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

June 2025

Dear Carson,

Welcome to the June edition of the MACS Monthly Newsletter!

As June arrives, so does PTSD Awareness Month, an important opportunity to recognize the experiences of those living with post-traumatic stress disorder. Data suggest that 30% - 60% of individuals living with SUD will experience PTSD in their lifetime, which is nearly four to eight times higher than the general population (8%). Understanding the reasons behind this elevated risk – including attempts to manage PTSD symptoms with substances, shared biological and environmental factors, and the potential for substance use to lead to trauma – is crucial for effective intervention.

MACS is committed to furthering trauma-informed practices. Explore how our resources, including our Providing MOUD from a Trauma-Informed Perspective ECHO Sessions, can enhance your ability to provide sensitive and comprehensive care.

For support in caring for patients with co-occurring PTSD and substance use disorders, providers can schedule an individualized consultation or register for an upcoming training with the MACS team of addiction medicine specialists by calling 1-855-337-MACS (6227) or visiting 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

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NEW MACS FACT SHEET

Medetomidine in the Illicit Drug Supply:

Emerging Clinical Challenges

Recent reports have indicated an increased presence of medetomidine in the illicit drug supply.

The latest fact sheet created by the MACS team provides crucial information about the effects of this veterinary anesthetic and clinical considerations for treatment.

Click the image below to access Medetomidine in the Illicit Drug Supply: Emerging Clinical Challenges.

EDUCATION

Upcoming MACS Training Opportunities

MACS Webinar

Extended 1.5-hour webinar with in-depth prescriber content

Opioid Use Disorder Treatment Integrated With Primary Care

Thursday, June 12 | 12:00 p.m. – 1:30 p.m.

Presented by MACS Consultant Michael Fingerhood, MD

Upcoming Trainings of Interest

Southeast ATTC

With Substance Use Disorders (SUD), is Your Focus on Recovery or Treatment and Why it Makes a Difference

Friday, June 6 | 12:00 p.m. – 1:00 p.m.

NAADAC

Unveiling ADHD's Complex Relationship with Substance Use and Young Adults

Wednesday, June 11 | 12:00 p.m. – 1:30 p.m.

Grayken Center for Addiction Training & TA

Alcohol Use Disorder 101

Thursday, June 13 | 1:00 p.m. – 2:00 p.m.

Mountain West AIDS Education & Training Center

Substance Use and HIV

Wednesday, June 18 | 3:00 p.m. – 4:00 p.m.

CA Bridge

Engaging Special Populations: Veterans

Thursday, June 26 | 2:00 p.m. – 3:00 p.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

Kratom

Aaron Greenblatt, MD

Wednesday, June 4

12:30 p.m. – 1:30 p.m.

Maternal Health

Nicotine Use and Pregnancy

Courtney Townsel, MD, MS

Tuesday, June 10

8:00 a.m. – 9:00 a.m.

Substance Use Disorders

Pain Management and Substance Use Disorders

Sarah Merritt, MD

Wednesday, June 18

12:30 p.m. – 1:30 p.m.

Providing MOUD from a Trauma-Informed Perspective

Stigma

Sal Corbin, PhD

Maryland Harm Reduction Training Institute Coordinator

Wednesday, June 25

12:00 p.m. – 1:00 p.m.

CONFERENCES AND EVENTS

Maryland Pharmacists Association's 143rd Annual Convention

Friday, June 6 – Sunday, June 8

Grand Hotel | Ocean City, Maryland

MACS exhibit table

NEWS

Buprenorphine Treatment in Pregnancy and Maternal-Infant Outcomes

A large-sample study highlights the positive impact of buprenorphine on maternal and infant health and underscores the importance of expanding its accessibility during pregnancy. The study, involving 14,463 maternal-infant dyads associated with the Tennessee Medicaid program (2010-2021), examined the impact of buprenorphine for opioid use disorder, a critical area given the 45% increase in serious maternal morbidity in the United States over the past two decades and the elevated risk for pregnant individuals with OUD. The findings indicate significant benefits, with buprenorphine use reducing the risk of severe maternal morbidity by 1.2 percentage points and preterm birth by 5.3 percentage points. Treatment retention among those on buprenorphine was notably high. However, the study also revealed racial disparities in access, with only 2.1% of buprenorphine-treated patients being Black, despite higher overdose risk among this population.

US Children Living With a Parent With Substance Use Disorder

This research letter, using 2023 data from the National Survey on Drug Use and Health, estimates that nearly 19 million US children (approximately 1 in 4) live in households with at least one parent or primary caregiver who meets the DSM-5 criteria for a substance use disorder. Of these children, over 7.6 million live with a parent with a moderate or severe SUD, and more than 3.4 million live with a parent with multiple SUDs. Furthermore, the research letter highlights that over 6.1 million children live with a parent who has a co-occurring substance use disorder and mental illness. The most common parental SUD involves alcohol. The authors emphasize that these children are at a higher risk for adverse health outcomes, underscoring the need for increased attention and evidence-based, family-focused treatment interventions at various levels.

Prevalence and Risk Factors for Opioid Overdose Among Women: A systematic review and meta-analysis

This systematic review and meta-analysis, encompassing 123 studies, examined opioid overdoses among women. The analysis found that women accounted for 30% of fatal opioid overdoses and 43% of non-fatal overdoses. However, the proportion and rates of overdoses in women varied significantly across different groups, overdose types and opioid types. Notably, women had higher overdose rates in cases of intentional self-harm, repeated overdoses and within community correction populations compared to men. The study identified several risk factors associated with increased opioid overdose risk in women, including older age, belonging to racial minority groups, having mental health disorders, specific marital statuses and experiencing economic disadvantage. The authors concluded that while opioid overdose is generally less prevalent in women than men, certain subpopulations of women are at higher risk and could benefit from tailored interventions.

Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial

This randomized clinical trial investigated the effectiveness of varenicline, a medication, combined with brief, remote behavioral counseling for nicotine vaping cessation in 261 young people aged 16 to 25 who vaped daily or near daily but did not regularly smoke. The study compared a 12-week regimen of varenicline plus counseling to a placebo plus counseling and an enhanced usual care group (referral to a text messaging cessation program). The key finding was that the varenicline group had significantly higher rates of biochemically verified continuous abstinence from vaping during the last four weeks of treatment (51%) compared to the placebo group (14%). This benefit persisted at the 6-month follow-up, with 28% abstinence in the varenicline group versus 7% in the placebo group. The medication was generally well-tolerated, with similar rates of treatment-emergent adverse events across the varenicline and placebo groups. The researchers concluded that varenicline, when added to brief counseling, is an efficacious and safe treatment to promote nicotine vaping cessation in this young population.