How ORN is Responding to the Co-Occurrence of Serious Mental Illness and Opioid Use Disorder

Past Year Serious Mental Illness and Opioid Use Disorder Among Adults Aged 18 or Older: 2019 [Source: 2019 National Survey on Drug Use and Health (NSDUH) Detailed Tables. Data extracted on 7/8/21.] In 2019, over 14 million adults in the United States reported experiencing past year serious mental illness (SMI) or opioid use disorder (OUD). Of those with OUD, nearly half (40.2%) also reported having SMI. The relatively high co-occurrence of SMI among those with OUD is an important consideration for providers, as treatment utilization is poor among those with co-occurring disorders. Prior research has shown that fewer than one in three individuals with co-occurring OUD and SMI receive substance use and mental health treatment (Novak, Feder, Ali, & Chen, 2019). How Has ORN Responded? From March 2018 to June 2021, the Opioid Response Network (ORN) responded to 84 specific requests for education and training related to SMI. This resulted in over 140 activities, delivered face-to-face and virtually, for a range of mental and behavioral health providers. Activity objectives encompassed awareness, education and training strategies related to a number of relevant topics, including medications for OUD, harm reduction, and recovery in this population. This data spotlight is part of a series brought to the Impact Bulletin by ORN partner organization, RTI International. Novak, P., Feder, K. A., Ali, M. M., & Chen, J. (2019). Behavioral health treatment utilization among individuals with co-occurring opioid use disorder and mental illness: Evidence from a national survey. Journal of substance abuse treatment, 98, 47-52.

Mark Your Calendars: Upcoming ORN Trainings

Social Work Chat Live: Kratom - Benefits, Risks and Harm Reduction Considerations (July 26, 2021) Funded by ORN, the Boston Medical Center's Office Based Addiction Treatment Program is running a series of Live Social Work Chats for social workers. This month, Dan Hogan will be leading a discussion of Kratom - Benefits, Risks and Harm Reduction Considerations. To register for this month's session and future Zoom sessions, visit: https://bit.ly/2V5lVvK.

To read the full news letter, forward to colleagues or add to your newsfeed use this link: View as Webpage

How can ORN help you? Visit www.OpioidResponseNetwork.org to submit a request for opioid use disorder and stimulant use disorder training and/or education.

orn@aaap.org 401-270-5900 www.OpioidResponseNetwork.org

The American Academy of Addiction Psychiatry (AAAP) is working in partnership with leadership from the National Judicial Opioid Task Force, a working committee of key judicial leaders, as well as addiction psychiatrists, the Conference of Chief Justices and the Conference of State Court Administrators, to create a variety of resources. The most recent is an educational guide for judges and other justice-system stakeholders on the basics of the medical perspective of substance use disorders. Available at no cost, the guide provides a foundational level understanding of the medical aspects of substance use disorders and the evidence-based practices needed in prevention, identification and treatment. This resource, supported by ORN, is available to all electronically and limited in print in the near future: https://www.aaap.org/education/law-and-medicine-guide/ Share with your colleagues.

COPE Announces Winners of the Medical Student Curriculum Challenge: Innovative Learning and Teaching About Substance Use/ Opioid Use Disorders

The Board of Directors of the Coalition on Physician Education in Substance Use Disorders (COPE), an ORN partner organization, is delighted to announce the winners of the Medical Student Curriculum Challenge: Innovative Learning and Teaching About Substance Use/ Opioid Use Disorders. This ORN-funded initiative challenged medical students to utilize their knowledge and creativity to design learning resources related to the development of the knowledge, skills and attitudes critical to providing care to persons with substance use/ opioid use disorders. Congratulations to the winners! See here for more information: https://adobe.ly/3z8b57Q

Opioid Regulations: State by State Guide

The American College of Emergency Physicians (ACEP) has developed a state-by-state guide on opioid regulations. This resource was created for the purpose of providing practical, state specific information for emergency physicians that prescribe opioid medications in an emergency department setting. This guide includes: PDMP mandates; accessibility by delegates of the physician in order to comply with those requirements; CME mandates; community availability of Naloxone and Suboxone; limitations on days’ supply of a prescription originating in the emergency department; and availability of community treatment resources. Anyone can access this free, ORN-funded resource. Submit a request at OpioidResponseNetwork.org.

Much more! View the complete newsletter.

Overdose Deaths Involving Psychostimulants Have Increased Drug overdose deaths involving psychostimulants, such as cocaine and methamphetamine, have increased drastically in the United States over the past decade, particularly after the rise of the opioid epidemic in 2014. From 2010 to 2019, overdose deaths involving psychostimulants were nearly 16 times higher than in the decade prior. Additionally, since 2016, overdose deaths in polysubstance use, such as psychostimulants in combination with synthetic opioids, have increased sharply.

Source: CDC WONDER How Is ORN Responding? In October 2020, ORN broadened its scope to include education and training to address misuse of psychostimulants. To build capacity to respond to requests in this area, ORN built a diverse team with experience in prevention, treatment and recovery of stimulant use disorder (StUD) from across the continuum of care. Co-chaired by Frances R. Levin, MD, and Bryan Hartzler, PhD, this workgroup leads the network’s efforts in identifying educational resources, vetting consultants, and creating training materials as needed. Nearly two dozen new consultants with StUD expertise have been added to ORN's national network of nearly 800 consultants -- with hundreds more available to support on request. Additionally, ORN's bank of evidence-based resources has been updated with new StUD specific material to support education and training in that area. How can ORN help you? Visit www.OpioidResponseNetwork.org to submit a request for StUD training and/or education. Within one business day a technology transfer specialist will respond to learn more about your request and determine how ORN can help. This data spotlight is part of a monthly series brought to the Impact Bulletin by ORN partner organization, RTI International. Stay tuned for more.

orn@aaap.org 401-270-5900 www.OpioidResponseNetwork.org

Funding for this initiative was made possible (in part) by grant no. 1H79TI083343 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

New and upcoming resources and trainings (all free!) from the Opioid Response Network (ORN). Do you have needs for education and training in the prevention, treatment and recovery of opioid use disorders and stimulant use? Learn more and submit a request at www.OpioidResponseNetwork.org.

Hot Topic Webinars from the American Osteopathic Academy of Addiction Medicine

In partnership with the ORN, the American Osteopathic Academy of Addiction Medicine is holding a series of webinars this spring on Hot Topics in Addiction Medicine. The first in the series, titled “Access to Buprenorphine Treatment for Opioid Use Disorder” is March 24 with a follow-up Q&A session March 31. Separate registrations are required for each webinar and Q&A session. 

More here.

Northwest Portland Area Indian Health Board Launches Behavioral Health ECHO Program

Clinicians serving American Indian and Alaska Native people are invited to participate in the Behavioral Health ECHO Program operated by the Northwest Portland Area Indian Health Board in partnership with the ORN. The program provides comprehensive information for clinicians to integrate evidence-based treatment with holistic, trauma informed and culturally appropriate care. CE will be offered. More here.

Adoption of Virtual Services in Judicially Led Diversion Programs Preliminary Findings: National Center for State Courts Report

The National Center for State Courts, Rulo Strategies and the Wayne State University Center for Behavioral Health and Justice, in partnership with the ORN, conducted one of the first nationwide explorations of virtual services in judicially led diversion programs since March 2020. The focus of the subsequent report is judicially led diversion programs, an umbrella term that encompasses drug courts, opioid courts, and recovery-oriented compliance dockets. Access here.

New Boston Medical Center App Provides Information, Guidance for Treating Patients with Opioid Use Disorder

Boston Medical Center, with the ORN, created an app that provides guidelines and resources for treating opioid use disorder with buprenorphine and naltrexone. Information on opioid use disorder treatment with methadone and pain management strategies are also included. Access via The Apple App Store and Google Play Store.

American Psychiatric Association Launches Medications for Opioid Use Disorder Virtual Learning Collaboratives

In partnership with the ORN, the American Psychiatric Association has launched a series of four 8-week virtual learning collaboratives on topics focused on using medications for opioid use disorder to treat patients. Each collaborative is led by a faculty expert and participants will earn up to 8.0 CMEs by completing various activities such as watching pre-recorded webinars, calling into office hours, participating in group discussions, analyzing case vignettes, and completing an individual project. More here.

PCSS-X is a free, six-session course that was created to give practitioners guidance on implementing medications for the treatment of opioid use disorder (OUD) into your practice. The first live Zoom session is Thursday April 8 at 3:00 pm ET.

PCSS-X is intended for an interprofessional audience, and participants are welcome to attend whichever sessions are most relevant to their current situation. Please go here for a summary of each session. Prescribers with frontline experience prescribing medications for OUD and developing clinic workflows will be available during each session to answer participants’ questions and discuss real-world cases.

SESSION 1 – EXPLORE, PART 1 – April 8 AT 3:00 PM ET

Presenter(s): TBA

Facilitator: Sherry Larkins, PhD, Director of International Programs and Research Sociologist, Integrated Substance Abuse Programs at the University of California, Los Angeles – Semel Institute for Neuroscience and Human Behavior

Cost: No fee

Target Audience: Physicians, nurse practitioners or other advanced practice nurses, PAs, psychologists, social workers, clinical administrators and healthcare teams.

Credit Designations Available: AMA PRA Category 1 Credit™, Nursing Contact Hours, AAPA Category 1 CME credit, SW CE credit, and Interprofessional Continuing Education (IPCE) credit.

Webinar Description: Have you considered prescribing Medications for Opioid Use Disorder (MOUD) to treat your patients with opioid use disorder (OUD)? Have you wondered what is required to prescribe buprenorphine or other pharmacotherapies? If you answered yes to either or both of these questions, this PCSS Exchange session could provide you with the critical information and steps in determining the readiness of your site and clinical leadership. Initiating MOUD into your setting requires that you understand how pharmacotherapies work, including buprenorphine and its various formulations. Programs must think through the business case for service expansion and strategize how to best engage key staff.

Educational Objectives: At the conclusion of Session 1, participants should be able to:

Go here for more CME information.

https://conta.cc/3t3escv

The American Osteopathic Academy of Addiction Medicine (AOAAM) is a partner of the Opioid Response Network, a coalition of 40 national organizations. The Physician Assistant Education Association (PAEA) is collaborating with the AOAAM to connect OUD-focused clinical sites with PA education programs. The goal is that collaboration will bolster the behavioral health workforce with qualified, well-trained, early-career practitioners.

PA students joining clinical sites for their rotations will be ready to apply their broad medical and behavioral health training to provide team-based psychiatric care, MAT, and primary care. With expanded OUD-treatment training and experience, these graduates will improve access to care for behavioral health practices and increase the availability of providers, helping to address health disparities related to OUD.

By participating in the program, behavioral health clinical sites will be connected with PA programs seeking to set up full-time, supervised, 4- to 8-week rotations for their students. Any honorariums or other compensation will need to be negotiated with the participating PA programs.

PAEA is specifically seeking training sites in New Hampshire, North Carolina, Kentucky, California, Northern Virginia, and Maryland. They are also immediately seeking a clinical placement specialist at Wichita State University in Kansas. They have lost two clinical sites placing graduation for several students in jeopardy. Placement for the following dates

• March 22-April 22
• May 17-June 17
• June 21-July 28

Use this link for additional information or contact DMurray@PAEAonline.org

Suspected Opioid Overdoses Increased During the Pandemic Suspected opioid overdoses reported from over 2,600 agencies across the United States showed an increase in the months following the onset of the COVID-19 pandemic. From March to May 2020, 62 percent of agencies in counties that provided data reported an increase in suspected overdose submissions.

Source: Overdose Detection Mapping Application Program (ODMAP) ODMAP submissions January 1, 2020 to March 18, 2020 compared to March 19, 2020 to May 19, 2020  How Has ORN Responded? One example: Early in the pandemic, the Opioid Response Network (ORN) identified urgent need for education and training regarding changing regulations and guidance concerning the use of telehealth/telemedicine in the management of substance use disorders to help combat a suspected increase in overdoses. One response came from ORN partner, the American Osteopathic Academy of Addiction Medicine, which created a telehealth webinar series. Over 4,000 individuals registered to learn about: federal telehealth regulations; strategies for conducting group and individual sessions; and management of opioid use disorder in the context of social distancing, stay at home, and shelter in place orders. Access the webinars here and other ORN COVID-19 resources here. This data spotlight is the first in a new monthly series brought to the Impact Bulletin by ORN partner organization, RTI International. Stay tuned for more. About the Opioid Response Network (ORN): ORN provides free, localized training and education for states, communities, organizations and individuals in the prevention, treatment and recovery of opioid use disorders and stimulant use. Learn more and submit a request at www.OpioidResponseNetwork.org. References: Alter, A. 2020. COVID-19 impact on US national overdose crisis. Overdose Detection Mapping Application Program. Retrieved from here. Funding for this initiative was made possible (in part) by grant nos. 1H79TI083343 and 6H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

One of the benefits of AOAAM membership is the opportunity to earn CME. Members can receive 3 AOA Category 1-B CME credits as a peer reviewer for manuscripts submitted to the Journal of Addictive Diseases for publication consideration. If you are interested in this opportunity please send a short email to R. Gregory Lande, DO at JAD@aoaam.org  describing your interest and experience reviewing manuscripts along with your CV. If you have limited experience with peer reviewing we can provide guidance and support to facilitate your contributions to academic publishing.

We are pleased to announce that the American Osteopathic Academy of Addiction Medicine is a National Advocacy Partner for the 2021 Addiction Medicine Advocacy Conference to be held on March 22-March 23.

We are excited to join the American Society of Addiction Medicine (ASAM) and the other National Advocacy Partners for this two-day virtual advocacy event. We look forward to advancing addiction medicine together by advocating for legislative objectives that support addiction prevention and treatment and the professionals working every day to save patient lives.

The deadline to register is March 1, 2021. Attendance is for ASAM members only.  To become an ASAM member, click here.  ASAM members can register for the2021 Addiction Medicine Advocacy Conference by clicking here.

We value your participation in this year’s advocacy conference and look forward to an active collaboration in 2021 on behalf of the millions of people who need and deserve evidence-based addiction prevention and treatment.

Hope to “see” you in March!

We want to make you aware of an upcoming event on Thursday, October 22, 2020, at 2pm EST. CDC's upcoming Clinician Outreach and Communication Activity (COCA) webinar on this date will feature subject matter experts from CDC, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the American Society for Addiction Medicine (ASAM) to highlight existing resources and exceptions for clinicians who prescribe medications for opioid use disorder, increase awareness of existing community-based linkage to care resources, and discuss the outpatient telemedicine experience from a front-line provider perspective. You can find more information about this call, including the webinar link and dial-in numbers, at this link: https://emergency.cdc.gov/coca/calls/2020/callinfo_102220.asp

Many of you who have been attending our monthly external stakeholder listening sessions have expressed the importance of increasing awareness on these topics among providers and identifying additional resources for the communities you serve. We are excited about the forum this call will provide and hope that it can spurn additional conversations through our recurring listening sessions. Our next session is scheduled for October 30th at 1pm, and we hope you all can join us as we continue to discuss opportunities to enhance resources and linkage to care among persons who use drugs or have substance use disorder.

Many thanks for the incredible work you all do.

Best,

Amy Board, Unit Lead
Persons Who Use Drugs or Have Substance Use Disorder
Disproportionately Affected Populations Team
Community Interventions and Critical Populations Task Force
CDC COVID-19 Response
ocg3@cdc.gov