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

October 2025

Greetings,

Welcome to the October edition of the MACS Monthly Newsletter!

October is Substance Use Prevention Month, a nationwide recognition of the role of prevention strategies in stopping first-time substance use, halting its progression, and reducing associated harms. This month, we honor prevention specialists who work to empower individuals, families and communities and foster supportive environments free of harmful stigma. The MACS team is comprised of prevention specialists who accomplish these goals through consultation with healthcare providers, targeted outreach campaigns and collaboration with local partners.

October is also a time to recognize the vital work of pharmacists and pharmacy technicians during American Pharmacists Month. These healthcare professionals play a crucial role in the prevention and reduction of overdoses and in expanding access to evidence-based treatment. The MACS team of addiction medicine experts includes pharmacists who assist in answering clinical questions from providers about evidence-based dosing, buprenorphine dispensing, harm reduction tools such as naloxone and additional patient-related issues.

In observance of the contributions pharmacy professionals make to improve the lives of individuals living with substance use disorders and chronic pain, MACS is hosting a live, virtual webinar on October 21. Join our guest presenter Tyler Varisco, PharmD, PhD, assistant professor of health outcomes and the director of the Pharmacy Addictions Research & Medicine Program at the University of Texas at Austin College of Pharmacy, as he presents on Closing the Loop: Transitions of Care for Persons With Opioid Use Disorder. Pharmacists, pharmacy technicians and all healthcare providers treating individuals with opioid use disorders are encouraged to attend this webinar, where CME and CPE credits will be provided

Providers can access support in caring for patients with substance use disorders and chronic pain by scheduling an individualized consultation or registering for an upcoming training with the MACS team of addiction medicine specialists.

Call 1-855-337-MACS (6227) or visit www.marylandmacs.org to learn more. Explore this newsletter and the tools available on the MACS website for additional information about provider education and treatment resources.

– The MACS Team

UPDATE ON TELEHEALTH FLEXIBILITIES FOR SUD TREATMENT

The American Society of Addiction Medicine has received member inquiries about certain federal telehealth flexibilities that were in place during the COVID-19 public health emergency but ended on September 30, 2025.

The article linked below contains answers to commonly asked questions about the expiration of those flexibilities and the related impact on treating patients for an SUD.

FAQ on Recent Changes

OCTOBER 25: NATIONAL PRESCRIPTION DRUG TAKE BACK DAY

National Prescription Drug Take Back Day is on Saturday, October 25. In addition to finding nearby collection sites, help your patients safely dispose of unused medications from home by requesting free, easy-to-use Deterra drug disposal pouches from MACS.

Please note that this form is for healthcare providers only and should be used to order pouches for their practices and organizations. Each order is limited to 50 pouches.

Request Deterra Pouches

EDUCATION

Upcoming MACS Training Opportunities

MACS Webinar

Closing the Loop: Transitions of Care for Persons With Opioid Use Disorder

In observance of Pharmacy Week 2025

Tuesday, October 21 | 12:00 p.m. – 1:00 p.m.

Presented by Tyler Varisco, PharmD, PhD

Assistant Professor of Health Outcomes

Director of Pharmacy Addictions Research & Medicine Program

University of Texas at Austin College of Pharmacy

MACS for MOMs Webinar

Understanding the Whole Patient: Social Drivers and Prenatal Substance Use

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

Presented by MACS for MOMs Consultant Courtney Townsel, MD

MACS Webinar

Confronting Stigma in Addiction Care

Thursday, December 4 | 12:00 p.m. – 1:00 p.m.

Presented by MACS Consultant Michael Fingerhood, MD

Upcoming Trainings of Interest

Grayken Center for Addiction Training & Technical Assistance

Safer Prescribing and Management of Benzodiazepines

Thursday, October 9 | 3:00 p.m. – 4:00 p.m.

New York Society of Addiction Medicine

Treating Traumatic Stress in Context of Substance Use

Friday, October 10 | 12:30 p.m. – 1:30 p.m.

NAADAC, the Association for Addiction Professionals

Befriend Your Brain, Heal Your Behavioral Addiction

Wednesday, October 29 | 12:00 p.m. – 1:30 p.m.

American Society of Addiction Medicine

Integrating Addiction Medicine with Treatment Courts

Friday, October 31 | 10:00 a.m. – 2:30 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.

Registration Changes to MACS ECHO Sessions

Registration procedures for MACS ECHO Sessions have been changed to better utilize electronic learning management dashboards.

Instructions to register for any of the Fall ECHO sessions are available on the MACS website.

Opioid Treatment Program

The Role of Opioid Antagonists in OUD

Devang Gandhi, MD

Wednesday, October 1

12:30 p.m. – 1:30 p.m.

Maternal Health

Vaping and Pregnancy

Katrina Mark, MD, FACOG, FASAM

Tuesday, October 14

12:00 p.m. – 1:00 p.m. New time!

Substance Use Care for the General Practitioner

Formerly Substance Use Disorders

ADHD and SUD

Devang Gandhi, MD

Wednesday, October 15

12:30 p.m. – 1:30 p.m.

CONFERENCES & EVENTS

2025 Maryland Rural Health Conference

Sunday, October 19 – Tuesday, October 21

DoubleTree by Hilton | Annapolis, Maryland

MACS exhibit table

MedChi Fall House of Delegates/Annual Meeting

Saturday, October 25

Hilton Baltimore BWI Airport | Linthicum Heights, Maryland

MACS exhibit table

NEWS

Trends in the Availability of Buprenorphine at US Retail Pharmacies, 2017–23

According to an analysis of prescription claims from over 90% of U.S. retail pharmacies, the percentage of pharmacies regularly dispensing buprenorphine increased from about 33% in 2017 to 39% in 2023. Despite this increase, the study found that only one in three retail pharmacies in the U.S. dispense buprenorphine. The availability of this medication varied significantly by location and demographics. Maryland had lower dispensing availability compared to most other states, at approximately 35%. There were also notable disparities based on race and ethnicity, with pharmacies in predominantly Black neighborhoods (around 18%) and Latinx neighborhoods (around 17%) being far less likely to carry buprenorphine compared to pharmacies in predominantly white neighborhoods (about 46%).

Pharmacy Barriers to Receiving Buprenorphine Among Patients Undergoing Telemedicine Addiction Treatment

This study explores the challenges patients face at the pharmacy level when filling buprenorphine prescriptions while receiving telemedicine treatment for opioid use disorder. A web-based survey of adults with OUD across five U.S. states found that approximately one-third of patients receiving telemedicine treatment were unable to get their buprenorphine prescriptions filled. The most common problems included insufficient pharmacy stock (55%), insurance coverage issues (22%) and pharmacies being hesitant to fill telemedicine prescriptions (19%). These buprenorphine prescription problems could have serious health consequences for rural and nonrural communities alike. Inconsistent access to medication can increase the risk of returning to non-prescribed opioid use and lead to harms like overdose.

Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states

A recent study found that the Communities That HEAL intervention significantly increased overdose education and naloxone distribution in jails across Kentucky, Massachusetts, New York and Ohio. As part of the NIH HEALing Communities Study, this initiative empowered local coalitions to work with correctional facilities, addressing the high risk of overdose for people released from incarceration. The percentage of jails providing overdose education nearly doubled, from 38% to 77%, and naloxone distribution at release more than doubled, from 26% to 71%. This success was driven by flexible, community-led approaches, where jails adopted various education methods, such as using tablets, kiosks, or facility communication devices, to allow for streamlined completion tracking. Naloxone was distributed at various points, with some jails providing it upon release and others at intake, placing it in personal belongings. Access methods included discharge kits, vending machines in release areas, or vouchers for community-based organizations or pharmacies. Ultimately, this community-engaged model proved effective in implementing life-saving prevention services at a critical point of transition.

Recommendations for Addressing In-Hospital Substance Use From a National Delphi Consensus Process

A new study outlines expert consensus recommendations for addressing substance use during hospitalization. Key recommendations include screening and treating substance use disorders (including offering medications), discussing pain and withdrawal management, respecting patient autonomy, providing harm-reduction supports, and using nonstigmatizing, patient-centered policies. This guidance highlights the need for hospitals to adopt evidence-based, nonpunitive approaches that prioritize safety, dignity and engagement in care.