New ORN Impact Data
The Opioid Response Network is reaching more people in effort to help states, organizations and individuals address the opioid crisis at the community level through free education and training. Since the beginning of the initiative (February 2018 - January 2020) we have reached 3,020,695 people.
Over 35 States Represented in Rhode Island on Treating Opioid Use Disorder in Corrections Settings
What started as a technical assistance request from the Rhode Island Department of Corrections (RIDOC) became a national conference for department of corrections staff and others in the justice system to learn promising models in implementing Medications for Opioid Use Disorder (MOUD).
The free, 2.5-day meeting was held from January 28-30, 2020 in Providence, RI. It highlighted RIDOC's model (one of the first states to incorporate MOUD state-wide, offering all three FDA approved medications), as well as other evidence-based delivery models from around the country.
Over 230 people, representing 34 states, attended the conference, which featured plenary sessions with leading behavioral health, clinical, justice and corrections experts followed by skills development workshops. Read More
Conferences and Events
Pilot Projects Uses Standardized Patients to Train Clinicians
In an effort to help providers with the waiver to prescribe medications and to enhance their comfort level, the Physician Assistant Education Association (PAEA), an ORN partner organization, hosted a pilot project using standardized patients. The intent was to help prescribers feel more confident in prescribing medications to treat opioid use disorders.
The training was held on January 25, 2020 and included a small group of physicians, a physician assistant and a nurse practitioner. All were waivered, but have not yet prescribed. Participants were asked to run an assessment for opioid use disorder and then develop a treatment plan. The training provided an opportunity for the prescribers to ask the standardized patient/actor questions and learn from an experienced prescriber.
According to PAEA's John Lopes, DHSc, PA-C, all participants indicated that the experience helped improve their..... Read More
Addressing Stigma in the Emergency Room
On January 23, 2020, ORN partner organization, the American College of Emergency Physicians (ACEP), convened a summit called Addressing Opioid Stigma in the Emergency Department. The 46 attendees included federal partners from the Department of Health and Human Services, Center for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, Drug Enforcement Agency and National Institute on Drug Abuse, as well as health care physicians, providers and leaders in the field of medicine.
The summit was an opportunity to discuss and share lessons learned and ideas about how to limit the impact of stigma on the care of emergency room patients with opioid use disorder. From the session, ACEP is developing a policy statement, a policy resource and education paper, and a paper on the role of stigma in the emergency department and how to effectively eliminate it. Read more.
Read the full ORN Bulletin
At the Maine Osteopathic Association meeting, UNECOM students recently presented a poster addressing the utilization of geographic information systems in developing best practices in containing and controlling the opiate epidemic in Maine. Clusters of overdosed citizens were plotted. This led to other maps addressing the need for medication assisted treatment and increasing access to qualified certified Addiction Medicine professionals.
UNECOM students placed 3rd in this competition. Congratulations to a job well done!
Emergency Room Physicians Overcoming Barriers to Opioid Use Disorder Treatment
The American College of Emergency Physicians (ACEP) is working to address barriers to treating opioid use disorder in emergency departments across the country. ACEP, an ORN partner, has developed new trainings, podcasts and a mobile app, all aimed at its 38,000 members.
The Collection of Opioid Response Network Brochures is Growing. At OpioidResponseNetwork.org you will find new prevention, recovery and American Indian/ Alaskan Native brochures.
Are You Interested in Exhibiting On Behalf of ORN? If so, please first check the exhibit tracking sheet to see if another party has already registered. If not, notify firstname.lastname@example.org and email@example.com. We are striving to avoid duplication and to also have TTSs exhibit as much as possible as it supports their role as the point person for each community. If you can not access the exhibit tracking sheet, please let Jane or Nic know.
and coordinate all efforts with the press through them. SAMHSA wants to make sure we are consistent in our message and it gives Jane and Nic an opportunity to help track and highlight for the website and newsletter. They are also available to help to prepare.
On Tuesday September 24th, the University of New England Student Chapter of AOAAM held an opioid overdose response training put on by the Portland, Maine Public Health Department for students from all the health profession schools as well as undergraduates. It was extremely helpful to hear from those who are in the midst of the crisis how we can all be prepared for such an event. They provided an inside perspective into how Maine is approaching this overwhelming issue.
Catherine Frye on behalf of University of New England Student Chapter of AOAAM
By Kathleen T. Brady
In response to the opioid epidemic in the U.S., cities, counties, states, insurers, and medical groups have filed more than 2,000 lawsuits seeking to hold pharmaceutical companies accountable for it. Those lawsuits are now consolidated in front of a single judge in Ohio who must decide how the billions of dollars in settlements should be used. Opinions abound on how this money should be spent.
In the midst of this discussion, we shouldn't miss the tragic reality that we are still losing 130 lives every day as a result of opioid overdoses.
That's why I, on behalf of five organizations representing physicians and experts on the front line of this crisis, urge that money garnered from the opioid settlement be used to directly combat the opioid crisis through three main approaches:
Treatment and prevention efforts desperately need financial support. Between 2009 and 2012, state budget cuts to mental health and addictions services amounted to $5 billion and have never recovered since. An abundance of evidence shows that these services actually make a difference. Numerous studies, for example, indicate that medications for addiction treatment significantly reduce the risk of overdose, relapse, and other health and social outcomes of opioid addiction.
But partly due to lack of funding, only about 10% of the 2 million Americans with substance use disorders receive treatment for them. And while the federal government recently announced some funding for access to evidence-based treatment for individuals with opioid use disorders, it's a short-term investment with an unclear future.
In spite of what we now know about treatment and its effectiveness, we can learn much more. Exciting advances in neuroscience have identified neural pathways underlying addictions and pain that can be used to develop new therapeutic interventions, but the pathway from basic discovery to everyday usage is costly. At a systems level, health services research can help transform and reshape the treatment system, making it more accessible and effective. And there is much more we can discover about preventing substance use disorder in the first place.
Most physicians and other health care providers receive only basic training in the prevention, recognition, and treatment of addiction and the care of pain. Lack of provider preparedness in these areas has been partially blamed for the limited response to the opioid crisis. Meanwhile, there is a dearth of qualified addiction treatment specialists. Funding from the opioid settlement should be dedicated toward extending the workforce capacity through additional addiction psychiatry and addiction medicine fellowships, as well as better training for health care providers in general on addiction and pain care.
The historic $246 billion Tobacco Master Settlement Agreement in 1998 was supposed to support treatment and prevention of smoking. But it mostly wound up covering state budget shortfalls, subsidizing tax cuts, and supporting general services. In fact, according to a report from the Campaign for Tobacco-Free Kids, 20 years after the settlement states had spent only 2.6% of the settlement revenue on smoking prevention and cessation programs.
It would be a shame not to use the opioid settlement to help the people who are living with this public health emergency across our country. The money from any forthcoming opioid settlement must be applied to the problem — to help victims of opioid and other substance use disorders through access to evidence-based care, research, and training.
Kathleen T. Brady, M.D., Ph.D., is professor of medicine and vice president for research at the Medical University of South Carolina, and president and chair of the International Society of Addiction Medicine's executive committee. The views expressed here are shared by the American College of Academic Addiction Medicine, the American Academy of Addiction Psychiatry, the American Psychiatric Association, the American Osteopathic Academy of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction. The American Academy of Addiction Psychiatry does not accept funds from pharmaceutical companies to support its educational programming, scientific program, seminars, or print materials. In 2016, Biodelivery Sciences was among the exhibitors at the academy's annual meeting in 2016, and Orexo was an exhibitor in 2018; both companies manufacture addiction treatments as well as opioid pain medications. The American Psychiatric Association receives funding from some pharmaceutical companies, including those that manufacture opioid analgesics, via advertising in its publications and at its meetings in the form of exhibits, sponsorships; or product theaters; those areas are segregated from the association's educational activities.
SAMHSA’s 2019 National Recovery Month Webinar – Strong Community, Strong Recovery.
Friday, September 20, 2019 - 12:00 PM EDT
Join SAMHSA’s Recovery Month webinar, Strong Community, Strong Recovery. This webinar will focus on how health practitioners, families, and individuals can implement community resources to maintain recovery for persons with mental and substance use disorders, as well as why fellowship sustains recovery.
Deaths involving synthetic opioids in the United States increased from roughly 3,000 in 2013 to more than 30,000 in 2018 and synthetic opioids are now involved in twice as many deaths as heroin. This book offers a systematic assessment of the past, present, and possible futures of synthetic opioids in the United States. The goal is to provide decision-makers, researchers, media outlets, and the public with information to better understand the synthetic opioid problem and how to respond to it.
Recovery Month is a national observance held every September to educate Americans that substance use treatment and mental health services can enable those with mental and substance use disorders to live healthy and rewarding lives. Now in its 30th year, Recovery Month celebrates the gains made by those in recovery.
This is an official
CDC HEALTH ADVISORY
Distributed via the CDC Health Alert Network
August 30, 2019, 9:35 AM ET
Severe Pulmonary Disease Associated with Using E-Cigarette Products
The Centers for Disease Control and Prevention (CDC) is providing: 1) background information on the forms of e-cigarette products, 2) information on the multistate outbreak of severe pulmonary disease associated with using e-cigarette products (devices, liquids, refill pods, and cartridges), and 3) clinical features of patients with severe pulmonary disease. This health advisory also provides recommendations for clinicians, public health officials, and the public based on currently available information.
E-cigarettes typically contain nicotine, most also contain flavorings and other chemicals, and some may contain marijuana or other substances. They are known by many different names and come in many shapes, sizes and device types. Devices may be referred to as “e-cigs,” “vapes,” “e-hookahs,” “vape pens,” “mods,” tanks, or electronic nicotine delivery systems (ENDS). Some e-cigarette devices resemble other tobacco products such as cigarettes; some resemble ordinary household items such as USB flash drives, pens, and flashlights; and others have unique shapes. Use of e-cigarettes is sometimes referred to as “vaping” or “juuling.” E-cigarettes used for dabbing are sometimes called “dab” pens.
E-cigarettes can contain harmful or potentially harmful substances, including nicotine, heavy metals (e.g., lead), volatile organic compounds, and cancer-causing chemicals. Additionally, some e-cigarette products are used to deliver illicit substances; may be acquired from unknown or unauthorized (i.e., “street”) sources; and may be modified for uses that could increase their potential for harm to the user. For example, some e-cigarette pods or cartridges marketed for single use can be refilled with illicit or unknown substances. In addition, some e-cigarette products are used for “dripping” or “dabbing.” Dripping involves dropping e-cigarette liquid directly onto the hot coils of an e-cigarette which can result in high concentrations of compounds (e.g., tetrahydrocannabinol [THC] and cannabinoid compounds). Dabbing involves superheating substances such as “budder”, butane hash oil (BHO), and “710” that contain high concentrations of THC and other plant compounds (e.g., cannabidiol [CBD]).
Youth, young adults, pregnant women, as well as adults who do not currently use tobacco products should not use e-cigarettes. E-cigarettes containing nicotine have the potential to help some individual adult smokers reduce their use of and transition away from cigarettes. However, e-cigarettes are not currently approved by the Food and Drug Administration (FDA) as a quit smoking aid, and the available science is inconclusive on whether e-cigarettes are effective for quitting smoking.
As of August 27, 2019, 215 possible cases have been reported from 25 states and additional reports of pulmonary illness are under investigation. One patient (in Illinois) with a history of recent e-cigarette use was hospitalized on July 29, 2019 with severe pulmonary disease and died on August 20, 2019. Although the etiology of e-cigarette-associated pulmonary disease is undetermined, epidemiologic investigations in affected states are ongoing to better characterize the exposures, demographic, clinical, and laboratory features and behaviors of patients. All patients have reported using e-cigarette products. The exact...... Read More
In a video presentation released with the NSDUH report, Elinore F. McCance-Katz, MD, PhD, Assistant Secretary for Mental Health and Substance Use, highlighted the State Targeted Response Technical Assistance grant. Dr. McCance-Katz says the Opioid Response Network "puts teams in every state to address the needs of that state as it relates to opioid issues." She underscored that the "program has had over 1,000 requests already and those requests have all been met to meet the needs of Americans living with opioid issues."
The NSDUH report helps to guide policy directions and decision-making about what types of resources are needed and where resources should be directed. For example, NSDUH's 2016-17 report found that SAMHSA efforts only provided technical assistance to grantees, and the number of grantees was low compared to the number of practitioners, community members and others who need access to information. So, SAMHSA expanded training and technical assistance nationally.
Read other news in the ORN Bulletin.
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