Volume 9 | October 2023

Maine SUD Learning Community Newsletter

Cole Bridges, OMS III

My name is Cole Bridges, and I was born and raised in Calais, Maine, where I grew up working on my family's blueberry farm. After graduating from Calais High School, I earned a degree in physics from Colby College. I then completed a post-baccalaureate program in biology at the University of Maine and worked as a medical scribe at Brewer Medical Center. Currently, I am a medical student at the University of New England College of Osteopathic Medicine, and I am performing my third-year clerkship rotations at Eastern Maine Medical Center in Bangor.

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Greetings, colleagues!

In the era of fentanyl, we wonder, is more buprenorphine better? Or does having more medication on-hand feed other use disorders, the purchase of more fentanyl, and/or promote diversion? This retrospective study from the Rhode Island PDMP suggests that a 24mg dose and/or the treatment approach that travels with it, captures slightly more people than a 16mg dose and/or its associated approach. (i.e., 59% discontinuation at 6months compared with 53% for 24mg, or HR 1.2). It does not tell us what is the driving force behind the outcome – the dose or a key unmeasured confounder such as the prescriber’s approach. Further it doesn’t evaluate whether starting at a lower dose, like 12 -16mg, and moving to 24mg if needed, would produce a similar result, with less risk for overprescribing. Meanwhile, the overall retention rates (41-47%%) indicate that struggles at 16 or 24mg signal that it’s time to start offering alternative solutions, like injectable medication or methadone.

Feel free to read on for the nitty gritty along with a little bit of background on the dose debates,


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Do hospitals test for fentanyl?

The Maine Opioid Response Clinical Advisory Committee just released a position statement recommending they do so. See the Proposed Position on Fentanyl Toxicology Testing (link to it on ME SUD LC website). The ME SUD LC is available to provide training and to assist the development of protocols, submit a request. An upcoming webinar is planned for Nov. 17 at noon.

 When will the Drug Enforcement Administration promulgate new rulemaking about telehealth prescribing of certain controlled medications?

The DEA recently extended for the second time the flexibilities enacted during COVID-19 to allow providers to continue to using telemedicine to prescriber certain controlled substances (schedule II-V) through the end of 2024.

Second Temporary Extension of COVID-19 Telemedicine Flexibilities

for Prescription of Controlled Medications

For these questions and technical assistance, contact the ME SUD Learning Community


Personal Recovery Story

Louis Grassi

Hi. I’m 32 and have lived in Maine all my life. I’m in recovery, and I’m proud of that.

I had a wonderful childhood – my parents were generous and very loving. They took us to church every weekend, and my siblings and I certainly were well fed – growing up in an Italian family, Sunday sauce was as vital as oxygen.

But as I grew into my teenage years, I became an anxious kid and fretted a lot over seemingly simple things. But I received more than enough love and support at home to deal with these issues.

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Identifying Emergent OB Issues: Practical Skills for Addiction Medicine Specialists

October 17, 20, & 24, 2023 | 12:00-1:00PM (three-part course)

Speakers: Matthias G. Muenzer, MD

Alcohol Use During the Perinatal Period

October 23, 2023 | 12:00-1:00PM

Speakers: Alane O'Connor, DNP

Xylazine 101

November 7, 2023 | 12:00-1:00PM

Speakers: Cara Zimmerman, MD, MBA

Adding Fentanyl Testing to Hospital Toxicology Assays

November 17, 2023 | 12:00-1:00PM

Speakers: Alane O'Connor, DNP | Scott Lowell, MHA, MLS (ASCP) | Robert Carlson, MD

Cytochrome P Four Who?: Demystifying Pharmacokinetic Drug Interactions

November 28, 2023 | 12:00 - 1:00 PM

Speakers: Stephanie Nichols, PharmD, BCPS, BCPP

Adolescents & Young Adults ECHO: Expanding Services for OUD/SUD, Mental Health and Other Complexities

Recurring every 2nd Wednesday of the month, 12-1pm, through May 8, 2024

NEXT SESSION: Wednesday, November 8

Presentation: Self-Harming Behavior and OUD/SUD | Ben Strick, LCSW

The Co-Occurring Collaborative Serving Maine has launched its third Project ECHO: Expanding Services for Behavioral Health Complexities for adolescents and transition-aged youth. The nine-month Project ECHO brings together Prescribers and their Teams.

To join, please complete the application: https://forms.office.com/r/SWwJ7TcjfU

A Zoom link will be sent to you after the review of your application.

FMI: Kate Chichester, Executive Director, CCSME, cchichester@ccsme.org 

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Online Self Paced Courses

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Enroll in one of our convenient online self-paced courses today!

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Please visit the ME SUD Learning Community website for upcoming Events and Resources.
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