ASAM 50th Annual Conference - Innovations in Addiction Medicine and Science - 2019 (85 CME)

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Overview

The ASAM Annual Conference is the nation’s premiere event showcasing best practices and the latest science, research, and innovations in addiction medicine. View over 60 high-quality educational sessions on a variety of topics to address your educational needs!

Learning Objectives

At the conclusion of this activity, 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.
  • Evaluation and Certificate - ASAM 50th Annual Conference

    Contains 2 Component(s), Includes Credits

    CME Evaluation for the ASAM 50th Annual Conference - Innovations in Addiction Medicine and Science

    Complete the course evaluation first and then claim credits. Attendees should claim only the credit commensurate with the extent of their participation in the activity.

    ASAM has been awarded the highest level of Accreditation with Commendation by the Accreditation Council for Continuing Medical Education (ACCME) as a provider of continuing medical education (CME) for physicians. Accreditation in the ACCME System seeks to assure the medical community and the public that ASAM delivers education that is relevant to clinicans' needs, evidence-based, evaluated for its effectiveness, and independent of commercial influence.



    The ASAM 50th Annual Conference - Innovations in Addiction Medicine and Science
    This activity has been approved for 22.25 AMA PRA Category 1 Credit(s)TMPhysicians should claim only the credit commensurate with the extent of their participation in the activity.

    The ASAM FundamentalsTM of Addiction Medicine: A Live Workshop
    The American Society of Addiction Medicine designates this live activity for a maximum of AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The ASAM Pain and Addiction: Common Threads Course XX
    The American Society of Addiction Medicine designates this live activity for a maximum of AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The ASAM Motivational Interviewing Workshop
    The American Society of Addiction Medicine designates this live activity for a maximum of AMA PRA Category 1 Credit(s)TM. 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 LLSA credits towards ABPM MOC Part II requirements.

    ABAM Transitional Maintenance of Certification (Tmoc)
    The ASAM 50th Annual Conference and its three pre-courses have been approved by the American Board of Addiction Medicine (ABAM) for Tmoc as credits towards ABAM LLSA Part II requirements.

    American Association of Nurse Practitioners (AANP)
    This education activity will be submitted to the American Association of Nurse Practitioners for approval of up to 20 contact hours of accredited education.

    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, Program Planning Committee, and Faculty Disclosure Information
    In accordance with disclosure policies of ASAM and the ACCME, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all CME activities. These policies include resolving all possible conflicts of interest for the CME Committee, MEC, Planning Committees, and Faculty. All activity Planning Committee members and Faculty have disclosed relevant financial relationship information. The ASAM CME Committee has reviewed these disclosures and determined that the 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
    • Students and Retirees
    • Counselors and Policymakers
  • The Addiction Dungeon: Journey of Addicted Women Through Maslow’s Hierarchy of Needs (1 CME)

    Contains 4 Component(s), Includes Credits

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning about Maslow's hierarchy of needs and how it can be implemented with recovery from The ASAM 50th Annual Conference (2019).

    Addictive disorders carry the risk of severe functional decline, while abstinence is usually accompanied by improvement in functional status, and a more consistent ability to get needs met; however, substance users struggle with conceptualizing their journey and future planning. Some evidence suggests Maslow’s Hierarchy can be helpful for psychological health and belief in internal control. There is little research on its direct application to substance use and recovery. In this workshop, we present a narrative, case-linked journey of women with addiction: along the way, we will discuss conceptualization of sobriety and/or abstinence and relapses in terms of Maslow’s hierarchy of needs. We will review the steps and goals of each stage of the hierarchy, which are physiological, safety, belonging/love, self-esteem, and self-actualization. We then introduce a concept coined by our patients in recovery: the addiction dungeon, which our users defined as the level below Maslow’s basic starting point. We will discuss the element of confinement and lack of choice or free will in situations such as imprisonment, involuntary commitment and other confined situations. Lack of free will eliminates the element of internal control, which we seek to help our patients attain. By removing internal control in confinement, those in recovery become blocked from self-actualization. In this workshop (sections below), we will introduce a modified Maslow’s Hierarchy, including the addiction dungeon, as a therapeutic tool to help patients set goals in recovery, and to better address the challenges associated with each level. 1. Maslow’s hierarchy: how does the path to self-actualization apply to women with addiction? 2. Narrative focus group results: presented by two student winners of the prestigious Albert Schweitzer fellowship, describing how women in rehab perceive their experiences with confinement. 3. Clinical applications of modified Maslow’s hierarchy: link to commonly used therapeutic modalities such as cognitive behavioral therapy and motivational interviewing.

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


    Learning Objectives:

    1.) Understand basic requirements of passing through the stages of Maslow’s Hierarchy
    2.) Have a general understanding of how Maslow’s Hierarchy can be applied to addiction
    3.) Learn about the impact of lack of free will leading to a new stage prior to Stage 1 of the hierarchy


    Nancy C. Shenoi

    Medical Student

    Nancy Shenoi is a fourth-year medical student at Baylor College of Medicine pursuing a career in psychiatry. She is interested in academic medicine, addiction psychiatry, and women’s mental health. With support from the Albert Schweitzer Fellowship, Nancy and her medical student colleague Maria Espinosa led health literacy and mental health workshops for women with substance use disorders at a state-funded residential rehab facility in Houston, Texas.

    Kimberly Parks

    MD

    Kimberly Parks, MD is an Assistant Professor of Psychiatry at Baylor College of Medicine where she is both a general and addiction psychiatrist. She recently graduated from the Baylor College of Medicine Addiction Psychiatry Fellowship and previously completed her general psychiatry residency at University of Southern California/Los Angeles County + USC Medical Center. Currently, she works at Ben Taub General Hospital in both the Substance Abuse Treatment Clinic and the Psychiatric Emergency Department. She is also a new addition to the Baylor Psychiatry Clinic where she is offering substance use treatment. She is passionate about the treatment of substance use disorders, resident education and women’s mental health.

    Nidal Moukaddam

    MD

    Nidal Moukaddam, MD PhD, Associate Professor at Baylor College of Medicine, is involved in clinical addiction medicine, education and research. Dr. Moukaddam’s interests include three distinct areas i)Scalable Health: the application of technology to mental health ii) Sociability and social ambiance automated measurements and iii) Instant countertransference (iCT) . The bulk of her work as a clinician revolves around difficult patients, those who have trouble getting care in traditional settings. Dr. Moukaddam's research interest focus on how psychiatry can benefit from technological advances for detection, tracking, diagnosis and treatment of mental illness & addiction. Prior efforts have led to the co-creation of a fee-free, dynamic platform for academic collaboration, Healthsense, that is available for researchers wishing to engage in sensor-based measurements in their studies. i) Scalable health: the application of technology to mental health. This is an area of collaboration with Rice University, Electrical and Computer Engineering department, which has produced innovative, cutting edge research into the applicability of measuring mental states objectively using smartphone applications. ii) Sociability and social ambiance automated measurements: the quantity and quality of connection between individuals determines the feelings of well-being and loneliness. Our aim as a research team has been to find ways to accurately and objectively measure an individual’s interactions, and quantify their ambiance in ways that can be used for psychiatric treatment. iii) Instant countertransference (iCT): this is a concept developed to bridge the gap between the notion of bias in healthcare, and the traditional psychiatric concept of countertransference. Looking for a flexible, nuanced explanation for how subjective clinician feelings can impact medical decisions. It is the answer of many years of experience in multidisciplinary work with emergency 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 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.

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

    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.

  • Assessing Burnout and Alcohol Use in Medical Students and Practicing Physicians (1 CME)

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

    Earn 1 AMA PRA Category 1 Credit(s)™ while learning useful interventions for burning out among medical students and practicing physicians from The ASAM 50th Annual Conference (2019).

    (1 CME) In this conference recording from the 2019 Annual Conference, you will learn: Medical student and practicing physician burnout is often seen in combination with an alcohol use disorder. The problem is significant for both the individuals and for patients under their care. US physicians report higher than normal burnout rates and burnout correlates with alcohol use problems. Specifically, AUDIT-C scores in 15.3% of physicians were consistent with DSM-IV diagnoses of alcohol abuse or dependence, especially for women (21.4% vs. 12.9%). Burnout also correlates with higher BMI, poor sleep, less exercise, and low career satisfaction. The problem likely starts in medical school. Medical students show very high rates of burnout (up to 50%) and suicidal ideation (estimated at 10%). In an older study of medical students, 32.4% met the DSM-IV diagnostic criteria for the diagnoses of alcohol abuse/dependence. Alcohol use continues to be problematic during residency as stressors shift more toward an expanding list of ethical, emotional, cognitive and physical challenges related to clinical care. Medical student, resident, and practicing physician burnout coincident with alcohol use impact both personal functioning and patient care. Burnout and alcohol use must be recognized in early medical training before dangerous coping patterns are established and to guide the development of strategies that build resilience to the stresses of clinical practice. Students and practicing physicians are often reluctant to seek help and express concerns; the healthcare professional must be skilled at recognizing a struggling student or colleague and in assessing current coping mechanisms including alcohol use. Until remedies are put in place to decrease stressors or build resilience, medicine needs vigilant colleagues with the skills to recognize burnout and coincident alcohol use in medical students, residents and practicing physicians. The presentation combines multiple teaching methods to establish skills that aid the addiction specialist in identifying and intervening in colleagues with the lethal combination of burnout and alcohol use. Through case studies, audience involvement, and "what if" role-play simulations, participants build an understanding of the causes of burnout, useful interventions, and the potential impact on provider and patient if burnout is not addressed.  

    1.) Identify common symptoms seen in medical students, residents, and practicing physician who are experiencing burnout and utilize a scale to scientifically assess the provider's risk of burnout.
    2.) Develop skills linking burnout assessment and alcohol use assessment to ensure a complete assessment of the medical student, resident, or practicing physician's impairment.
    3.) Offer referral and intervention recommendations to impaired physicians and medical students to address issues related to being burned out and demonstrating risky alcohol use.


    Dr. Bradley Tanner, MD, ME, MBA

    President, Clinical Tools Inc/Health Impact.Studio

    Bradley Tanner, MD, ME, MBA is Board Certified in Psychiatry and Obesity Medicine.  His expertise as a psychiatrist and neuroscientist directs solutions that apply neuroscience principles and psychological theory to influence decision making, lifestyle change, and self-assessment. Topics of emphasis include reward systems as they impact opioid addiction, physician and medical student burnout, CNS and biome systems that affect nutritional food selection/obesity, risk-taking and alcohol use, and pain control. 

    Following his psychiatric training and subsequent Attending Physician role at the University of Pittsburgh, Dr. Tanner left full-time academia in 1995 to pursue small business solutions and harness the potential of a commercial enterprise to access capital, build close customer relationships, and specifically target customers needs to enhance overall impact. His organization has received over 23M in federal awards in the past 22 years. Dr. Tanner now leverages his unique business, technological, and clinical background to develop and evaluate novel gaming solutions that engage and inspire an audience and simultaneously impact health or skills. Dr. Tanner remains involved in residency training and clinical care as a Clinical Associate Professor Psychiatry at the University of North Carolina, Chapel Hill.

    Dr. Tanner received his MD from the University of Virginia and Bachelors from Dartmouth College from his attendance at Dartmouth and Williams College. His home is in Chapel Hill, NC, but in the winter he can often be found in the mountains of Utah. He can be reached best via email: bradtanner@gmail.com.

    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.

  • 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.


    Dr. Vania Rudolf, MD, MPH, FASAM

    Medical Director, Addiction Recovery Services, Swedish Medical Center

    Dr. Rudolf is a family and addiction medicine physician who is providing care to pregnant and parenting women with substance use disorder. She has a background in family medicine with OB and has completed Fellowships in Integrative Medicine, Addiction Medicine and High Risk Obstetrics at Swedish Medical Center. She has earned public health training at the UW. Dr. Rudolf continues to be a compassionate advocate for improving kind non-judgmental services and removing barriers to care. Providing compassionate trauma-responsive care to vulnerable women, babies and families is the primary focus of her practice in addition to clinical research related to clinical outcomes for substance use disorder, transition to MAT and prescribing policies to optimize safe and adequate postpartum analgesia management. She is the Medical Director for Addiction Recovery Services at Swedish Medical Center, an assistant professor at University of Washington, Seattle, WA and the Chair for the National Womens' Addiction Group related to the American Society of Addiction Medicine. She serves on the maternal mortality review board for the state of Washington and has many years as a practicing clinician.

    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.

    Dr. Mishka Terplan, MD, MPH, FACOG, FASAM

    Senior Physician Research Scientist, Friends Research Institute

    Mishka Terplan is board certified in both obstetrics and gynecology and in addiction medicine. His primary clinical, research and advocacy interests lie along the intersections of reproductive and behavioral health. He is Senior Physician Research Scientist at Friends Research Institute and adjunct faculty at the University of California, San Francisco where he is a Substance Use Warmline clinician for the Clinical Consultation Center. He is also the Addiction Medicine Consultant for Virginia Medicaid and a consultant for the National Center on Substance Abuse and Child Welfare. Dr. Terplan has active grant funding and has published over 100 peer-reviewed articles with emphasis on health disparities, stigma, and access to treatment. He has spoken at local high schools and before the United States Congress and has participated in expert panels at CDC, SAMHSA, ONDCP, OWH, FDA and NIH primarily on issues related to gender and addiction.

    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



    Dr. Brian Hurley, MD, MBA, DFASAM

    Director of Addiction Medicine, Los Angeles County Department of Health Services

    Brian Hurley, MD, MBA, DFASAM is an addiction physician and the Director of Addiction Medicine for the Los Angeles County Department of Health Services. As Director-at-Large, Brian currently serves as a board member of ASAM and gives presentations around the world regarding addiction medicine. He co-chairs the Los Angeles County Department of Health Services’ Substance Use Disorders Workgroup and the SafeMedLA Medications for Addiction Treatment Action Team, and is the Clinical Director of the Treatment Starts Here program through the Center for Clinical Innovation, focused on increasing the delivery of medications for addiction treatment in California’s community health centers. He is a senior researcher at the Friends Research Institute and is a primary investigator on a Tobacco Related Disease Prevention Program-funded project integrating smoking cessation services into community mental health centers and patient-centered medical homes and is the grant lead for three Medications for Addiction Treatment Access Points projects funded by the Sierra Health Foundation supporting access to medications for addiction treatment across Los Angeles County. He is also a co-investigator for several Rand Corporation projects evaluating the integration of substance use disorder treatment within community mental health and Federally Qualified Health Center settings. He also serves on the American Board of Psychiatry and Neurology’s Addiction Psychiatry Examination Writing Committee. Brian completed the Robert Wood Johnson Foundation Clinical Scholars Program at the University of California, Los Angeles (UCLA) and is an alumnus of the Massachusetts General Hospital and McLean Hospital Psychiatry Residency Training Program and the New York University Addiction Psychiatry Fellowship. Additionally, he has served in various roles for the Massachusetts Society of Addiction Medicine, New York Society of Addiction Medicine, and California Society of Addiction Medicine.

    Carla Marienfeld

    MD

    Carla Marienfeld, MD
    Affiliation: Associate Professor of Psychiatry
    University of California, San Diego

    Carla Marienfeld, MD, is a board-certified addiction psychiatrist and Associate Professor at the University of California, San Diego who supports recovery through therapy, motivational interviewing, and medication treatment. Her research looks at health outcomes for individuals with substance use disorders, and she published a book Motivational Interviewing for Clinical Practice. She has been highly involved in education of colleagues and trainees about addiction psychiatry and effective interventions including buprenorphine treatment and motivational interviewing, and she is the fellowship director for the UCSD Addiction Psychiatry Fellowship. Dr. Marienfeld completed a fellowship in addiction psychiatry and residency training in psychiatry at Yale. During her residency, she was chief resident of psychiatry and founded (and later led) the Yale Global Mental Health Program as junior faculty at Yale. She earned a medical degree with honors from Baylor College of Medicine in Houston.

    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)

    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. 

    Dr. JoAn Laes, MD

    Attending Physician, Division of Addiction Medicine, Hennepin County Medical Center

    Dr. Laes is an addiction medicine physician at Hennepin Healthcare, Minneapolis, MN and core medical toxicology faculty for the Minnesota Poison Center, Minneapolis, MN. Her focus is inpatient addiction medicine and toxicology consultation and outpatient treatment of opioid and other substance use disorders. She provides medical directorship for detoxification facilities, and expert opinion in the fields of addiction medicine and medical toxicology. 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. She has spoken nationally on the subjects of addiction medicine and toxicology.

    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

    Lewis S. Nelson MD
    Affiliation: Chair, Department of Emergency Medicine
    Rutgers New Jersey Medical School

    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 a member of the Board of Directors of the American Board of Emergency Medicine and a Past-President of the American College of Medical Toxicology. He remains actively involved with CDC, FDA, DHS, and with several professional medical organizations including ASAM. Dr. Nelson is an editor of the textbook Goldfrank’s Toxicologic Emergencies and on the editorial boards of several journals. In addition to providing direct clinical care to patient in the ED and his efforts at New Jersey Poison Information & Education System, his specific expertise include the consequences of licit and illicit opioids, emerging drugs of abuse, opioid stewardship, and alcohol withdrawal.

    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.

    Dr. Hannah Snyder, MD

    Assistant Clinical Professor, University of California San Francisco

    Dr. Hannah Snyder practices primary care and addiction medicine at Zuckerberg San Francisco General Hospital (ZSFG) and is a Clinical Assistant Professor in the Department of Family and Community Medicine at the University of California San Francisco. She is a co-principal investigator of the statewide California Bridge Project and the Director of Inpatient Services for that program. Through this program, she supports acute care hospitals in offering low barrier buprenorphine starts and linkage to ongoing treatment.

    She completed Medical School at the University of Chicago, residency in Family and Community Medicine at the University of California San Francisco (UCSF), and a fellowship in Primary Care Addiction Medicine at UCSF. Her clinical work includes addiction consultation in clinic and in the hospital, primary care, and hospital medicine.  At ZSFG, Dr. Snyder is the Associate Direct of the inpatient Addiction Care Team and the Director of the Bridge Clinic, a low-barrier addiction treatment program focused on patients transitioning from acute care to the community. 

    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.

  • 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.

  • Harm Reduction in the Addiction Continuum: Not as Radical As One Thinks (1.5 CME)

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

    Earn 1.5 AMA PRA Category 1 Credit(s)™ while learning how harm reduction can be used in clinical practice 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:

    Learning Objectives:


    1.) Review the definition and background of harm reduction and demonstrate that it is congruent with the management of patients with other chronic relapsing illnesses.

    2.) Describe case examples of patients who benefit from low threshold or harm reduction care to keep them engaged, and to lower the risks associated with ongoing substance use.

    3.) Identify opportunities for integrating harm reduction into your own practice.

    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 prescription drug monitoring programs, 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 patients in this manner, we help keep them 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. The session organizers will review harm reduction as patient centered care congruent with the practice of all medical specialties.    They will describe specific case examples of how harm reduction can be used in clinical practice, review flexible care models to engage patients with ambivalence or other competing life priorities, and explore ways to gain buy-in from colleagues in order to shift culture and increase comfort in providing harm reduction care within their continuum. The second half of the session will be spent in small groups where participants will review potential barriers to incorporating harm reduction into practice and explore how they would envision operationalizing and providing such care within their current practice.  

    Dr. Laura G. Kehoe, MD, MPH, FASAM

    Medical Director, MGH SUD Bridge Cliic, Assistant Professor in Medicine, Massachusetts General Hospital/Harvard Medical School

    Dr. Kehoe is the medical director of the Massachusetts General Hospital Substance Use Disorder Bridge Clinic, an immediate access, low barrier transitional clinic, which is a component of MGH’s Substance Use Disorder Initiative.   She is an Assistant Professor of Medicine at Harvard Medical School and she received her A.B. from Washington University in St. Louis, her MD from Tufts University School of Medicine, and her MPH from Boston University School of Public Health. She completed her residency in internal medicine at Massachusetts General Hospital, and is board certified in both internal medicine and addiction medicine. She has cared for patients in primary care, inpatient, residential and outpatient addiction treatment settings, and as a medical director at a Boston area methadone maintenance treatment program.  

    Dr. Kehoe was the co-chair of the hospital-wide Substance Use Disorder Education Committee, leads buprenorphine trainings for the MGH ED "Get Waivered" program, and supervises MGH addiction medicine fellowship trainees.  

    She teaches locally, regionally and nationally, is a PCSS mentor, member of ASAM's Prisoner Health Interest Group and the Annual Conference Planning Committee, and Secretary of Massachusetts ASAM chapter. 

    In addition to providing clinical care and teaching, Dr. Kehoe co-founded  W.A.T.E.R.town (Watertown Access to Treatment Education and Recovery), a community coalition working to expand prevention, intervention and treatment for people with substance use disorder in Watertown, MA, for which she received the Harvard Medical School Dean’s Community Service Faculty Award.

    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.

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 85 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 85 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 85 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 85 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.

Who Should Attend

Healthcare professionals dedicated to increasing access and improving the quality of addiction treatment and care, including:

  • Physicians and Clinicians
  • Researchers and Academics
  • Students and Retirees
  • Counselors and Policymakers