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

May 2026

Greetings,

Welcome to the May edition of the MACS Monthly newsletter!

May is Mental Health Awareness Month, an important opportunity to deepen our collective understanding of mental health conditions and connect individuals, families and providers with the resources they need. Among the most pressing challenges in behavioral health is the intersection of mental health and substance use disorders, which frequently co-occur and compound one another. Nationally, more than one in three adults (35%) living with a mental health disorder also experience a substance use disorder, a reminder that these conditions rarely exist in isolation. When mental health conditions go unaddressed, substance use often intensifies, making integrated, whole-person care a cornerstone of effective treatment.

To access additional information on the screening and treatment of co-occurring disorders, visit the Substance Abuse and Mental Health Services Administration's advisory on substance use disorder treatment for people with co-occurring disorders.

For support in caring for patients with co-occurring mental health and substance use disorders, schedule an individualized consultation or register 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

STIGMA ABOUT PRESCRIBING MOUD

Check out your colleagues featured in our latest digital campaign with the Maryland Department of Health addressing stigma toward prescribing medications for opioid use disorder (MOUD).

Visit our informational webpage to learn more and hear directly from your colleagues in their own words.

(Clockwise: Aliya Jones, MD, MBA, Andrew Stolbach, MD, MPH, FACMT, FAACT, FACEP, Franklin J. Dyson, MHS, Yngvild Olsen, MD, MPH)

NEW FACT SHEET

We are sharing a new fact sheet created by the MACS team: “Synthetic Cannabinoids."

This new fact sheet provides an overview of synthetic cannabinoids, including common names such as K2 and Spice, challenges with screening and health risks associated with these rapidly evolving substances. It also outlines signs of intoxication, emergency response considerations, and treatment strategies for clinicians caring for patients affected by synthetic cannabinoid use.

Fact Sheet: Synthetic Cannabinoids

EDUCATION

Upcoming MACS Training Opportunities

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

MACS Webinar

Experience to Impact – Peer Recovery ECHO Introduction

Thursday, June 11 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Consultant Devang Gandhi, MD, and Director of BHA Office of Consumer Affairs Brendan Welsh

Save the date! Registration link coming soon.

MACS Webinar

Medetomidine Intoxication and Withdrawal

Monday, June 22 | 12:00 p.m. – 1:00 p.m.

Presented by Jordan Nahas-Vigon, MD, internist at Johns Hopkins Bayview Medical Center and Johns Hopkins Hospital

Upcoming Trainings of Interest

Opioid Response Network

Medetomidine Impacts on Clinical Management and Systems of Care

Wednesday, May 13 | 5:00 p.m. – 6:00 p.m.

CA Bridge

Empowering Our Female Patients: MAT and reproductive care for pregnant & non-pregnant patients in the ED

Thursday, May 14 | 3:00 p.m. – 4:00 p.m.

Grayken Center for Addiction Training & Technical Assistance

Buprenorphine 101

Tuesday, May 27 | 10:00 a.m. – 11:00 a.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.

Opioid Treatment Program

ADHD and Substance Use Disorders: A Complicated Relationship

Devang Gandhi, MD

Wednesday, May 6

12:30 p.m. – 1:30 p.m.

Maternal Health

Trauma Informed Care for MOMs

Kay Connors, MSW, LCSW-C

Tuesday, May 12

12:00 p.m. – 1:00 p.m.

Substance Use Care for the General Practitioner

Ethical Issues in SUD Care

Michael Fingerhood, MD

Wednesday, May 20

12:30 p.m. – 1:30 p.m.

Providing MOUD from a Trauma-Informed Perspective

Trauma and Suicide Risk in Opioid Use Disorder

Max Spaderna, MD

Wednesday, May 27

12:00 p.m. – 1:00 p.m.

CONFERENCES & EVENTS

STTI Lambda Eta Spring 2026 Evidence-Based Practice (EBP) and Quality Improvement (QI) Conference

Wednesday, May 13

TidalHealth Peninsula Regional Hallowell Conference Center | Salisbury, Maryland

MACS exhibit table

Maryland Annual School-Based Health Care Conference

Thursday, May 14

The Meeting House | Columbia, Maryland

MACS exhibit table

Maryland Pharmacists Association 144th Annual Convention

Friday, June 26 – Sunday, June 28

Princess Royale Oceanfront Resort | Ocean City, Maryland

MACS exhibit table

NEWS

Driving Distance From US Jails to Opioid Treatment Programs

A recent cross-sectional study examined the driving distance between nonfederal U.S. jails and the nearest opioid treatment program (OTP) to identify geographic barriers to providing medications for opioid use disorder (MOUD). Of the 3,228 U.S. jails and 2,096 OTPs included in the study, the mean driving distance to a clinic was 54.6 minutes. Over half of all sampled jails (51.5%) were located more than 30 minutes from an OTP, with rural jails facing the longest travel times, averaging 85.3 minutes. Travel distance is a major structural barrier to providing MOUD, creating geographic gaps that likely limit access to life-saving treatment for the incarcerated population.

Extending harm reduction through public health vending machines: Insights from implementation efforts in the United States

This qualitative study examined the implementation of public health vending machines (PHVMs) — automated dispensers stocked with harm reduction supplies such as naloxone, sterile syringes, and fentanyl test strips — across 14 U.S. states and Washington, D.C. Researchers interviewed 26 individuals from health departments, harm reduction organizations, VA health systems, and correctional settings about their experiences launching and maintaining PHVMs. Site selection was most often driven by host site willingness rather than community need, and unanticipated maintenance and restocking costs emerged as the primary operational challenge. PHVMs proved to be a versatile, low-barrier tool for reaching underserved populations, and the authors call on policymakers to pass local ordinances supporting PHVM placement and securing access to the life-saving materials housed within them

Evaluating the optimal duration of medication treatment for opioid use disorder

A study of over 32,000 U.S. veterans found that the longer people remain on MOUD, whether buprenorphine, methadone, or extended-release naltrexone, the greater their probability of short- and medium-term survival, with this benefit continuing to increase for at least four years of ongoing treatment. Researchers observed that the risk of mortality was highest in the period immediately following treatment discontinuation, regardless of how long a patient had previously been stable on medication. Furthermore, the data showed no "threshold" at which the benefits of MOUD leveled off, suggesting that the protective effects against overdose and all-cause mortality persist indefinitely with continued use. These findings emphasize that for many patients, MOUD should be approached as a long-term or even lifelong maintenance therapy rather than a short-term intervention, as the risks associated with stopping treatment remain significant even after years of stability.

Real-time peer-navigation support during community re-entry for adults with opioid use disorder

This recent qualitative study identified three primary domains of support that peer navigators provide to individuals with opioid use disorder (OUD) reentering the community after incarceration. Peer navigators deliver direct services such as transportation to pharmacies and court dates, informational services such as resource education and MOUD visit reminders, and facilitation services such as advocacy with parole officers and assistance with social service paperwork. By leveraging shared lived experience to build trust, these peer-led interventions address critical social determinants of health and reduce stigma. The findings suggest that integrating peer navigation into the re-entry process is a vital strategy for increasing MOUD retention and preventing fatal overdose during the high-risk period following release.

RESOURCES

ASAM Practice Pearls podcast: Kratom and 7-OH: What Clinicians Need to Know (American Society of Addiction Medicine)

Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome (Centers for Disease Control and Prevention)

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