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

October 2024

Dear Anna,

Autumn is here, and with its arrival comes plenty of opportunities to support providers in our community.

October is Substance Use Prevention Month, a nationwide recognition of the role of prevention strategies in preventing first-time substance use, halting the progression of substance use and reducing harms associated with substance use. This month, MACS joins countless organizations and individuals honoring prevention specialists who work in our communities to educate and empower others, foster supportive environments and combat harmful stigma. Our team is comprised of prevention specialists who accomplish these aims through consultation with healthcare providers, targeted outreach campaigns and collaboration with local partners. Learn more about our prevention efforts – and gain clinical insight on strengthening protective factors and reducing risk factors – by visiting our website or reaching out to MACS at 1-855-337-MACS (6227).

When it comes to substance use prevention, youth and adolescents are a crucial population to support. MACS has developed an Adolescents and Substance Use Fact Sheet to equip healthcare providers with essential information to understand substance use trends among adolescents, implement effective prevention strategies, identify risk factors and foster healthy environments.

October also marks American Pharmacists Month. These healthcare professionals play a crucial part in the prevention and reduction of drug overdoses as well as expanding access to evidence-based treatment methods. The MACS team of addiction medicine experts includes pharmacists who assist in answering critical questions from providers about evidence-based dosing, buprenorphine dispensing, harm reduction tools such as naloxone and additional patient-related issues. Contacting MACS can access answers to these pharmacological concerns, training on substance use disorders and real-time, online learning sessions in the form of ECHO Clinics.

Just in time for American Pharmacists Month, the National Association of Boards of Pharmacy and the National Community Pharmacists Association will begin distributing the Pharmacy Access to Resources and Medication for Opioid Use Disorder (PhARM-OUD) Guideline to the 60,000 community pharmacists nationwide. Tailored to pharmacists and designed to educate them about the importance of providing access to buprenorphine, the practice guideline is the first of its kind. By utilizing this important resource, pharmacists can gain assistance navigating the complex regulatory and clinical barriers to prescribing buprenorphine.

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

The MACS Team

EDUCATION

Upcoming MACS Training Opportunities

MACS for MOMs Webinar

Birth is Not an Endpoint

Wednesday, October 23 | 12:00 p.m. – 1:00 p.m.

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

MACS Webinar

PCSS-MOUD Half and Half Training Hosted by MACS

Thursday, October 24 | 12:00 p.m. – 4:15 p.m.

Presented by MACS for MOMs Consultants Christopher Welsh, MD, and Marian Currens, CRNP

Upcoming Trainings of Interest

Grayken Center for Addiction Training & TA

Trans and Gender Diverse Folks and Substance Use Treatment: Foundations

Thursday, October 17 | 11:00 a.m. – 12:00 p.m.

All Rise & American Society of Addiction Medicine

Integrating Addiction Medicine With Treatment Courts

Wednesday, October 30 | 10:00 a.m. – 5:00 p.m.

MACS ECHO Clinics

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

Maternal Health ECHO

Street Drugs and Pregnancy

Christopher Welsh, MD

Tuesday, October 8

8:00 a.m. – 9:00 a.m.

Substance Use Disorders ECHO

ADHD and SUD

Devang Gandhi, MBBS, MD

Wednesday, October 16

12:30 p.m. – 1:30 p.m.

Providing MOUD from a Trauma-Informed Perspective

Adolescents and Trauma

Marc Fishman, MD

Wednesday, October 23

12:00 p.m. – 1:00 p.m.

Conferences and Events

American Society of Addiction Medicine 2024 State of the Art Course

Thursday, October 17 – Friday, October 18

Marriott Baltimore Waterfront | Baltimore, Maryland

Tobacco Use among Older Adults: A Forgotten Population

Presentation by MACS Director of Research and Evaluation Annie Kleykamp, PhD

Chaired by MACS Consultant Michael Fingerhood, MD

Maryland Society of Health-System Pharmacy Fall Conference

Friday, October 18

Sheraton Baltimore Washington Airport | Linthicum, Maryland

MACS exhibit table

MedChi Fall Membership Conference

Saturday, October 26

Hotel at Arundel Preserve | Hanover, Maryland

MACS exhibit table

Maryland Rural Health Association Annual Conference

Sunday, November 3 – Tuesday, November 5

Crowne Plaza Annapolis | Annapolis, Maryland

MACS exhibit table

Sigma Theta Tau International Honor Society of Nursing Annual Substance Use Disorder Conference

Wednesday, November 13 | 5:00 p.m. – 9:00 p.m.

TidalHealth Peninsula Regional | Salisbury, Maryland (Virtual attendance available)

Naloxone to the Rescue: Update on Community Efforts to Combat Overdose

Presentation by MACS Consultant Bethany DiPaula, PharmD

Nurse Practitioner Association of Maryland Fall Conference

Saturday, November 16

Howard Community College | Columbia, Maryland

MACS exhibit table

NEWS

Curbing Baltimore's Opioid Epidemic: Advocates and Hospitals Take Novel Approaches

This article from Baltimore magazine examined the approaches hospitals and advocates are taking to combat opioid use citywide. Medical Director Eric Weintraub, MD, shared details about the approach of MACS in engaging with healthcare providers throughout local communities. By equipping a variety of providers with addiction-treatment resources and trainings, MACS improves the care of individuals with substance use disorder (SUD) alongside additional featured agencies.

Trends and Disparities in Initiation of Buprenorphine in US Emergency Departments, 2013-2022

In this retrospective cross-sectional study, researchers evaluated nationwide trends in buprenorphine initiation in emergency department (ED) settings. In doing so, they also analyzed the demographic and socioeconomic factors associated with its initiation. By reviewing data available from research system Epic Cosmos, accounting for 1100 hospitals and 7.2 billion encounters, researchers found that ED encounters involving buprenorphine increased to 27.3% of opioid-related encounters in 2022 from 2.75% in 2013. Barriers to access still exist, however, as buprenorphine was prescribed in 5.7% of opioid-related ED encounters between 2019 and 2022, a lower rate than that of one-time administration (14.8%). This study also found that racial and gender disparities in buprenorphine administration, with decreased initiation associated with the female sex.

Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization

The objective of this cross-sectional study was to examine the association between higher doses of buprenorphine (above 16mg and 24mg) and subsequent emergency department or inpatient service use among patients diagnosed with opioid use disorder (OUD). By reviewing insurance claims data from over 35,000 individuals diagnosed with OUD and who began receiving buprenorphine treatment between 2016 and 2021, researchers found that those receiving a buprenorphine dosage exceeding the recommended daily dose of 16mg may have a lower risk of subsequent emergency department visits or use of inpatient services related to behavioral health.

Telemedicine for Initiation of Alcohol Use Disorder Medications

A case-control study examined telemedicine-based initiation of medications for alcohol use disorder (MAUD) and compared characteristics of U.S. adults who initiate through telemedicine v. in-person means. Findings suggest that despite the majority of MAUD initiations occurring in-person, telemedicine can play an important role in the initiation of efficacious medications. In addition, greater access to telemedicine in higher-income locales points to concerns about how the "digital divide" impedes access to care.

Alcohol habits and alcohol-related health conditions of self-defined lifetime abstainers and never binge drinkers

In this survey-based study out of Denmark, researchers sought to investigate the consistency of self-reported rates of lifetime abstention from alcohol and never-binge drinking. Part of their aim was to validate prior research showing that using lifetime abstainers as a reference group to examine associations between alcohol use and health-related consequences has disadvantages. By drawing from two waves of survey collection, and further linking the findings to morbidity data in a national patient register, the research reaffirmed self-reported lifetime abstainers to be an unreliable reference group and indicated a non-negligible proportion of them had been diagnosed with an alcohol-related health condition.

Disparities in Medication Use for Criminal Justice-Referred Opioid Use Disorder Treatment

This cross-sectional study analyzed over 3 million admissions to treatment centers for opioid use disorder (OUD) between 2014 and 2021 in hopes of understanding disparities in the use of medications for opioid use disorder (MOUD) between individuals referred to treatment by the criminal justice system in comparison to other referral sources. While the probability of criminal justice-referred individuals receiving treatment that included MOUD increased within the study's timeframe, by 2021 it remained over 15 percentage points lower than those referred by other sources. These results suggest the need for targeted efforts to increase MOUD use among individuals with OUD and involvement in the criminal justice system in order to address poor health outcomes among this population.