The latest in substance use disorders and pain management education for healthcare providers

April 2026

Greetings,

Welcome to the April edition of the MACS Monthly newsletter!

April is Alcohol Awareness Month, a critical time to address the complexities of alcohol use disorder (AUD). Excessive alcohol use contributes to more than 178,000 deaths each year, according to the National Institute on Alcohol Abuse and Alcoholism. Additionally, estimates suggest that alcohol played a role in at least 8.4% of emergency department visits and about 16% of deaths due to opioid overdoses in 2022. From managing co-occurring opioid use disorder (OUD) and depression to mitigating long-term cancer risks, healthcare professionals can support patients navigating AUD. Through screening and personalized, evidence-based treatment plans, providers can bridge the gap between diagnosis and recovery.

Access support in caring for patients with substance use disorder (SUD) and chronic pain by scheduling an individualized consultation or registering for an upcoming training with MACS. To learn more, call 1-855-337-MACS (6227), email macs@som.umaryland.edu or visit www.marylandmacs.org.

Explore this newsletter and the tools available on the MACS website for additional information about provider education and treatment resources.

– The MACS Team

MARYLAND DEPARTMENT OF HEALTH'S RESOURCES ON MEDETOMIDINE

The Maryland Department of Health has compiled resources to inform healthcare providers about the rising prevalence and clinical risks of medetomidine, a potent veterinary sedative increasingly found in the state's illicit drug supply.

Public Health Advisory (March 2026): This report outlines the increasing prevalence of medetomidine in Maryland, its extreme potency compared to xylazine, and specific clinical guidance for managing overdose and severe withdrawal.

Medetomidine Palm Card (English): A tool designed to help individuals who use drugs communicate potential exposure and withdrawal symptoms to first responders and healthcare providers.

Medetomidine Palm Card (Spanish): A Spanish-language version of the information card to ensure broad access to life-saving guidance and clinical resources.

APRIL 25: NATIONAL PRESCRIPTION DRUG TAKE BACK DAY

National Prescription Drug Take Back Day is on Saturday, April 25. In addition to finding nearby collection sites, help your patients safely dispose of unused medications from home by requesting free, easy-to-use Deterra drug disposal pouches from MACS.

Please note that this form is for healthcare providers only and should be used to order pouches for their practices and organizations.

Request Deterra Pouches

NEW FACT SHEET

We are sharing a new fact sheet created by the MACS team: "Transitioning from Methadone to Buprenorphine: General Guidance for Clinicians."

This new fact sheet explores the clinical considerations for a successful transition and provides an overview of different initiation strategies, including traditional tapers, low-dose initiation, and bridge or specialty-setting transitions.

Fact Sheet: Transitioning From Methadone to Buprenorphine

EDUCATION

Upcoming MACS Training Opportunities

MACS Webinar

The Role of Telemedicine in Expanding Access to Medications for Opioid Use Disorder (MOUD) Care in Underserved Areas

Monday, April 20 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Medical Director and Consultant Eric Weintraub, MD

MACS Webinar

Providing SUD Care for the Unstably Housed Patient: Teaching Belonging & Connection

Thursday, May 14 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Consultant Nicholaus Christian, MD

MACS for MOMs Webinar

Acute Management of Withdrawal in Pregnancy

Thursday, May 28 | 12:00 p.m. – 1:00 p.m.

Presented by MACS for MOMs Consultant Katrina Mark, MD, FACOG, FASAM

Upcoming Trainings of Interest

Providers Clinical Support System-Medications for Alcohol Use Disorder

Rebuilding Together: How Family Support Impacts Alcohol Use Disorder Treatment

Thursday, April 9 | 1:00 p.m. – 2:15 p.m.

Institute for Research, Education and Training in Addictions

Medetomidine: An Emerging Adulterant Reshaping Toxicity and Withdrawal Management

Wednesday, April 15 | 12:00 p.m. – 1:30 p.m.

Grayken Center for Addiction Training & Technical Assistance

Essentials of Treating Stimulant Use Disorder

Thursday, April 16 | 1:00 p.m. – 4:00 p.m.

CA Bridge

Keep Kids Alive: Screening & Identification of High Risk Youth with SUD

Wednesday, April 29 | 3:30 p.m. – 4:30 p.m.

MACS ECHO Sessions

Join our learning communities for continuous case-based discussions and didactic presentations linking expert specialist teams with healthcare providers and their practices. MACS ECHO sessions count toward the required 8-hours of SUD training for DEA license renewal or registration.

The April SUC ECHO will not take place due to the 2026 Tuerk Conference. Join us for the next session on May 20.

Opioid Treatment Program

New and Emerging Drugs

Christopher Welsh, MD

Wednesday, April 1

12:30 p.m. – 1:30 p.m.

Maternal Health

Postnatal and Long-Term Neonatal Outcomes

Courtney Townsel, MD, MS

Tuesday, April 14

12:00 p.m. – 1:00 p.m.

Providing MOUD from a Trauma-Informed Perspective

Population Health and the Opioid Crisis: The Integration of Upstream and Downstream Strategies for an Effective Response

Malik Burnett, MD, MBA, MPH

Wednesday, April 22

12:00 p.m. – 1:00 p.m.

CONFERENCES & EVENTS

Tuerk Conference on Mental Health & Addiction Treatment

Wednesday, April 15

Baltimore Convention Center | Baltimore, Maryland

MACS Exhibit Table

Maryland Academy of Advanced Practice Clinicians Pharmacology Update 2026

Saturday, April 18

Doordan Institute Conference Center and Event Space | Annapolis, Maryland

MACS Exhibit Table

Mid-Atlantic Patient Safety Conference 2026

Tuesday, April 21

Hilton Baltimore Inner Harbor | Baltimore, Maryland

MACS Exhibit Table

2026 Maryland Society of Health-System Pharmacy Spring Seminar

Friday, April 24

Sheraton Baltimore North Hotel | Towson, Maryland

MACS Exhibit Table

Maryland Chapter American College of Emergency Medicine 2026 Educational Conference & Annual Meeting

Thursday, April 30

SMC Campus Center | Baltimore, Maryland

MACS Exhibit Table

Presentation by MACS Consultant Michael Fingerhood, MD

NEWS

Emergency Department–Initiated Buprenorphine for Opioid Use Disorder

A new multicenter randomized trial examines whether 7-day extended-release injectable buprenorphine improves treatment engagement compared to the sublingual preparation for patients with untreated opioid use disorder (OUD) in the emergency department. The study found that two formulations of buprenorphine (extended-release and sublingual) resulted in similar engagement in OUD treatment (~40% of patients after one week).

Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders

A recent cohort study of more than 460,000 adolescents (ages 13–17) found that cannabis use during teenage years is associated with a significantly increased risk of developing psychotic, bipolar, depressive, and anxiety disorders by age 26. Participants were adolescents in a northern California healthcare system who were screened for cannabis use during standard pediatric care and diagnoses were based on electronic health record data. As cannabis legalization expands, these findings emphasize the urgent need for targeted early prevention, clear public health messaging, and policy development to limit youth exposure and mitigate long-term psychiatric risks.

Opioid use disorder of any severity is associated with increased suicidality

Research utilizing cross-sectional data from the National Survey on Drug Use and Health highlights a critical link between opioid use disorder (OUD) and suicidality, revealing that OUD of any severity is associated with increased odds of suicidal thoughts, plans, and attempts. While severe OUD presents the highest risk, with nearly tenfold odds for suicide attempts, even mild OUD significantly raises the risk profile for patients. These findings underscore the clinical necessity of universal suicide screening not only within addiction treatment settings but also in pain management practices, where mild OUD may otherwise go undetected.

Smokeless Tobacco and Oral Cancer in Global Perspective

Smokeless tobacco (ST), which includes products that are made, entirely or partly, from tobacco leaves or extract and are consumed orally without being burned, remains a major, preventable cause of oral cancer and premature death, affecting over 360 million people across 140 countries. Classified as a group 1 carcinogen, ST products like gutka, khaini and snuff contain high levels of harmful compounds and areca nut, driving a rise in oral cancer incidence particularly in regions where ST is the primary form of tobacco consumption. While behavioral counseling and pharmacologic interventions such as varenicline and nicotine replacement therapy are effective for cessation, clinical attention to ST use remains disproportionately low. ST does not include nicotine pouches, which do not contain tobacco. Some nicotine pouches have been authorized by the FDA for the protection of public health.

Patient-Centered Podcasts: An Educational Innovation to Improve Attitudes Toward Patients with Opioid Use Disorder Among Internal Medicine Practitioners

Addressing the challenge of healthcare-related stigma, a recent pilot study explored the efficacy of patient-centered podcasts in shifting clinical attitudes toward opioid use disorder (OUD). The intervention, which featured three 30-minute episodes focused on lived-experience narratives, was tested among 15 internal medicine practitioners at an academic medical center. Participants reported high satisfaction with the format's accessibility and relevance, and post-intervention data showed a statistically significant improvement in the Medical Condition Regard Scale (MCRS) scores. These results suggest that humanizing digital curricula via podcasts is a promising, scalable innovation for busy clinicians to decrease bias and improve the therapeutic alliance in OUD care.