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

February 2025

Dear Carson,

Welcome to the February edition of the MACS Monthly Newsletter!

A recently published article in the International Journal of Drug Policy examined the relationship between state-level opioid policies and opioid overdose deaths in the United States from 2013 to 2020. The findings suggest that the implementation of stronger harm reduction measures, such as increasing access to naloxone and establishing Good Samaritan Laws, were associated with a reduced risk of opioid overdose deaths. Conversely, early in the study period (2013-2016), opioid prescribing restrictions were associated with higher overdose rates.

The study supports MACS's role in promoting access to medication for opioid use disorder (MOUD) and expanding practices' capacities through technical assistance. By providing education and support to healthcare providers on the appropriate use of MOUD and addressing potential barriers to its implementation, MACS improves access to evidence-based treatment for individuals with opioid use disorders (OUDs).

In addition, Children of Addiction Awareness Week (February 9 – February 15) takes place this month and is a reminder of the unique challenges faced by children who grow up in homes affected by substance use.

According to the National Association for Children of Addiction, youth with a parent who has a substance use disorder (SUD) are more prone to experience anxiety, depression, confusion and anger. In addition, those with a parent who has an SUD are the most likely group of children to develop SUDs themselves due to both genetic and environmental factors.

We encourage healthcare providers to consult with our team of substance use specialists by calling 1-855-337-MACS (6227) or visiting www.marylandmacs.org for consultation and resources to support individuals with SUDs.

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

The MACS Team

MACS IN THE MEDIA

MACS Medical Director and Consultant Eric Weintraub, MD, appeared on the latest episode of Maryland Rural Health Association's podcast!

In the episode, Dr. Weintraub highlighted how MACS empowers rural healthcare providers to deliver effective care for substance use disorder through a combination of training, consultation and peer support.

To connect with resources like the MACS warmline and ECHO Clinic learning communities, call 1-855-337-MACS (6227) or visit www.marylandmacs.org.

Listen to the podcast episode using the link above.

EDUCATION

Upcoming MACS Training Opportunities

MACS Webinar

Optimizing the Pharmacy Partnership in Managing Patients With OUD

Thursday, February 6 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Consultant Bethany DiPaula, PharmD, BCPP, FASHP

MACS Webinar

Alcohol Use Disorder Review, Co-Occurring Disorders, and Pharmacologic Treatments/Pitfalls

Friday, March 7 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Consultant Avinash Ramprashad, MD

MACS for MOMs Webinar

In partnership with Circle of Hope and the American College of Obstetricians and Gynecologists

Alcohol Use in Pregnancy and Fetal Alcohol Spectrum Disorder (FASD)

Tuesday, March 18 | 12:00 p.m. – 1:00 p.m.

Presented by MACS for MOMs Consultant Courtney Townsel, MD, MS

Upcoming Trainings of Interest

Yale Program in Addiction Medicine

Addiction Medicine Grand Rounds: Integrated Care for Substance Use Disorder and HIV

Tuesday, February 11 | 12:00 p.m. – 1:00 p.m.

NIH Heal Initiative, NIDA and NIMH

HEAL Workshop: Health Economics Research to Address the Needs of Those With Serious Mental Illness, Substance Use Disorder, and Comorbid Conditions

Friday, February 14 | 10:00 a.m. – 3:45 p.m.

Grayken Center for Addiction Training & Technical Assistance

Alcohol Use Disorders 101

Friday, February 21 | 10:00 a.m. – 11:00 a.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.

Opioid Treatment Program

Presented by:

Devang Gandhi, MD

Wednesday, February 5

12:30 p.m. – 1:30 p.m.

Maternal Health

Presented by:

Ben Wormser, MD, MPH, Rebecca Dineen, MS, and Amy Secrist, MPH, CHES

Tuesday, February 11

8:00 a.m. – 9:00 a.m.

Substance Use Disorders

Presented by:

Avinash Ramprashad, MD

Wednesday, February 19

12:30 p.m. – 1:30 p.m.

Providing MOUD from a Trauma-Informed Perspective

Presented by:

Gregory Malik Burnett, MD

Wednesday, February 26

12:00 p.m. – 1:00 p.m.

CONFERENCES AND EVENTS

Maryland Academy of Family Physicians Annual Meeting & Winter Refresher

Saturday, February 22 – Sunday, February 23

The Graduate Hotel Annapolis | Annapolis, Maryland

MACS exhibit table

Maryland Chapter of American College of Emergency Physicians Educational Conference and Annual Meeting

Thursday, March 27

University of Maryland, Baltimore | Baltimore, Maryland

MACS exhibit table

Maryland Academy of Advanced Practice Clinicians Pharmacology Update Conference 2025

Saturday, March 29

Anne Arundel Community College | Arnold, Maryland

MACS exhibit table

NEWS

Trends in Treatment Need and Receipt for Substance Use Disorders in the US

This study, utilizing data from the National Survey on Drug Use and Health, examined trends in substance use disorder (SUD) treatment needs and receipt in the United States between 2013 and 2023. Key findings revealed a substantial increase in SUD prevalence during the COVID-19 pandemic, followed by an initial decline in treatment rates. While treatment rates have since rebounded, the study highlights a significant disparity between the need for and receipt of treatment. Notably, a low proportion of individuals with untreated SUD perceived a need for treatment, and an even smaller percentage actively sought care. This underscores the urgent need for interventions that improve access to SUD treatment, such as expanding insurance coverage, increasing public awareness and integrating SUD care into primary healthcare settings.

Craving changes in first 14 days of addiction treatment: an outcome predictor of 5 years substance use status?

This study examined the predictive value of early craving changes on long-term substance use outcomes in individuals undergoing addiction treatment. Using an Ecological Momentary Assessment approach, researchers collected real-time data on craving intensity and substance use from participants during the initial 14 days of treatment. The study found that individuals experiencing a slower decrease in craving intensity and lower craving inertia (the tendency for craving to persist) during this crucial period were more likely to exhibit increased substance use five years later. These findings suggest that the trajectory and dynamics of craving during the early stages of treatment may serve as valuable predictors of long-term treatment success.

Trends in Buprenorphine Dispensing Among Adolescents and Young Adults in the US

This study analyzed buprenorphine dispensing trends among adolescents and young adults (ages 10-24) in the US from 2020 to 2023. While dispensing increased among adolescents, particularly those aged 10 to 19, it significantly decreased among young adults. This suggests potential disparities in access to and utilization of medication-assisted treatment for opioid use disorder within this age group. Despite recent policy changes aimed at improving access, such as expanded telehealth prescribing and the elimination of waiver requirements, these changes may have had a differential impact on adolescents and young adults. Key findings include significant increases in dispensing among some prescriber specialties among adolescents, while others, particularly among young adults, experienced significant decreases. Nurse practitioners were the most frequent prescribers of buprenorphine to this population.

Cannabis Use and Trajectories of Depression and Stress Across the Prenatal Period

This cohort study recruited pregnant individuals at an obstetric clinic at an academic hospital between July 2019 and January 2024. The study investigated the relationship between prenatal cannabis use and changes in depression and stress during pregnancy. Findings revealed no significant association between prenatal cannabis use and changes in depression or stress trajectories, even among those using cannabis to cope with mental health problems. While individuals using cannabis for mental health reasons had higher initial depression scores, their rate of depression decline was not significantly different from those who did not use cannabis. These findings suggest that prenatal cannabis use does not necessarily accelerate the rate of change in depression or stress during pregnancy and emphasize the importance of providing pregnant individuals with access to effective and evidence-based treatments for mental health conditions.

RESOURCES

Cannabis Tip Sheets Series (NCSACW)

Community Opioid Overdose Reversal Medications (OORMs) Planning Toolkit (SAMHSA)

National Guidance on Essential Specialty Substance Use Disorder (SUD) Care (SAMHSA)

Nora's Blog: A new roadmap for cannabis and cannabis policy research (NIDA)

1-855-337-MACS (6227) | www.marylandmacs.org | MACS@som.umaryland.edu