Integrating Addiction Treatment into General Medical Health Systems (1.5 CME)
(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn that general medical settings are opportune for the identification and initiation of addiction treatment. There is strong evidence for delivering primary care-based alcohol and tobacco screening, brief interventions, and referrals to higher levels of specialty addiction treatment, providing integrated psychiatric, addiction, and general medical treatment, and additional evidence that addiction pharmacotherapies and outpatient psychotherapies can be feasibly delivered in a variety of general medical settings. Collaborative care models have been long-demonstrated to improve depression treatment outcomes in primary care, and there is emerging evidence that these models have applicability to opioid and alcohol use disorders. Population-based chronic disease management is characterized by longitudinal care delivery, integrated and coordinated primary and specialty care, explicitly supported and seamless transitions between care intensities and settings, evidence-based care plans, and the availability of subspecialty expert care. The implementation of an integrated system of care may overcome the barriers to the effective application of chronic disease management for addictive disorders. The existing healthcare system has significant fragmentation, overall access problems, and specific inaccessibility to highly effective addiction treatments. Building an integrated system of care within existing healthcare enterprises requires addressing these factors. Within this context, addiction medicine clinicians often encounter barriers and facilitators associated to the delivery of addiction treatment in general medical settings, particularly with patients with co-occurring addiction and other psychiatric conditions.
This session will briefly review the evidence of collaborative care and other integrated care models for addiction medicine clinicians in the general medical setting-based treatment of addiction. The panelists will review the real-world barriers and facilitators to the identification of addiction and initiation of addiction treatment in these settings. The majority of the session will engage workshop participants in a facilitated discussion, where participants will be asked to reflect upon their institutional climates and identify key opportunities for collaborative care in their institutional settings. Participants will be split into small groups where they will be asked to develop and discuss a personal strategy for enriching their own institutional practices and promote the integration of addiction treatment into general health systems. The session will conclude with a large group reflection on the knowledge learned, skills acquired, and inventory of attitudes.
MD, MBA, DFASAM
Dr. Brian Hurley is an addiction psychiatrist and Medical Director for Co-Occurring Disorder Services for the Los Angeles County Department of Mental Health (LACDMH), supporting the identification and management of co-occurring substance use among patients with mental illness served by LACDMH. He is an assistant professor of Addiction Medicine at UCLA.
Brian serves as the Treasurer and is a Distinguished Fellow of the American Society of Addiction Medicine. Brian joined ASAM in 2002 as a first year medical student, and has served on the ASAM Board of Directors in various capacities since 2003. Brian previously served as chair of ASAM’s Membership Committee and Physicians-in-Training Committee and is formerly ASAM’s alternate delegate to the American Medical Association. Brian additionally served on the EVP/CEO search committee in 2010 that led to Penny Mill’s selection as ASAM’s current EVP/CEO. He has additional served in various roles for the Massachusetts Society of Addiction Medicine, New York Society of Addiction Medicine, and California Society of Addiction Medicine.
Brian completed the Robert Wood Johnson Foundation Clinical Scholars Program at the University of California, Los Angeles (UCLA), and was previously a Veterans Administration National Quality Scholar at the VA Greater Los Angeles Healthcare System. He completed residency training at the Massachusetts General Hospital and McLean Hospital, where he was Chief Resident in Addiction Psychiatry and addiction psychiatry fellowship training at Bellevue Hospital and the New York Veterans Administration. Brian is a graduate of the Keck School of Medicine and Marshall School of Business of the University of Southern California. He was a 2012 American College of Psychiatrists Laughlin fellow, a 2010-2013 American Psychiatric Association (APA) Public Psychiatry Fellow, and a 2015-2017 Group for Advancement of Psychiatry Fellow. Brian has previously served on the Board of Trustees of the APA.
Stephen Wyatt, D.O, is a Board Certified Psychiatrist with added subspecialty certification in Addiction Psychiatry. He currently serves as the Medical Director of Addiction Medicine for Carolinas HealthCare System, CHS. He is a CHS Professor of Psychiatry and an adjunct clinical faculty member of the University of North Carolina. Dr. Wyatt practiced Emergency Medicine in Michigan for 13 years before entering psychiatry training; finishing in an addiction psychiatry clinical research fellowship at the Yale School of Medicine. He is the current Chairman of the NC Psychiatric Asso. Addiction Psychiatry Committee and the Vice Chair of the Coalition on Physician Education in Substance Use Disorders a national organization focused on addiction medicine medical school education. He participated in the writing of the ASAM Clinical Guidelines for Office Based Opioid Treatment and is a Clinical Expert for the SAMHSA funded Provider Clinical Support System for Medication Assisted Treatment.
R. Corey Waller
MD, MS, DFASAM
R. Corey Waller, MD, MS, FACEP, DFASAM, is an addiction, pain and emergency medicine specialist. Dr. Waller earned his bachelor's degree in biology and his master's degree in neuromolecular biology at Southwest Texas State University in San Marcos, Texas. He earned his medical degree at University of Texas Medical School in San Antonio. Dr. Waller completed his emergency medicine residency at Thomas Jefferson University in Philadelphia. He is board certified and fellowship trained in addiction medicine.
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 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.