Neonatal Abstinence Syndrome (NAS) secondary to in-utero exposure has increased 5-fold in the US. Providing clinical recommendations, developing safe guidelines to improve care for women with opioid use disorders and their neonates is gaining in priority for programming, policy and research. The panel will discuss NAS through the lens of neonatal and long-term development. Public health and research perspectives will be condensed, with the aim to translate data into a practical clinical guide. The panel will explore compassionate ways to normalize postpartum care while supporting the mom/baby/family triad and the community.

This workshop features national thought leaders in hospital-based addiction medicine care who will expertly discuss and describe treatment approaches to challenging addiction medicine cases. The session will describe clinical scenarios that challenge the inpatient medical team and will offer evidence-based approaches, including ways to integrate a diverse addiction medicine workforce into routine hospital-based care. Cases include management of post-operative pain in the setting of OUD, use of illicit substances by hospitalized patients, initiation of medication for opioid use disorder in patients prescribed full opioid agonists, and management of patients requiring prolonged intravenous antibiotics for complications of injection drug use including management of care transitions.

The workshop engages participants using principles of motivational interviewing in the teaching methodology to build participants’ motivation to use and familiarity with the technique of motivational interviewing in clinical practice.

Methamphetamine (MA) use continues to be a significant public health problem in some parts of the US. Overdose deaths associated with MA in the United States have escalated rapidly since 2015, including MA-related deaths involving fentanyl. During this session, research on MA will be discussed including common clinical challenges in treating individuals with MA use disorders which includes powerful craving, hypersexuality, anhedonia, cognitive deficits, and poor retention in treatment. Additionally, medication for MA use disorder treatment will be presented such as: topirimate, mirtazapine, bupropion, naltrexone, amphemtamine/methylphenidate. Behavioral interventions, which are the mainstay of MA use disorder treatment, will be reviewed. Examples of these interventions that will be discussed are contingency management, the community reinforcement approach, Matrix Model and exercise.

People who use substances are at higher risk for treatable and preventable infectious diseases, but current models of care are insufficient for the rising epidemics. This presentation by Infectious Disease Addiction Medicine physicians from different states, will 1) review the epidemiology of IDU-associated infections in the United States 2) discuss best practice screening and prevention recommendations for addiction medicine providers, including pre-exposure prophylaxis for HIV and harm reduction principals 3) showcase novel models of care that engage vulnerable individuals, and 4) review recent practice-changing international studies that highlight ID "hot topics," such as oral versus intravenous antibiotics, and use of multidisciplinary inpatient teams for serious bacterial infections in people who inject drugs.

This session will present highlights of the process and provoke discussion about how guidelines assist clinicians in the treatment of patients with OUD. Presenters will highlight the changes in the National Practice Guideline (NPG). A greater understanding of the process to develop guidelines will stimulate a group discussion regarding the process of guideline development, the focused update, and how the results of the focused update will better inform the treatment of Opioid Use Disorder. Active implementation and sustainable evaluation of the process is key to shaping the quality of addiction now and in the future.

This busy, rapid-fire session consists of brief journal club presentations of 30-40 of the highest impact peer-reviewed manuscripts and notable publications of 2019-2020 in the field of Addiction Medicine, spending 1-2 slides on each article. Relevant to the busy clinician and adaptable as teaching material, this session’s outline follows the ASAM Principles of Addiction Medicine chapter index. Presenters critically review recent newsmaker articles spanning neurobiology, pharmacology, intoxication and withdrawal, screening and diagnosis, treatment, mutual help, and special topics and populations. Newsmaker trends and the 'most covered' manuscripts in terms of mainstream and social media hits are the focus.

Alcohol-related liver disease (ALD) is now the leading indication for liver transplant, and successful disease management requires long-term alcohol abstinence. Alcohol use disorder (AUD) treatment is fundamental to managing ALD. These two co-occurring disorders are best managed by highly-cohesive multidisciplinary teams, yet such integrated ALD/AUD clinics are exceedingly rare. This 90-minute session will include didactic instruction and small group discussions led by an experienced multidisciplinary team to: a) depict the scope of the AUD/ALD problem and need for multidisciplinary care, b) review integrated alcohol-related care models, c) share strategies for developing multidisciplinary ALD clinics and, d) collaborate with the audience to consider how multi-disciplinary models can be applied at their home institutions.

Education of community partners and ongoing dissemination of knowledge is an integral component of academia. Project ECHO is a novel learning and guided practice model that revolutionizes medical education and its ongoing delivery. TeleECHO™ links primary care clinicians and other providers, through a knowledge network, with an interprofessional team of specialists from an academic medical center; where expert mentors can educate and guide each other via case-based learning coupled with brief didactics. A mock ECHO session offers clinicians the freedom to learn in a non-critical environment, emphasizing real-time multidirectional feedback and encouraging knowledge and skill transfer. This session will equip participants with the ability to initiate a Project ECHO at their home institution.

Physicians deal with ethical issues impacting patient safety and confidentiality on a regular basis, and these can be challenging when patients have problems related to substance use. Ethical issues arise when there are conflicts between principles of patient autonomy, physician beneficence, and justice that may relate to both public safety and individual health. Legal concerns often relate to privacy and confidentiality and vary from state to state. This session will provide an overview of ethical principles and how to apply them to complex clinical situations. Through case based discussion, attendees will work through challenging ethical dilemmas they may encounter in their practice related to substance use or its consequences.

This session is for anyone who wishes to publish in the area of addiction science, particularly fellows, junior faculty and those who do not regularly publish. Presenters will share how to choose a journal, how to prepare papers for submission, how to report research, how to respond to reviewers and editors, and publication-related ethical issues. Presenters will address primary research articles as well as review articles, case reports and others. The link to the book Publishing Addiction Science (free) will be made available. The Editors and Editorial Fellows will lead discussion with participants regarding questions and challenges they have faced. Participants are encouraged to bring brief examples of their writing or peer reviews.

In the setting of the opioid epidemic, there has been a call for enhanced and expanded medical education in substance use disorders. As the number of addiction medicine physicians completing training grows, so too do the multiple career pathways within the field. From inpatient and outpatient settings to private, public, and academic domains, a newly trained fellow or medical trainee can explore a diverse number of career options. Many fellows are engaged primarily in academic environments and are not exposed to the variety of career trajectories in the field. This session seeks to assist those who are early in their career who are either interested in or committed to addiction medicine.

Alcohol-related liver disease (ALD) is now the leading indication for liver transplant, and successful disease management requires long-term alcohol abstinence. Alcohol use disorder (AUD) treatment is fundamental to managing ALD. These two co-occurring disorders are best managed by highly-cohesive multidisciplinary teams, yet such integrated ALD/AUD clinics are exceedingly rare. This 90-minute session will include didactic instruction and small group discussions led by an experienced multidisciplinary team to: a) depict the scope of the AUD/ALD problem and need for multidisciplinary care, b) review integrated alcohol-related care models, c) share strategies for developing multidisciplinary ALD clinics and, d) collaborate with the audience to consider how multi-disciplinary models can be applied at their home institutions.

The prevalence of substance use disorder (SUD) among individuals involved in the criminal justice (CJ) system is well documented. There are numerous calls for public health interventions addressing SUD within CJ systems. This session will provide on-the-ground examples of effective health care- criminal justice partnerships at multiple sequential intercepts. Panelists will discuss cognitive behavioral therapy-based and motivational interviewing-based programming in New South Wales prison system and initiatives in Cook County to link individuals to medications for addiction treatment and recovery support in pre-trial services, jail, and adult probation. Through panel discussion and small group exercises, attendees will explore key drivers of successful collaboration as well as challenges and how to address them.

In the midst of the nation’s prescription drug and opioid crisis, the number of pregnant women entering treatment for prescription opioid misuse has increased from 2% in 1992 to 28% in 2012. Recent child welfare legislation included requirements for medical staff to notify child protective services when an infant is identified as “affected by substance abuse, displays withdrawal symptoms or has Fetal Alcohol Spectrum Disorders.” This presentation 1) provides current federal regulations regarding mandatory reporting and plans of safe care; 2) explores the intersections between addiction and child welfare; and 3) offers practice-informed approaches to help addiction medicine professionals develop family-centered plans of safe care that are responsive to the needs of mothers and their infants.