Harm Reduction in the Addiction Continuum: Not as Radical As One Thinks (1.5 CME)
(1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:
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.|
Laura G. Kehoe
MD, MPH, FASAM
Dr. Kehoe is an Assistant Physician at Massachusetts General Hospital and an Assistant Professor of Medicine at Harvard Medical School and is board certified in both Internal Medicine and Addiction Medicine. She attended Tufts University School of Medicine and Boston University School of Public Health and completed her residency in Internal Medicine at Massachusetts General Hospital. At Massachusetts General Hospital, she is the Medical Director of the Substance Use Disorder Bridge Clinic, an immediate access, urgent care addiction program. She is actively involved in medical student and resident education as an attending physician on the inpatient Addiction Consult Team (ACT), and she is the co-chair of the hospital-wide Substance Use Disorder Education Committee, where she works with other team members to expand evidence-based treatment of patients with addiction.
Outside of MGH, she was the Medical Director of Baycove Treatment Center for Opiate Addictions Methadone Maintenance program and she treats patients as part of a multidisciplinary addiction team at the supportive housing and outpatient non-profit, Right Turn. Lastly, Dr. Kehoe is a founding member of 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.
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.