America is confronted with surging overdose deaths in historically and continually marginalized communities. How will we respond?

December 21, 2021, East Providence, RI --Recent data analysisi bears truth to previously anecdotal reports of surging overdose deaths. This research is also exposing how ongoing structural racism is resulting in disproportionately high rates of overdose deaths within historically and continually marginalized communities. The Covid-19 pandemic is exacerbating this reality.

The research (Friedman & Hansen, 2021): Black overdose mortality overtook that of White overdose mortality in 2020 for the first time since 1999. Rates were 16.3% higher for Black individuals than White individuals in the same period. American Indian and Alaska Native individuals experienced the highest rate of overdose mortality in 2020. Rates for this populations were 30.8% higher than the rate for White individuals. Why? Health disparities resulting from structural racism spur increased drug overdose mortality within Black and Native communities.ii

STATEMENTS FROM OPIOID RESPONSE NETWORK WORKGROUP CHAIRS

Addressing opioid and stimulant use disorders within Black and Native Communities can't be achieved with a one size fits all approach. To this end, the Opioid Response Network, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), relies on its expansive, diverse array of consultants and workgroups.

"There has always been a severe gap in efforts to reach Black communities to address substance use disorders. This is alarming in the face of evidence that rates of overdose deaths in these communities outpace other populations. However, just reaching Black communities is not sufficient in-and-of-itself. Engagement must be tailored to meet individual and community identified needs. Working together we can identify and address health disparities and change the direction of these frustrating statistics."

Opioid Response Network Black Communities Workgroup Co-Chairs: Tracie Gardner, Senior Vice President of Policy Advocacy, Legal Action Center, and Myra Mathis, MD Senior Instructor of Psychiatry, Addiction Psychiatrist, Department of Psychiatry, University of Rochester

"For over 500 years, Native communities have been faced with relocation, forced assimilation, and attempts at genocide resulting in generations of historical trauma. This set the stage for the current opioid and stimulant epidemics and the increasing rate of mortality from overdose in Native communities that new research has exposed. Recognizing that conventional efforts to address this have been compromised from issues including disparities in healthcare access, it is clear new strategies are needed that center solutions within Native communities and provide consultation and resources to support these efforts. Through culturally informed education and training delivered in partnership with diverse Native communities, we can make a difference."

Opioid Response Network Indigenous Communities Workgroup Co-Chairs: Holly Echo-Hawk, MSc (Pawnee), and Aimee Campbell, PhD, Associate Professor of Clinical Psychiatric Social Work, Columbia University Irving Medical Center

"LGBTQ+ people face intersecting racism, discrimination, and stigma that can lead to elevated rates of substance use and mortality from overdose. LGBTQ+ people also often face health disparities as a result of structural racism, which is a key factor in increasing mortality rates in Black and Native communities. Culturally informed education and training, which the Sexuality and Gender Diversity Workgroup supports, is key to addressing increasing overdose mortality rates and for all people with substance use disorders."

Opioid Response Network Sexuality and Gender Diversity Workgroup Co-Chairs: Jeremy Kidd, MD, MPH, Assistant Professor of Clinical Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute, and Margaret Paschen-Wolff, DrPH, MSW Assistant Professor of Clinical Psychiatric Social Work, Columbia University Irving Medical Center & New York State Psychiatric Institute

To supplement efforts taking place across the country and U.S. territories to address opioid and stimulant use disorders and the overdose crisis, the Opioid Response Network's coalition of national organizations and individuals is providing no cost education and training. To ensure cultural responsivity and acknowledging and actively working to dismantle the structures which uphold health disparities, Opioid Response Network's workgroups advise on all activities facing historically and continually marginalized communities. Visit OpioidResponseNetwork.org for more information and to submit a request for training and education to enhance your efforts and meet your needs. Email orn@aaap.org with questions.

About the Opioid Response Network

The Opioid Response Network (ORN) was established through Substance Abuse and Mental Health Services Administration funding awarded to the American Academy of Addiction Psychiatry working collaboratively with the Addiction Technology Transfer Center Network, at the University of Missouri - Kansas City, Columbia University Division on Substance Use Disorders and 40 national organizations. ORN provides education and training in the prevention, treatment and recovery of opioid and stimulant use disorders at the local level and at no cost.

For more information, contact:
Nicholas Canning
Sr. Project Manager
Opioid Response Network
nic@aaap.org | 401-270-1173

Treating HIV and Substance Use Disorders in Gay Black Men

Opioid Response Network (ORN) trainings that help others address racism and homophobia for better outcomes

Benjamin Nguyễn, MSW, ASW, CPH, is ORN’s representative for the American Southwest. If you’re in New Mexico, Arizona or Nevada and seek out ORN for education and training, it’s Ben on the other end of the line. Recently, Ben received a request for training from the Nevada Pacific AIDS Education and Training Center. “They were preparing for their annual conference for HIV care providers and were looking for a speaker on best practices for substance use disorder treatment and recovery with a focus on the LGBTQ+ community and racial disparities. It was a perfect fit for ORN,” said Ben.

For the job Ben worked closely with ORN Advanced Implementation Scientist Larry Bryant, PhD, MPH, BSW, RRT. Dr. Bryant crafted a training to share immediate actions and long-term strategies to apply to their work. This included affirmative language to use when communicating with patients; education on how to structure specific situations so that LGBTQ+ patients feel comfortable in sharing private information; and how best to engage this population in treatment. “It was also largely a discussion on common life experiences that often influence the behaviors of gay Black men. Providers need to understand where these patients are and then meet them there in order to effectively address their treatment and recovery needs,” shared Dr. Bryant. Read more.

Training and education from ORN is designed to be culturally intelligent. To help improve practice standards, ORN established several workgroups including the Sexuality and Gender Diversity Workgroup and Black Communities Workgroup. Would you like to learn about how these multi-disciplinary teams can help your efforts? Email orn@aaap.org with a specific question.

UPCOMING TRAININGS AND ORN EDUCATIONAL RESOURCES

If an opportunity listed below sparks interest, but you have questions or are not quite sure how it could fit into your own plans, email orn@aaap.org. We can help! Stay tuned to ORN's evolving events page for upcoming opportunities. All ORN trainings are free.

TAILORD ON DEMAND TRAININGS: Making Sense of the Federal Health Privacy Laws

Free training opportunities for individuals and networks that provide or administer substance use disorder services

Multiple federal laws, including HIPAA and 42 CFR Part 2, protect the confidentiality of substance use disorder treatment information. These laws permit sharing patient records in certain circumstances — however, it can be hard to understand when they apply, what information should be kept private, what can be shared, with whom, and when. With funding from ORN, ORN partner organization CAI will be conducting a limited number of free virtual trainings regarding health privacy laws. These tailored trainings will address common questions about health privacy laws and their application in practice. See here for more information and information on how to request a training. 

TAILORD ON DEMAND TRAININGS: ToxIC Novel Opioid and Stimulant Exposures

Free training opportunities with medical toxicologists for individuals and organizations

The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of approximately 800 physicians with recognized expertise in medical toxicology. Medical toxicologists are specially trained physicians who diagnose, treat, manage, and prevent human poisonings, such as overdoses from prescribed or illicit drugs, including opioids and novel psychoactive substances. As an ORN partner organization, ACMT is providing tailored trainings about novel opioid cases through the use of the Toxicology Investigators Consortium (ToxIC) Core Registry, a multi-center surveillance network that includes cases submitted by medical toxicologists after formal consultation of patients who presented in the acute care setting with an overdose or toxic exposure. Do you have questions? For more information or to coordinate your own tailored training, email Dr. Kim Aldy at Kim.Aldy@acmt.net.

Upcoming Training and Training of Trainers:
Peer Support for Pregnant and Parenting Families

Training scheduled for January 4 and 5, 2022
Training of Trainers scheduled for January 25 and 26, 2022

This ORN-funded training developed by the Addiction Technology Transfer Center will prepare Peer Recovery Support Specialists to meet the diverse needs of pregnant and parenting families in early recovery. Recovery and parenting both occur in the context of relationships. This training is designed to help participants build skills to support/ strengthen families as they grow and develop in their roles as nurturing parents. The Training of Trainers will prepare the participants to teach the Providing Peer Based Recovery Support Services for Pregnant and Parenting Families curriculum. More information can be found here.

Faces & Voices of Recovery Learning Community
Begins January 5, 2021 (note multiple events)

This free Virtual Learning Community (VLC) is funded by ORN and developed and coordinated by Faces & Voices of Recovery. The VLC features a series of six 1-hour sessions with subject matter experts on a bi-weekly basis. Series for Cohort One begins Jan. 5, 2022. The format for each session includes a brief presentation on the topic and then a discussion and Q&A session with the presenter. Register once for the entire series; attendance at all 6 sessions is highly encouraged.

See here for more information and to register.

Training: Stimulants 101
January 12, 2021

The ORN-funded training from the Boston Medical Center is designed to provide an overview of stimulant use disorder for all healthcare organization staff including providers, nurses, counselors and other non-clinical staff. The training reviews stigma, identifying stimulant overdose, managing acute stimulant intoxication, de-escalation techniques, and evidence-based treatment for people who use stimulants. See here for more information and to register. 

Training: Initiation of Medications for Opioid Use Disorder
January 14, 2021

The final session in National Alliance for HIV Education and Workforce Development's Bridging HIV, HCV, & SUD: Innovations in the Field 7-part webinar series, Initiation of Medications for Opioid Use Disorder, will be on Friday, January 14th, at 12 pm ET. In order to effectively end the HIV epidemic in the United States, providers who care for people with or at-risk for HIV need to be equipped to effectively identify and treat opioid use disorder. This ORN funded presentation will provide practical guidance on the use of medications for opioid use disorder. See here for more information and to register. 

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

From the U.S. Food and Drug Administration:

The US Food and Drug Administration’s Controlled Substances Program is holding a virtual information session on research funding to improve scientific understanding of psychedelics. 

During the session, we will provide information about FDA’s recent activities regarding psychedelics, and we will share how the upcoming research funding opportunity fits into our work. We will also give a brief overview of the Controlled Substances Program, which aims to promote the public health by minimizing risks associated with problematic use of controlled substances while enabling appropriate access for medical use.

The session will take place on Friday, December 17^th at 11.05 AM EST. RSVPs will be accepted to CDERCSP@fda.hhs.gov on a first-come, first-served basis no later than 12/15/21. If you are unable to attend but would like to learn more, please email CDERCSP@fda.hhs.gov to receive a recap email after the information session. 

Demonstrating the Value of Recovery Housing: Expert Panel Findings

In January 2021, the National Council for Mental Wellbeing, with funding from ORN, hosted a technical expert panel to explore ways to best demonstrate the value of recovery housing in the United States. Recovery housing refers to safe, healthy, alcohol and drug-free living environments that support individuals in recovery from substance use disorders. The panel reviewed the current recovery housing landscape and identified areas for improvement. They discussed:

• What's missing from the current recovery housing framework?
• What strategies can be implemented to bridge the cultural divide between the social model (recovery housing) and the medical model (treatment)?
• What are the current opportunities and limitations in the funding of recovery housing? What is an ideal funding model for recovery housing?
• What policies and systems should be implemented to create a more cohesive recovery housing ecosystem?

At the conclusion of the panel, recommendations were identified and next steps proposed to strengthen the system in an effort to build the recovery housing network and demonstrate the value of the service. The report developed as a result identifies key strategies and recommendations. Request access for it (asking for the Demonstrating the Value of Recovery Housing: Expert Panel Findings Report) by submitting a request at OpioidResponseNetwork.org. It just takes a minute and your local ORN Technology Transfer Specialist can share it (at no cost to you) and provide you with additional educational resources and training to meet your needs and enhance your work as it relates to services for people in recovery from opioid and stimulant use disorders.

Training: Advancing Racial Equity in the Substance Use Field

ORN is committed to supporting the integration of racial equity across substance use disorder prevention, treatment, recovery and harm reduction, and offers workshops, education, training and consultation for all your diversity and racial equity capacity building efforts. ORN funded racial equity trainings focused on the substance use field include:

1. Developing a Shared Language For Diversity, Equity and Inclusion (90 minutes)
2. Systemic Racism and Substance Use Disorder: Anti-Racist Strategies (2 hours)

These two trainings are available live (in person or online) and/or offered as a (pre-recorded) self-pace workshop you can do individually, as a team, or across your organization. Learn more.

Training: Waiver Trained: Now What? The Nuts and Bolts of Addiction Treatment

This ORN funded training from Boston Medical Center, an ORN partner organization, will provide waivered prescribers with the skills needed to implement office-based addiction treatment into an ambulatory practice setting. Additionally, this talk will provide expert, concrete tips to facilitate the provision of care for patients with substance use disorders utilizing medications in their treatment. Intended audience: Prescribers who have recently obtained their X-Waiver (or who are contemplating getting their waiver) and are looking to increase provision of care for patients with substance use disorder in an outpatient setting. Register here.

Training: Bluegrass Care Clinic: Coordinated Team-Based Approach to Opioid Treatment with HIV Primary Care 
Friday, November 12, 2021 at 12 PM EST

The 5th session in the National Alliance for HIV Education and Workforce Development's Bridging HIV, HCV, & SUD: Innovations in the Field 7-part webinar series will be held on Friday, November 12, 2021 at 12 PM EST. Bluegrass Care Clinic: Coordinated Team-Based Approach to Opioid Treatment with HIV Primary Care will share the steps the team took to identify gaps in care related to the opioid epidemic and discuss successful approaches. Register here. Funded by ORN.

Toolkit: Working with People with Intellectual and Development Disabilities who Struggle with Substance Use Disorders

Upcoming: The Working with People with Intellectual and Development Disabilities who Struggle with Substance Use Disorders toolkit is the result of a roundtable discussion that brought together professionals from the substance use disorder services and intellectual/developmental disabilities services fields in Iowa, Nebraska, Missouri and Kansas. During the roundtable professionals shared ideas and identified gaps in communication and services for people living with both a substance use disorder and an intellectual and developmental disability. This toolkit provides resources and tools to serve individuals living at this intersection in your community. It was developed with ORN funding and in partnership with the Mid-America Addiction Technology Transfer Center and the Institute for Human Development. The toolkit will be available soon. Request access by submitting a request at OpioidResponseNetwork.org using the toolkit's name. 

Read more

Reminder: Virtual Meet and Greet with the Opioid Response Network Sexuality and Gender Diversity Workgroup

ORN's Sexuality and Gender Diversity Workgroup (formally called the LGBTQ+ Workgroup) virtual meet and greet will be held on October 22, 2021 at 12:00 PM EST.This Friday! Members will be sharing how the workgroup supports ORN’s mission to help you help others reach LGBTQ+ communities facing opioid and stimulant use struggles and how to access ORN as a free resource. Learn more and register for the meet and greet. 

One Way to Overcome Substance Use Disorder as a Barrier to Financial Aid for Working Families

Awareness

Dear Opioid Response Network Community: The Child Tax Credit in the American Rescue Plan provides the largest Child Tax Credit ever and historic relief to the most working families ever. This program is reaching most American families with automatic monthly payments without them having to take any action and it is a key strategy to lift many out of poverty. Reaching even more families continues to be a national priority and awareness is critical, especially in reaching families who have not filed taxes recently and therefore need to sign up themselves to receive payments. Today, we ask for this community’s support in sharing this message with your members, within your practices and at all junctures where our work directly reaches individuals and families impacted by substance use disorders. Let's reach and help more families. 

Research shows us that poverty can lead to substance use disorders, including opioid and stimulant use issues. Research also shows that drug-related death rates have been seen to be significantly higher in poorer areas and in areas with high levels of family distress. To this end, programs like the Child Tax Credit offer an important strategy to address a key social determinate of health for individuals who are at risk for opioid or stimulant use and their families. Assisting families in obtaining resources such as early childhood education, welfare benefits and adult education has been a frequent call to action during many Opioid Response Network training events. But addressing barriers for non-filers (individuals who have not filed taxes recently) in particular presents clear challenges. We ask that you share these outreach materials as broadly as possible. Together – we can make a difference!

Upcoming Trainings and New ORN Educational Resources

Harm Reduction Through a Prevention Lens

Learning Collaborative in Session: Integrated Treatment for Individuals with Co-Occurring Substance Use Disorders and Serious Mental Illness

The American Psychiatry Association, an ORN partner organization, is hosting an ORN-funded online learning collaborative called Integrated Treatment for Individuals with Co-Occurring Substance Use Disorders and Serious Mental Illness, which is being led by Ken Minkoff, MD, Senior System Consultant, ZiaPartners, Inc., Part-time Assistant Professor of Psychiatry, Harvard Medical School. Open now through November 21, 2021, this collaborative serves as a virtual community for participants working in settings serving people with serious mental illness (SMI) to understand how to implement the routine delivery of integrated mental health/substance use disorder services to individuals with SMI, co-occurring substance use conditions (with a particular focus on co-occurring opioid use disorder), and other complex needs, within their own practice, their own program, and their own agency.

Harm Reduction Through a Prevention Lens

New resource within the ORN's repository: Harm Reduction Through a Prevention Lens. This one-page information sheet, developed by the Prevention Technology Transfer Center, provides a brief overview of harm reduction and its connection with prevention. It also includes basic harm reduction strategies for commonly used substances and viral infections that are a heightened risk for people who use substances. Submit a request today for access at OpioidResponseNetwork.org. Your local Technology Transfer Specialist can not only provide access, but, as your local champion, provide you with a range of related education and training support. 

Substance Use Disorders in the LGBTQ Population

New presentation within the ORN's repository: Substance Use Disorders in the LGBTQ Population. This presentation tool examines understanding of why sexual minorities are at increased risk for substance use disorders; epidemiology of substance use disorders with a focus on methamphetamine use; recommendations for substance use disorder treatment in the LGBTQ population; and more. If you would like a similar, but tailored training, for your community, staff, etc., submit a request today at OpioidResponseNetwork.org and your local Technology Transfer Specialist will be in touch within one business day.

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

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Providing Affirming Care for LGBTQ+ People in Substance Use Treatment Settings

In the last addition of the Bulletin we shared that Columbia University Department of Psychiatry Division on Substance Use Disorders has created a one-of-a-kind, web-based training funded by ORN that will help substance use disorder treatment providers deliver more affirming care to their LGBTQ+ clients. This course has since launched and is available to access, and benefit from, at no cost. Authors: Margaret Paschen-Wolff, DrPH, MSW; Jeremy D. Kidd MD, MPH; Avery DeSousa, BA; Theresa V. Navalta, BA; and the Community Advisory Board. Duration: 1 - 1.5 hours. Access here.

How else can ORN support your efforts in delivering affirming care for LGBTQ+ people? ORN's Sexuality and Gender Diversity Workgroup (formally known as the LGBTQ+ Workgroup) is coordinating a virtual “Meet and Greet” aiming to introduce you and your organization to the workgroup's members and share how the workgroup supports ORN’s mission to help you help others reach LGBTQ+ communities facing opioid and stimulant use struggles. Learn how to access ORN as a free resource to receive support in providing affirming, culturally intelligent and evidence-based education and trainings around substance use. Register here for the Meet and Greet. 

Deadly Adulterants: Another Threat from the Opioid Epidemic

The American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (ToxIC) is identifying and reporting on novel and emerging opioid and stimulant exposures for ORN every quarter. ACMT is an ORN partner organization. The latest in the series of reports is titled "Deadly Adulterants: Another Threat from the Opioid Epidemic."

Adulteration and contamination of illicit drugs has long been a potential hazard for people who use both sporadically and chronically. Over the centuries, clusters of illness tied to specific adulterants can be found in historical descriptions. For example, in 1982 four young adults living around San Jose, CA developed Parkinson’s like movements after intravenous illicit opioid drug use. The substance was tested and found were byproducts of the production of a synthetic “street heroin” that was newly emerging in northern California at the time. Read the full report here. Past reports here.

Adverse Childhood Experiences (ACEs) Data Spotlight

 The increased accessibility to prescription pain medications over the last 20 years has made it easier for adolescents to engage in opioid misuse and, subsequently, be at heightened risk for opioid use disorder and related adverse outcomes. As a result, it is important to identify risk factors for opioid misuse to inform prevention and treatment efforts among children and adolescents. Recent research has highlighted a significant relationship between adverse childhood experiences (ACEs) and subsequent opioid misuse among adolescents. Specifically, findings show that adolescents who are exposed to five or more ACEs are 15 times more likely to report recent opioid misuse. In total, over 70% of recent opioid misuse is attributed to previous childhood adversity.

Past Month Opioid Misuse Among Adolescents, by Number of ACEs

[Source: Swedo, E. A., Sumner, S. A., de Fijter, S., Werhan, L., Norris, K., Beauregard, J. L., ... & Massetti, G. M. (2020). Adolescent opioid misuse attributable to adverse childhood experiences. The Journal of Pediatrics, 224, 102-109.]

How is ORN Responding? ORN responds to technical assistance requests from individuals, organizations (and anyone!) specific to ACEs both in-person and virtually. These requests and subsequent action result in training, educational materials, and strategic planning which spans prevention, treatment and recovery. For example, ORN conducted a webinar on the association between ACEs and criminal justice involvement. This presentation highlighted the extent to which ACE trauma has been linked to challenges with brain development in adults and subsequent behavioral health issues. For example, a study of California’s prison population reported that over half of inmates had experienced ACEs. For access to this resource (all at no cost) or to coordinate your own training submit a request at OpioidResponseNetwork.org.

This data spotlight is part of a series brought to the Bulletin by ORN partner organization, RTI International.

Upcoming Education and Training Opportunities

Medication for Opioid Use Disorder (MOUD) Implementation Guides for Probation and Parole

Justice System Partners, in a partnership with the Brown University School of Public Health, and with ORN funding, is developing a suite of resources and practical tools for implementing MOUD in criminal justice settings. A series of guides for community corrections work are now available. The series is for individuals trying to ignite (or re-ignite) an interest in using or expanding the use of MOUD within communities, and specifically within probation and parole. Contact your local ORN representative by submitting a request at OpioidResponseNetwork.org for access to the guides - provided at no cost.

AUGUST 27, 2021• PRESIDENTIAL ACTIONS

The overdose epidemic has taken a toll on far too many Americans and their loved ones.  Addiction is a disease that touches families in every community, including my own.  The epidemic is national, but the impact is personal.  It is personal to the millions who confront substance use disorder every day, and to the families who have lost loved ones to an overdose. 

During Overdose Awareness Week, we recommit to taking bold actions to prevent overdoses and related deaths, and enhance our support for individuals with substance use disorders.

In recent years, we have seen synthetic opioids, such as illicitly manufactured fentanyl, drive many overdose deaths with cocaine- and methamphetamine-related deaths also increasing at alarming rates.  The COVID-19 pandemic has exacerbated the overdose epidemic, as necessary pandemic restrictions made it harder for individuals with addiction to receive the treatment and support services they need.  These factors contributed to the more than 93,000 drug overdose deaths in 2020.  As a Nation, we need a strong response to America’s overdose epidemic and an investment in prevention, harm reduction, treatment and recovery services, as well as strategies to reduce the supply of illicit drugs.  

While drug overdose and addiction affect many different communities across the United States, we also recognize the longstanding inequities experienced by people of color, people who identify as LGBTQ+, formerly incarcerated individuals, people experiencing homelessness, and others.  For too many years, these communities have faced disparate access to health care, differential treatment in the criminal justice system, and poorer health outcomes. 

My Administration is committed to addressing addiction and the overdose epidemic with evidence-based strategies.  In April, to ensure that the Federal Government is promoting evidence-based public health and safety interventions, the Office of National Drug Control Policy released my Administration’s first year drug policy priorities.  These include expanding access to prevention, treatment and harm reduction efforts, reducing youth substance use, reducing the supply of illicit substances, advancing recovery-ready workplaces, and expanding the addiction workforce and access to recovery support services for all Americans.  My Administration is also committed to eliminating racial disparities in responding to the overdose epidemic as well as reviewing the overall approach to drug policy.

This effort requires significant investments in our health care infrastructure.  In my American Rescue Plan, we provided crucial funding for substance use disorder treatment and harm reduction, including a nearly $4 billion investment in our Nation’s behavioral health infrastructure.  This includes $30 million for a new Substance Abuse and Mental Health Services Administration grant program to support community-based efforts aimed at preventing overdoses and reducing harm associated with substance use. 

We also recognize that many of our brave veterans recovering from service injuries may be vulnerable to opioid addiction.  I signed the Dispose Unused Medications and Prescription Opioids Act to ensure that Veterans Affairs facilities provide locations to dispose controlled substances in a safe, secure and supportive environment. 

Agencies across the Federal Government are also making significant strides in supporting individuals with substance use disorders.  The Department of Health and Human Services continues to work on expanding access to evidence-based treatment, including a new policy to expand access to buprenorphine, a medication for the treatment of opioid use disorder.  The Drug Enforcement Administration also issued a new rule that allows more opioid use disorder treatment programs to operate mobile components to better serve rural and underserved communities.  These actions are only the beginning.  My Administration will be taking additional actions to reduce barriers to life-saving treatment and expand access to prevention, harm reduction, and recovery support services.

Overdose Awareness Week provides us an opportunity to recommit ourselves to addressing this epidemic.  By enhancing our support for individuals facing substance use disorder we can save lives. 

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim August 29 through September 4, 2021, as Overdose Awareness Week.  I call upon citizens, government agencies, organizations, healthcare providers, and research institutions to raise awareness of substance use disorders to combat stigma, to promote treatment and celebrate recovery, and to strengthen our collective efforts to prevent overdose deaths.  August 31st also marks Overdose Awareness Day, on which our Nation mourns the lives lost to the drug overdose epidemic.  

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-seventh day of August, in the year of our Lord two thousand twenty-one, and of the Independence of the United States of America the two hundred and forty-sixth.

JOSEPH R. BIDEN JR

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.

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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.