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Bringing DC healthcare providers the latest news, events, and resources to improve care for patients with substance use disorders and chronic pain management.

December 2024

Dear DACS Provider,

Every first of December, DACS joins the global community to recognize #WorldAIDSDay. As we unite to combat HIV/AIDS, DACS remains steadfast in our commitment to supporting affected communities. Understanding the intersection between infectious disease and substance use, we are dedicated to breaking down barriers, empowering individuals and providing equitable access to care. Together, we can build a future free from stigma and discrimination.

In additional end-of-year news, the U.S. Departments of Health and Human Services, Labor, and Treasury recently issued new final rules to strengthen the Mental Health Parity and Addiction Equity Act (MHPAEA). These rules, most of which are effective January 1, 2025, will improve access to mental health and substance use disorder treatment.

Key changes include:

Equal Access: Health plans must provide equal coverage for mental health and substance use disorder services as they do for medical and surgical care. New rules require health plans to conduct meaningful comparative analyses of provider networks, how much they pay out-of-network providers, and how often they require – and deny – prior authorizations.
Reducing Barriers and Increasing Transparency: Health plans cannot use more restrictive prior authorization, or other medical management techniques, or narrower networks to make it harder for people to access mental health and substance use disorder benefits than their medical benefits. And they will be required to provide more information about their coverage policies and practices.
Closing Loopholes: The new rules will close loopholes in the MHPAEA, expanding coverage to millions more Americans, including state and local government employees.

These changes are expected to benefit millions of Americans by reducing barriers to care and improving mental health outcomes. Explore this newsletter and the tools available on the DACS Website for additional information about provider education and treatment resources.

We wish you a joyful holiday season and a healthy 2025 to come!

Sincerely,

The DACS Team

Education

Upcoming DACS Trainings

PCSS-MOUD Half and Half Training hosted by DACS

Wednesday, January 29 | 12:00 –4:00 p.m.

Presented by DACS Medical Director Eric Weintraub, MD, and Consultant Jasleen Salwan, MD

DACS Webinar: Management of Opioid Use disorder: Update on the Changing Clinical and Regulatory Landscape

Thursday, February 13th | 12:00 –1:00 p.m.

Presented by DACS Consultant, Devang Gandhi, MD

Additional Trainings of Interest

Yale Program in Addiction Medicine

Addiction Medicine Grand Rounds: Perinatal Substance Use

Tuesday, December 17 | 12:00 p.m. – 1:00 p.m.

Researchers at the University of Maryland School of Medicine conducted a preclinical animal study on rats exposed to cannabinoids in the womb, finding that it increases the risk of addiction to opioids later in life. The study discovered that prenatal exposure to THC, the main psychoactive ingredient in cannabis, causes changes in the brain's reward system, leading to a heightened release of dopamine upon exposure to opioid drugs in adolescence.

Association between state-level medical marijuana legalization and marijuana use during pregnancy: A population-based study

Using National Survey on Drug Use and Health data from 2015 to 2021, this population-based study examined the association between pregnant women's marijuana use in the past month and the legal status of medical marijuana in their state of residence. Results indicated that about 5.7% of pregnant women reported marijuana use in the past month, and 59% of them lived in states where medical marijuana had legal status across 2015 to 2021. Pregnant women living in states with medical marijuana legalization reported past-month use at higher rates than those living in states without such legal status (6.5% v. 4.6%). Despite increased marketing of marijuana and related products, pregnant women should be informed of adverse pregnancy and birth outcomes associated with marijuana use during pregnancy.

Availability of Medications for Opioid Use Disorder in US Psychiatric Hospitals

In this cross-sectional analysis of facility-level responses to the 2022 National Substance Use and Mental Health Services Survey, psychiatric hospitals reported their medication for opioid use disorder (MOUD) availability. Survey results found that of the 1,021 responding psychiatric hospitals, 490 reported providing MOUD. With MOUD provided in less than one-half (47.99%) of the responding psychiatric hospitals, the study exposes room for improvement when it comes to MOUD provision for individuals with comorbid opioid use disorder (OUD) and mental health conditions.

Wound Characteristics Among Patients Exposed to Xylazine

This case series using data from three academic hospitals in Philadelphia, Pennsylvania, analyzed 59 wounds among 29 hospitalized patients with confirmed xylazine exposure. Of these wounds, 53 were located on patients' extremities and 41 involved their extensor surfaces. Out of the 57 wounds that were photographed, 34 contained wound beds of mostly devitalized tissue. In addition, the longer these wounds persisted, the more likely they were to have larger and necrotic wound beds. The study's authors hope to inform xylazine-associated wound identification, management and research to combat an emerging threat to public health.

Holidays and Observances

Holidays

DACS Phone Line Will Be Closed

December 25 – Christmas

January 1 – New Year's Day

January 20 – Martin Luther King Jr. Day

December Observances

World Aids Day

December 1

Relevant Resources

DACS Fact Sheet: Adolescents and Substance Use

Opioid, Stimulant, and Substance Use Disorders in Pregnant and Postpartum Patients

A screening and resource guide for healthcare providers, patients, and caregivers in the District of Columbia, prepared by the MedStar Health National Center for Human Factors in Healthcare.

Opioid Use Disorder During and After Pregnancy

A patient resource guide on tips for a Healthy Pregnancy.

Care for the Caregiver

A guide for caregivers of pregnant and postpartum patients with opioid, stimulant, and other substance use disorders.

Buprenorphine Drug Assistance Program (BUP-DAP)

Designed to increase access to drugs used primarily in medication-assisted substance misuse treatment (Buprenorphine, Naltrexone, Suboxone, and Naloxone). When presented to participating pharmacies, it can cover medicine costs, co-pays, and pharmacy dispensing fees. Recipients will need to present a government issued photo ID.

Pocket Guides for Safe Opioid Prescribing

Contains a number of resources to providers, including: CDC guidelines for safe opioid prescribing, a Morphine Milligram Equivalent (MME) conversion chart, a checklist for prescribing opioids for chronic pain, medications for opioid use disorder (MOUD), and additional resources for providers and patients.

DC Center for Rational Prescribing (DCRx)

This learning portal provides information about medications and other therapeutic options. The DC Department of Health provides non-commercial, independent continuing education courses, free to ALL DC licensed healthcare professionals.

The DC Prescription Drug Monitoring Program (DC PDMP)

The Prescription Drug Monitoring Program (PDMP) aims to improve the District’s ability to identify and reduce diversion of prescription drugs in an efficient and cost effective manner that will not impede the appropriate medical utilization of controlled substances.

Live.Long.DC

A coordinated multi-stakeholder approach to comprehensively address the opioid epidemic by sharing data, discussing initiatives and best practices, and identifying common approaches. The initiative is led by the DC Department of Behavioral Health with a goal of reducing opioid use, misuse, and opioid-related deaths in DC. For more information about Live.Long.DC strategies and initiatives, visit: https://livelong.dc.gov/

1-866-337-DACS (3227) | www.districtdacs.org | dacs@som.umaryland.edu