with high risk obstetrics at Tacoma Family Medicine, UW Family Medicine Residency Network. She pursued further public health education at the University of WA and has completed fellowships in Integrative Medicine at University of AZ, Addiction Medicine at Swedish Medical Center, Seattle and most recently Advanced Obstetrics Fellowship under Maternal Fetal Medicine at Swedish Medical Center, Seattle, WA. Clinically she provides specialty inpatient and outpatient services to pregnant women with substance use disorders. Her ultimate professional goal is to positively impact the lives of patients with addiction, with emphasis on public health clinical outcomes and social justice.Her research efforts are dedicated to promotion of compassionate care, elimination of treatment barriers, diminishing stigmatization, and building innovative frameworks for both healthcare providers and patients.

    Tricia E. Wright

    MD MS FACOG DFASAM

    Tricia Wright, MD MS is an Associate Professor of Obstetrics, Gynecology and Women’s Health and Clinical Associate Professor of Psychiatry at the University of Hawai‘i John A. Burns School of Medicine and founder of the PATH Clinic, an outreach clinic of Waikiki Health, which provides perinatal and medical care to women with a history of substance use disorders.  She is board certified in both Ob/Gyn and Addiction Medicine and a Fellow of the American College of Obstetrics and Gynecology and the American Society of Addiction Medicine. She has published multiple papers on pregnancy and addiction as well as a textbook Opioid Use Disorders in Pregnancy published in 2018 by Cambridge University Press. Dr. Wright completed her undergraduate degree in Biological Sciences from Stanford University, her MD from the University of Michigan. She completed her residency in Obstetrics and Gynecology from the University of New Mexico and obtained a Master’s Degree in Clinical Research from the University of Hawai‘i.

    Mishka Terplan

    MD, MPH, FACOG, FASAM

    Mishka Terplan is a physician boarded in both obstetrics and gynecology and addiction medicine. His clinical, research and advocacy work focuses on the intersection of reproductive health and addictions. He is currently Medical Director of Behavioral Health System Baltimore, the local behavioral health authority, adjunct faculty at University of Maryland Department Epidemiology and Public Health, and staff physician at Planned Parenthood Maryland. He has represented both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Society of Addiction Medicine (ASAM) on federal taskforces and in testimony including before the House Energy and Commerce Subcommittee regarding H.R. 1462, the “Protecting Our Infants Act".

    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • When Your Patient on Opioid Agonist or Antagonist Therapy Gets Sick (1 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning how to manage patients currently on medication assisted treatment from The ASAM 50th Annual Conference (2019).

    (1 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    In 2016, an estimated 20.1 million persons aged 12 or older had a substance use disorder in the past year. Patients with substance use disorders have disproportionately high rates of emergency department visits and hospitalizations due to increasing medical complications from substance use, such as infectious endocarditis, overdose, or withdrawal. However, many acute care providers struggle with the management of patients with substance use disorders due to unfamiliarity with the medical treatments for addiction, regulations regarding use of opioid agonists, or with systems of care for addiction. With limited literature to provide guidance to providers, addiction medicine consultative expertise can provide assistance and education to medical and surgical teams for management of complex issues related to medication assisted treatment.  This cased based workshop will allow providers to better understand how to care for patients who are currently on opioid agonist (methadone, buprenorphine) or naltrexone therapy in the emergency department, hospital or other acute care settings and how management may change depending on the medical complexity or disposition of the patient. Cases will explore clinical questions of how to address methadone therapy when there is QTc prolongation, or continuation of opioid agonist therapy when there has been an interruption of care such as when the patient has been in the correctional system or when agonists are not immediately continued in the acute care setting. When patients on opioid antagonists such as injectable naltrexone miss a regular dose what questions should be answered prior to resuming this therapy and how can therapy be resumed in the acute care setting? The workshop will also touch on management strategies when patients exhibit risk factors that affect the safety of their current medication regimen, as with concurrent sedative hypnotic misuse. Finally, key issues with disposition planning will be discussed. For example, what are the key factors that need to be addressed if a patient is being discharged to a sub-acute rehabilitation facility prior to returning home, or when communication to the prescribing provider is required due to a change in dose or concern regarding their current regimen.  

    Learning Objectives:

    1.) Explore considerations for management of patients currently on medication assisted treatment (buprenorphine, methadone, naltrexone) when they interact with the healthcare system and affect on management  in the acute care setting
    2.) Describe the regulations that may affect buprenorphine or methadone continuation in the acute care setting and list the exceptions to waivered use of buprenorphine and non-opioid treatment program dispensed methadone
    3.) Learn methods to ensure continuity of care with patients’ substance use disorder treatment providers. 


    JoAn Leas

    MD

    JoAn Laes, MD is an addiction medicine physician at Hennepin Healthcare in Minneapolis, Minnesota, focusing on inpatient addiction medicine and toxicology consultation as well as outpatient treatment of opioid and other substance use disorders. She is a core medical toxicology faculty for the Minnesota Poison Center, Minneapolis, Minnesota, medical director for Missions Inc. Detox facility in Plymouth, Minnesota and 1800 Chicago detox facility in Minneapolis, MN and a nocturnist at Mercy Hospital in Coon Rapids, Minnesota. She is the chair of the medical toxicology workgroup for the American Society of Addiction Medicine and the president elect for the Minnesota chapter of ASAM. She completed internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota and is board certified in Internal Medicine, Medical Toxicology, and Addiction Medicine.

    Timothy Wiegand

    , MD, FACMT, FAACT, DFASAM

    Timothy Wiegand, MD, FACMT, FAACT, DFASAM is the Director of Toxicology for the University of Rochester Medical Center and an Associate Professor of Emergency Medicine with secondary appointment in Public Health Sciences.  He holds Board Certification in Medical Toxicology and Addiction Medicine and has an active clinical practice through the Department of Emergency Medicine running the Toxicology Consult Service, which serves as the foundation for the toxicology/addiction rotation at URMC.  Dr Wiegand is also the Associate Fellowship Director for the URMC Combined Addiction Medicine Fellowship and he serves as Medical Director for Huther Doyle a Rochester, NY area outpatient addiction treatment program.  Dr. Wiegand is active professionally with a variety of professional organizations and he serves on the Board of Directors for the American College of Medical Toxicology, was recently elected to the American Society of Addiction Medicine Board of Directors as an At-Large Director (starts April, 2019) and is President Elect of the New York Society of Addiction Medicine.  Dr. Wiegand also serves on the Board of the Medical Toxicology Foundation which has as a priority to support research, innovation and education related to the interface of toxicology and addiction in particular related to the opioid and overdose epidemic.  Dr. Wiegand lectures on a variety of toxicology and addiction subjects at the national and international level and common subjects include the treatment of drug and alcohol withdrawal in paticular the use of buprenorphine to stabilize opioid withdrawal in the Emergency Department and hospital settings.  A significant component of his clinical, research and educational time and effort involves buprenorphine use including perioperative use and in acute pain management for patients maintained on buprenorphine for opioid dependence.

    Catherine Earl-Torniainen

    PA-C

    Catherine Earl-Torniainen is a Physician Assistant - Certified, specializing in Addiciton Medicine at Hennepin Healthcare in Minneapolis, MN.  Catherine has been a team member of the Addiction Medicine Inpatient Consult service for 3 years. Catherine also offers follow up services through Hennepin Healthcare outpatient Addiction Medicine clinic with Suboxone and/or Vivitrol maintenance.   Catherine graduated from the University of Wisconsin - Madison Physician Assistant program in 2000, and spent 6 years working in Family Medicine, then 10 years in Internal Medicine, before specializing in Addiction Medicine.

    Jade Malcho

    MD

    Jade Malcho, MD. Addiction Medicine Fellow and Clinical Instructor of Emergency Medicine at University of Rochester Medical Center, Rochester NY. My focuses have been on developing emergency room induction protocols and establishing links to community treatment programs from the ED, as well initiating and continuing chemical dependency treatment to hospitalized patients with IVDU related infections.  

    ACCME Accredited with Commendation

    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 XX 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 XX 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 XX AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn XX Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Finding Meaning in Suffering: A Workshop on Managing Patients with Complex Problems (1.5 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning about practical framework on how to support patients to find meaning in their suffering from The ASAM 50th Annual Conference (2019).

    (1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    Human suffering takes many forms, and occurs throughout the lifespan. Physical, emotional, spiritual, and existential suffering are an integral part of human existence, and addiction medicine physicians encounter it on a daily basis. When we encounter patients with complex problems who do not appear to respond to our best efforts to provide care, it can generate negative feelings within us. Our responses can range from distancing ourselves from the patient to over involvement with increased feelings of anger and frustration. Most often if because we do not understand and appreciate the dynamics underlying our response. Finding meaning in experience is a fundamental human desire. Recurrent failure to do so can lead to compassion fatigue, burn out, addiction and unprofessionalism in the work place. This facilitated small group session will use the art of story weaving (narrative and improvisation) to safely and gently explore some of the difficult and painful emotions addiction medicine care providers might experience when caring for those who are suffering. The facilitators demonstrate the spirit of motivational interviewing namely compassion, acceptance, partnership and evocation to engage participants in the process of story weaving. We will also evoke the participant’s experience and wisdom to discuss how we can support our patients to find meaning and resolution of suffering in their own distress. The session concludes with the co-creation of ways to be aware of these effects on ourselves and how we can be renewed by finding meaning in our practice.  

    Learning Objectives:

    1.) Reflect on and share the effects of witnessing patient and family suffering on their own levels of compassion and acceptance
    2.) Co-create a practical framework on how to support patients to find meaning in their suffering
    3.) Co-create a practical framework on how to support themselves and their colleagues maintain balance in coping with distress, suffering and difficulty in practice


    Peter Selby

    MBBS, CCFP, FCFP, DFASAM

    Peter Selby MD is the Director of Medical Education and a Clinician Scientist at the Centre for Addiction and Mental Health. He is a Professor in the Departments of Family and Community Medicine, Psychiatry, and the Dalla Lana School of Public Health at the University of Toronto. He is also a Clinician Scientist in the Department of Family and Community Medicine. Dr. Selby is the Executive Director and creator of the TEACH project; a continuing education certificate program in Applied Counselling for Health with a focus on smoking cessation, through the University of Toronto. Dr. Selby’s research, as a Principal Investigator at the Ontario Tobacco Research Unit, includes smoking cessation especially in smokers with co-morbid conditions. As the Principal Investigator of the STOP Study, he investigates the effectiveness of NRT and counselling in different types of intervention settings. He is also the PI of CANADAPTT- a unique Canadian Smoking Cessation Guideline development and dissemination project. Dr. Selby also continues his clinical research with pregnant women who use substances and is the PI of a knowledge translation program (PREGNETS) to increase the adoption of evidence-based interventions with pregnant smokers. 

    He has received grant funding totaling over 80 million dollars from CIHR, NIH, and Ministry of Health and has published 130 peer reviewed publications. He has published 5 books (including 4 edited), is the author of 30 book chapters, and 32 research reports prepared for the government. He is the Co-Chair for the Ministry of Health Cessation Task force and the Chair of the Canadian Centre on Substance Abuse National Task Force on Treatment for Prescription Drug Misuse. Dr. Selby mentors Fellows in Addiction Medicine and Addiction Psychiatry, junior investigators and medical students. Dr. Selby a sought after speaker for various topics including addictive disorders, motivational interviewing, and health behavior change.

    Miriam Komaromy

    , MD, FACP,DFASAM

    Dr. Miriam Komaromy is a physician and professor of medicine at the University of New Mexico in the United States.  She is board certified in Internal Medicine and Addiction Medicine.  She has been an Associate Director in the ECHO Institute, leading ECHO programs that are focused on treatment of substance use disorders for the past 13 years.  She consults with programs around the world on implementation of the ECHO model to expand access to specialized medical care, and particularly focuses on ECHO for addictions, mental health, care of complex populations, and ECHO programs to support community health workers. Dr. Komaromy provides clinical consultation and outpatient care for patients with complex substance use disorders.  She has served as Medical Director for New Mexico’s addiction treatment hospital, and led the development of the state’s guidelines for treatment of opioid use disorder.  Dr. Komaromy is a member of the board of directors of the American Society of Addiction Medicine (ASAM), which is the largest addiction-specialty society in the United States.  She is vice-chair of ASAM’s national medical education committee, and she chairs their Fundamentals of addiction medicine committee.  She was recently elected ASAM educator of the year for 2019.  Dr. Komaromy lectures nationally and internationally on addiction medicine topics, including treatment of opioid use disorder, harm reduction, and how to address the use of amphetamine-type substances.  Dr. Komaromy is currently serving as a Fulbright Scholar in Hanoi, Vietnam, performing research and providing education on treatment of substance use disorders.


    ACCME Accredited with Commendation

    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.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • Collaborative Care for MAT: Evidence-Based Support and New Reimbursement Strategies (1 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning about collaborative care model and reimbursement requirements from The ASAM 50th Annual Conference (2019).

    (1 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    The Collaborative Care Model of integrated primary and behavioral health care adds a behavioral care manager and addiction specialist to the MAT prescribing team to improve outcomes. This already widely implemented team-based approach to care utilizes key crucial elements from over 90 randomized trials of the model including measurement based care and registry guided changes to treatment for patients who are not improving.  The model has been extensively studied across many psychiatric illnesses including depression and anxiety. Collaborative care has been tested in numerous settings including rural sites and across diverse racial and payer groups and has been found to increase access to effective and evidence-based mental health treatment.  Most recently the SUMMIT (Substance Use Motivation and Medication Integrated Treatment) trial demonstrated using this approach improved engagement in treatment and abstinence from alcohol and drugs at 6 months compared to usual care. New Current Procedural Terminology Codes (CPT) have been developed and released to fund the collaborative care model in primary care settings and offers a unique opportunity to offer this treatment.  This reimbursement mechanism for the crucial behavioral care management tasks that are needed is being utilized nationally to treat a variety of conditions.  The codes have been approved for Medicare, some state Medicaid agencies and with some commercial carriers so the timing is right to get MAT services reimbursement for this robust delivery approach. Some modifications in the model around the key tasks and measurement tools will be necessary in the area of MAT to provide the best level of care and need to be explored more fully. Developing consensus and testing these variations has started and key leaders in the field are exploring what is needed. This session brings together key national leaders with decades of experience in research and implementation of the collaborative care model.  Lori Raney, MD is a Master Trainer through the American Psychiatric Associations Support and Alignment grant from CMMI to train 3,500 psychiatrists in the model and has published extensively on this approach.  Mark Duncan MD is a board certified in both Addiction Psychiatry and Family Medicine and is an Assistant Professor of Psychiatry at the University of Washington the C-Director of the Psychiatry and Addiction Case Conference (Project ECHO).  Virna Little LCSW, Director of the Center for Innovation in Mental Health at the CUNY School of Public Health, is one of the pioneers of integrated behavior health and brings a wealth of expertise and experience with New York’s Zero Overdose and collaborative care implementation efforts. These speakers will describe the collaborative care model and reimbursement requirements and then engage with the audience in smaller group discussions to describe training needs, tracking and workflow changes as well as measurement-based approaches to demonstrating outcomes specific to OUD.  

    Learning Objectives:



    1.) List the core elements of effectiveness of the collaborative care model and the roles of the key team members including the consultant addiction specialist
    2.) Adapt the collaborative care model to MAT for opioid use disorder while maintaining fidelity to the model including appropriate registry tracking with treatment to target.
    3.) Show how the psychiatric collaborative care management CPT codes can be utilized for MAT by capturing key qualifying tasks and processes that lead to successful reimbursement.


    ACCME Accredited with Commendation

    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 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 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 AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • How to Critically Appraise Studies to Apply Them in Practice (1 CME)

    Product not yet rated Contains 4 Component(s), Includes Credits

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning how to critically appraise published addiction medicine research using a standard framework from The ASAM 50th Annual Conference (2019).

    (1 CME) In this conference recording from the 2019 Annual Conference, you will learn:

    Journal of Addiction Medicine editors will critically appraise published addiction medicine research and facilitate discussions to impart skills of critical appraisal. Participants will be able to assess the validity and applicability of recent impactful published research to decide when to apply findings to clinical practice. We will critically appraise literature using a standard framework. Critical appraisal involves beginning with a clinical question or scenario, assessing whether reported study methods support validity to address the question (specific to whether the question is about treatment, diagnosis or prognosis), noting the results and their precision, and assessing the applicability of the study results to clinical practice. We will lead critical appraisal discussions about recent published addiction medicine research. Each article type has a series of criteria relevant to its critical appraisal and these are the standards to be used in evaluating the research. Participants will be able to apply these to future published work.

    Learning Objectives:

    1.) Conduct a critical appraisal of an addiction medicine research article
    2.) Decide whether to apply reported research results to clinical practice
    3.)Describe the steps taken to determine study validity and applicability


    Richard Saitz

    MD, MPH, DFASAM, FACP

    Richard Saitz MD, MPH, FACP, DFASAM is a general internist (DABIM) and primary care physician, an addiction medicine specialist (DABAM), Chair and Professor of Community Health Sciences at Boston University (BU) School of Public Health, and Professor of Medicine at BU School of Medicine. He Chaired the Treatment and Services review committee for the National Institute on Alcohol Abuse and Alcoholism, is Associate Editor of JAMA and Senior Editor of Journal of Addiction Medicine, Section Editor and sole author of key chapters in UpToDate on unhealthy substance use, an editor of the ASAM Principles of Addiction Medicine, and author of >200 peer-reviewed publications http://profiles.bu.edu/display/151440 http://www.bu.edu/sph/profile/richard-saitz/ He was Director of Boston Medical Center’s Clinical Addiction Research and Education (CARE) Unit for over a decade, has been Chairman of an Institutional Review Board, Associate Director of Clinical Research for BU, President of the Association for Medical Education and Research in Substance Abuse (AMERSA), steering committee member of the Motivational Interviewing Network of Trainers (MINT), and was coordinating committee member of International Network for Brief Intervention for Alcohol and other drug problems (INEBRIA). He is Vice President of the International Society of Addiction Journal Editors (ISAJE). His primary areas of expertise supported by NIH, RWJF, and SAMHSA, are screening and brief intervention, integrating substance-related and general health care, improving the quality of care for people with unhealthy substance use, particularly in general health settings, and basing care on science. He validated single-item screening questions recommended by NIDA and NIAAA. Awards: Alpha Omega Alpha Honor Society, Boston Jaycees Ten Outstanding Young Leaders Award, Best Doctors in America®, AMERSA’s W. Anderson Spickard, Jr. Excellence in Mentorship Award, the R. Brinkley Smithers Distinguished Scientist Award (ASAM), Research Society on Alcoholism Distinguished Researcher Award.

    Frank Vocci

    PhD

    Frank J Vocci, PhD;  President and Senior Research Scientist, Friends Research Institute, Inc., Baltimore, Maryland   Following a post-doctoral fellowship in addiction pharmacology at the Medical College of Virginia, Dr. Frank Vocci spent 11 years at the FDA where he reviewed applications for marketing of analgesic medications and also participated in domestic and international drug scheduling issues.  In 1989, he joined the Medications Development Program at the National Institute on Drug Abuse and became the Director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse (DPMC) in 1997. During his tenure at NIDA, four addiction drug products that were developed or co-developed by his division were approved by the FDA and another was approved following his retirement from NIH in 2010. Following his retirement from NIDA in December 2008 Dr. Vocci became President of Friends Research Institute in January 2009.  He has published over 100 articles and book chapters and has participated as a grant reviewer for the Department of Defense, the Veterans Administration, the National Institutes of Health,  the Brain Research Foundation, and the Peter Dodge Foundation,   He is a Past-President of the College on Problems of Drug Dependence and a co-editor of the Journal of Addiction Medicine. 

    Martha J. Wunsch

    MD, FAAP, DFASAM

    Martha J Wunsch, MD, FAAP , DFASAM is an addiction specialist with The Permanente Medical Group in Northern California. She is the Program Director for the Kaiser Addiction Medicine Fellowship and Medical Director of the San Leandro Hospital Addiction Medicine Consultation and Liaiason Service. Marty earned a medical degree at Uniformed Services University of the Health Sciences in Bethesda, Maryland, completed a pediatric internship and residency at Children’s Hospital Los Angeles (1983-1986), and practiced general pediatrics in the Indian Health Service in Arizona.

    Dr. Wunsch was the Hoff Addiction Medicine Fellow at Medical College of Virginia/Virginia Commonwealth University (2000-2002). She is a distinguished fellow of the American Society of Addiction Medicine and a founding co-editor of the Journal of Addiction Medicine. Dr. Wunsch is a founding director of the American Board of Addiction and the President Elect of The Addiction Medicine Foundation.

    ACCME Accredited with Commendation

    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 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 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 AMA PRA Category 1 Credit(s)™ for completing this course.

    ABIM Maintenance of Certification (MOC)

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.