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

July 2026

Greetings,

Welcome to the July edition of the MACS Monthly newsletter!

July is National Minority Mental Health Awareness Month, a time to highlight persistent disparities in mental health and substance use disorder (SUD) treatment among racial and ethnic minority communities. Opioid-related mortality continues to fall unevenly across populations — Black and American Indian/Alaska Native men have experienced the steepest increases in overdose deaths, driven in large part by the proliferation of illicit fentanyl. Unequal access to culturally competent SUD treatment, discrimination in healthcare settings and the dangers of the fentanyl-laced drug supply all compound these risks.

Despite some recent decline in overall overdose deaths, certain groups remain at outsized risk. Between 2015 and 2023, there was a nearly 5-fold increase in overdose deaths among non-Hispanic Black men aged 55 and older — with deaths in that group nearly triple the national average for that age group. These risks are especially pronounced in Maryland. Understanding these disparities is a vital step toward developing targeted, effective interventions that improve the health of all individuals with SUDs.

For support in caring for all patients with SUDs and chronic pain, 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

MEDETOMIDINE: CLINICAL OVERVIEW & INSIGHTS

As medetomidine continues to emerge within the illicit drug supply, staying informed of clinical trends is vital for patient care. In this video overview, Malik Burnett, MD, and Yngvild Olsen, MD, discuss the emergence of medetomidine in the illicit drug supply and the critical insights healthcare providers need to know.

Alongside this video overview, the MACS team has developed a comprehensive suite of materials within our resource library to support providers navigating the evolving medetomidine landscape. Our updated collection features a recording of our recent webinar, "Medetomidine Intoxication and Withdrawal," presented by Jordan Nahas-Vigon, MD, as well as a MACS fact sheet and additional relevant recordings and links.

Learn More

NEW FACT SHEET

MACS has published a new fact sheet on tianeptine and phenibut, two psychoactive substances increasingly encountered in clinical and substance use settings. Neither substance is FDA-approved in the United States, yet both are sold online and in convenience stores, often marketed with unproven claims of stress relief or cognitive enhancement. The sale and distribution of these substances is illegal.

In Maryland, Senate Bill 820 — which specifically identifies tianeptine and phenibut products as targets for seizure and enforcement actions — took effect on July 1, 2026.

Fact Sheet: Tianeptine and Phenibut

EDUCATION

Upcoming MACS Training Opportunities

MACS for MOMs Webinar

Postpartum Pain Management for People With Substance Use and Use Disorders

Tuesday, July 7 | 12:00 p.m. – 1:00 p.m.

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

MACS Webinar

Trauma and Suicide Risk in Opioid Use Disorder

Monday, August 3 | 12:00 p.m. – 1:00 p.m.

Presented by Max Spaderna, MD, Assistant Professor of Psychiatry at the University of Maryland School of Medicine

MACS for MOMs 1-Day Virtual Course

In partnership with the University of Maryland Taghi Modarressi Center for Infant Study and the Danya Institute

Perinatal Substance Use Disorder Management: Clinical Best Practices

Friday, September 18 | 8:15 a.m. – 5:00 p.m.

Presented by:

Hendrée E. Jones, PhD, LP, Professor, Department of Obstetrics and Gynecology, the University of North Carolina School of Medicine

MACS for MOMs Consultant Katrina Mark, MD, FACOG, FASAM

Essence Hairston, PhD, LCSW, LCAS, CCS, Assistant Professor, Department of Obstetrics and Gynecology, the University of North Carolina School of Medicine

Upcoming Trainings of Interest

Drug Policy Alliance

Kratom, 7-OH, and Beyond: Finding a Path Forward through Responsible Regulation, Health-Centered Policies, and Public Education

Thursday, July 9 | 2:00 p.m. – 3:30 p.m.

Yale Program in Addiction Medicine

Addiction Medicine Grand Rounds: National Drug Early Warning System (NDEWS)

Tuesday, July 14 | 12:00 p.m. – 1:00 p.m.

Grayken Center for Addiction Training & Technical Assistance

Between the Leaves: Prevalence, Withdrawal and Approaches to Care for Kratom Use

Wednesday, July 22 | 2:00 p.m. – 3:00 p.m.

CA Bridge

Case Studies in Managing Pain

Thursday, July 30 | 12:00 p.m. – 12:50 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

The Syndemic of Hepatitis C and Opioid Use Disorder

Sarah Kattakuzhy, MD

Wednesday, July 8

12:30 p.m. – 1:30 p.m.

Maternal Health

OUD Withdrawal Management

Christopher Welsh, MD

Tuesday, July 14

12:00 p.m. – 1:00 p.m.

Substance Use Care for the General Practitioner

Changing the Conversation: Fighting Opioid Use Disorder Stigma One Word at a Time

Bethany DiPaula, PharmD

Wednesday, July 15

12:30 p.m. – 1:30 p.m.

Providing MOUD from a Trauma-Informed Perspective

Vicarious Trauma

Kelly Coble, LCSW-C

Wednesday, July 22

12:30 p.m. – 1:30 p.m.

CONFERENCES & EVENTS

Maryland Academy of Physician Assistants 2026 Annual Conference

Wednesday, August 19 – Saturday, August 22

Hyatt Regency Chesapeake Bay | Cambridge, Maryland

MACS exhibit table

NEWS

Do US Adults View Drug and Alcohol Addiction as a Health Condition?

A new report from the Addiction Policy Forum and Gallup examines Americans' addiction literacy and its relationship to stigma, attitudes toward people in recovery and support for public health policy. The nationally representative study surveyed more than 5,000 U.S. adults and found that higher addiction knowledge is strongly associated with lower stigma and greater support for evidence-based policies. While 77% of respondents recognize addiction as a health condition and 74% agree it is treatable by healthcare professionals, knowledge gaps persist — particularly around medications as an effective treatment, which only 62% endorsed. Stigma remains prevalent: more than half of respondents reported feeling anxious or nervous around someone in recovery, and acceptance dropped sharply in personal contexts. The findings underscore that improving addiction literacy at the population level could meaningfully reduce stigma and expand support for treatment access.

Race, Ethnicity, and Language Disparities in Alcohol and Drug Screening and Medication Treatment

A cohort study analyzed health records for more than 2 million adults across 1,300 community health center clinics in 25 states to assess racial, ethnic and language-based disparities in substance use screening and medication treatment for alcohol use disorder (AUD) and opioid use disorder (OUD). Researchers found that only 40% of patients had ever completed alcohol or drug screening — and that disparities in medication prescribing were significant across all minoritized groups. While Spanish-preferring Latino patients had the highest odds of receiving screening, they — along with non-Hispanic Black and English-preferring Latino patients — had significantly lower odds of being prescribed medications for addiction treatment compared to non-Hispanic white patients. Non-Hispanic Black patients faced the steepest gap, with 45% lower odds of receiving medication for AUD and 62% lower odds for OUD. The findings highlight an urgent need to expand substance use screening and close treatment inequities in community health settings serving diverse populations.

Cost-Effectiveness of the START Hospital Addiction Consultation Service for Opioid Use Disorder Treatment

An economic evaluation assessed the cost-effectiveness of START (Substance Use Treatment and Recovery Team), a hospital-based addiction consultation service, in improving care for hospitalized patients with OUD. Based on data from 325 patients across three academic medical centers, researchers found that START was highly cost-effective compared to usual care — well below the standard willingness-to-pay threshold used in health economics. START was associated with increased initiation of FDA-approved medications for OUD during hospitalization and improved linkage to follow-up care after discharge. The findings make a strong economic case for implementing hospital-based addiction consultation services as a scalable, cost-effective strategy for addressing OUD in inpatient settings.

Reducing Buprenorphine Misinformation as a Strategy to Improve Adoption in Primary Care

A recent study examined buprenorphine misinformation as a modifiable barrier to prescribing among 63 primary care providers (PCPs) who completed a brief prescribing support program. Common misconceptions included that buprenorphine substitutes one harmful drug for another, should be prescribed short-term at the lowest dose possible, and is complicated to manage. These misconceptions were more prevalent among rural providers and those who had never prescribed buprenorphine. Following the intervention, misinformation decreased — particularly among first-time prescribers. The findings highlight the potential for brief educational programs to improve buprenorphine adoption in primary care settings, though further research is needed to assess the impact on actual prescribing behavior.

RESOURCES

9 Facts About Kratom and 7-OH (Drug Policy Alliance)

Addiction Stigma in America Featured Report: How Public Knowledge Shapes Attitudes Toward Recovery (Addiction Policy Forum and Gallup)

Know the Risks: Drug Safety Quiz (Maryland's Office of Overdose Response)

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