Treating Youth with Opioid Addiction: Cases and Controversies (1.5 CME)
(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn about more about treating youth with opioid addiction through cases and controversies. Young people are disproportionately affected by the current opioid epidemic, with catastrophic consequences for youth and their families. Despite the urgent need, there is a lack of consensus about treatment approaches for youth. Many practitioners have questions, and struggle with this “mysterious” and difficult to engage population. This workshop will feature an interactive, case-based format. Workshop leaders will present 4-5 cases with background and treatment course, each punctuated by “what would you do next…” management questions for guided discussion at several pivotal decision points in the course. Cases are chosen to reflect real world concerns and clinical conundrums, key learning objectives, practice debates and controversies.
The goal is to engage participants in a lively conversation about developmentally-informed strategies, approaches, and treatment options in the treatment of this critical target population.
- 18 M at 5th episode of residential detoxification who has been unable to sustain continuing outpatient care despite previous course of buprenorphine.
- 19 F who becomes pregnant during treatment with extended release naltrexone.
- 20 M in outpatient treatment, abstinent from opioids on buprenorphine, but struggling with cocaine and other non-opioid substances, opposes communication with family.
- 17 F who presents in crisis to residential treatment seeking detoxification, and struggles with the process of decision making around recommendations for and choice of relapse prevention medications (buprenorphine vs extended release naltrexone).
- 18 M with sickle cell anemia with repeated relapses despite multiple treatment levels of care, including multiple attempts at outpatient buprenorphine treatment under various programmatic conditions.
The case discussions will cover a range of questions, including:
- developmentally specific approaches to treatment of adolescents and young adults with OUDs;
- use of relapse prevention medication (MAT) in youth;
- the role of families, when and how to involve them;
- confidentiality; use of various levels of care;
- the impact of other substance use disorders (primarily cannabis and alcohol);
- delivery models for medications and psychosocial treatment modalities; and others.
Marc Fishman MD is a specialist in addiction psychiatry and addiction medicine. He is a member of the faculty of the Department of Psychiatry at the Johns Hopkins University School of Medicine. He leads Maryland Treatment Centers, which offers programs for residential and outpatient treatment of drug-involved and dual-diagnosis adolescents and adults. He has written and lectured widely on a variety of topics including youth treatment, placement and treatment matching strategies, co-occurring disorders, and medication treatment for addiction. His research focus has been in treatment of opioid use disorders in youth.
Dr. Fishman served as a co-editor for the most recent editions of ASAM's 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, and also a current member of the Board.
Bikash Sharma, MD is currently a medical director for adult services at the Mountain Manor Baltimore, Maryland Treatment Centers. Dr. Sharma has board certifications with the American Board of Psychiatry and Neurology as well as the American Board of Addiction Psychiatry. He has been published in numerous journals where he has written about opioid use disorders, and alcohol and substance use in African Americans.
Ann Bruner, MD is a Medical Director, who treats youth at the Mountain Manor Baltimore, Maryland Treatment Centers. Dr. Bruner is referenced as an author or co-author in dozens of peer-reviewed journals in the Journal of Adolescent Health, and a contributor to the Clinical Handbook of Adolescent Addiction.
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.