Medications for Opioid Use Disorder. Charles Brackett, MD, MPH General Internal Medicine, DHMC

Size: px
Start display at page:

Download "Medications for Opioid Use Disorder. Charles Brackett, MD, MPH General Internal Medicine, DHMC"

Transcription

1 Medications for Opioid Use Disorder Charles Brackett, MD, MPH General Internal Medicine, DHMC

2 Opioid Related Deaths are on the Rise in the US National Vital Statistics System Mortality File

3 Deaths are the tip of the iceberg SAMHSA NSDUH, DAWN, TEDS data sets Coalition Against Insurance Fraud. Prescription for Peril. 3

4 Vivek Murthy, M.D., M.B.A. Surgeon General 12/14-4/17 Substance use disorders are one for the most pressing public health crises of our time. They prevent people from living healthy and productive lives and have profound effects on families, friends, and entire communities. We need a cultural shift: addiction is not a character flaw or moral failing. It is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer. 4

5 Hijacking the Brain

6 Withdrawal Normal Euphoria Natural History of Opioid Use Disorder Tolerance & Physical Dependence Acute use Chronic use

7 Drug Dependence, a Chronic Medical Illness -McLellan, JAMA 10/4/02 Acute care paradigm inappropriate Comparable to asthma, htn, DM2 re: Genetic heritability (~50% for OUD) Role of personal responsibility, environment Goal is not cure, but remission/reduction in harms Effective medications are available But only 10-20% of those who need treatment get it Outcomes expectations and measures

8 Medication Assisted Therapy Full MU Agonist: Methadone Partial MU Agonist: Buprenorphine MU Antagonist: Naltrexone Naltrexone has the highest receptor BINDING AFFINITY, then buprenorphine, then methadone

9

10 Naltrexone Opiate receptor antagonist- no effect on craving or withdrawal Can work for patients who are highly motivated or legally mandated to be abstinent in closely supervised settings milder OUD In occupations not permitting OAT: driving, medical Oral: No better than placebo, due to poor adherence Probation: 70% less opiate use, 50% less reincarceration Medical personnel Injectable monthly form: Vivitrol Limited data, low quality studies No head to head trials, until.

11

12 Withdrawal Normal Euphoria Opioid Agonist Therapy (OAT) Methadone & Buprenorphine Tolerance & Physical Dependence OAT Acute use Chronic use

13 OUD is associated with a 10x increase in mortality OAT reduces all cause mortality by 70% reduces overdose mortality by 80% Mortality risk in the 4 weeks immediately after cessation of treatment is high (>30/1000 person years)

14 Opioid Agonist Treatment Improvements in: Illicit opioid use Other drug use Criminal activity Needle sharing and HIV transmission Pro-social activities Employment Mental health

15 Methadone Maintenance Full agonist gold standard : 50+ years Can only be administered through OTP Drawbacks: Weight gain, brain fog, hypogonadism Daily observed ingestion initially: transportation/availability for-profit clinics, risk by association Stigma

16 Buprenorphine Partial agonist with high binding affinity Ceiling effect: blocks effect of other opiates Safer: Overdose unlikely buprenorphine+naloxone (4:1) Generic sublingual pills Suboxone films, Bunavail, Zubsolv Probuphine (6mo implant), Sublocade (7 and 28 day sq)

17 Prescribing buprenorphine Need a special DEA # DATA 2000: MDs prescribe after 8 hour course CARA 2016: PAs and NPs prescribe after 24 hour course (as of 2/27/17) 30 first year, can then apply to go up to 100 Can prescribe in outpatient setting- PC, psych Greater access/availability, less stigma Schedule III- available in pharmacies: 30d with RF OK to use in hospital for intercurrent illness and dispense 3d without DEA X#

18 Buprenorphine: taper vs. maintenance Evidence: Psychosocial counseling PLUS Buprenorphine 60-75% pt still in treatment after 1 year Reduced HIV/Hep C infx Fewer ED and Hosp adm Johan Kakko, Kerstin Dybrandt Svanborg, Mary Jeanne Kreek, Markus Heilig.1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial.the Lancet Feb 22, 2003; (361)

19 MAT vs. PAP Of all the treatments, opioid agonist maintenance treatment is most effective and the most cost effective. Psychosocial service should be made available to all patients, although those who do not take up the offer should not be denied effective pharmacological treatment.

Buprenorphine as a Treatment Option for Opioid Use Disorder

Buprenorphine as a Treatment Option for Opioid Use Disorder Buprenorphine as a Treatment Option for Opioid Use Disorder Joji Suzuki, MD Assistant Professor of Psychiatry Harvard Medical School Director, Division of Addiction Psychiatry Brigham and Women s Hospital

More information

Medication-Assisted Treatment. What Is It and Why Do We Use It?

Medication-Assisted Treatment. What Is It and Why Do We Use It? Medication-Assisted Treatment What Is It and Why Do We Use It? What is addiction, really? o The four C s of addiction: Craving. Loss of Control of amount or frequency of use. Compulsion to use. Use despite

More information

Opioid Treatment in North Carolina SEPTEMBER 13, 2016

Opioid Treatment in North Carolina SEPTEMBER 13, 2016 Opioid Treatment in North Carolina SEPTEMBER 13, 2016 Source Where Pain Relievers Were Obtained for Most Recent Nonmedical Use among Past Year Users Aged 12 or Older: 2007 Source Where Respondent Obtained

More information

Overview of Medication Assisted Treatment Methadone, Buprenorphine and Naltrexone

Overview of Medication Assisted Treatment Methadone, Buprenorphine and Naltrexone Overview of Medication Assisted Treatment Methadone, Buprenorphine and Naltrexone Alexander Y. Walley, MD, MSc Associate Professor of Medicine Director, Addiction Medicine Fellowship Boston University

More information

Treatment Alternatives for Substance Use Disorders

Treatment Alternatives for Substance Use Disorders Treatment Alternatives for Substance Use Disorders Dean Drosnes, MD, FASAM Associate Medical Director Director, Chronic Pain and SUD Program Caron Treatment Centers 1 Disclosure The speaker has no conflict

More information

Addiction to Opioids. Marvin D. Seppala, MD Chief Medical Officer

Addiction to Opioids. Marvin D. Seppala, MD Chief Medical Officer Addiction to Opioids Marvin D. Seppala, MD Chief Medical Officer Mayo Clinic Opioid Conference: Evidence, Clinical Considerations and Best Practice Friday, September 30, 2016 26 y.o. female from South

More information

Kurt Haspert, MS, CRNP University of Maryland Baltimore Washington Medical Center

Kurt Haspert, MS, CRNP University of Maryland Baltimore Washington Medical Center Kurt Haspert, MS, CRNP University of Maryland Baltimore Washington Medical Center Data from the National Vital Statistics System Mortality The age-adjusted rate of drug overdose deaths in the United States

More information

Shawn A. Ryan MD, MBA President & Chief Medical Officer Board Certified, Addiction Medicine

Shawn A. Ryan MD, MBA President & Chief Medical Officer Board Certified, Addiction Medicine [Patient-focused, evidence-based addiction treatment] Shawn A. Ryan MD, MBA President & Chief Medical Officer Board Certified, Addiction Medicine BrightView Health All Rights Reserved www.brightviewhealth.com

More information

Medication Treatment and Opioid Use Disorder

Medication Treatment and Opioid Use Disorder Medication Treatment and Opioid Use Disorder Colleen T. LaBelle, MSN, RN-BC,CARN Program Director, Office-Based Addiction Treatment Director, STATE OBOT-B Boston Medical Center Disclosures I have no disclosures

More information

Opioids Research to Practice

Opioids Research to Practice Opioids Research to Practice CRIT Program May 2009 Daniel P. Alford, MD, MPH Associate Professor of Medicine Boston University School of Medicine Boston Medical Center 32 yo female brought in after heroin

More information

Medication Assisted Treatment for Opioid Use Disorders and Veteran Populations

Medication Assisted Treatment for Opioid Use Disorders and Veteran Populations Medication Assisted Treatment for Opioid Use Disorders and Veteran Populations Kamala Greene Genece, Ph.D. VP, Clinical Director Phoenix Houses of New York Benjamin R. Nordstrom, M.D., Ph.D. President

More information

FY17 SCOPE OF WORK TEMPLATE. Name of Program/Services: Medication-Assisted Treatment: Buprenorphine

FY17 SCOPE OF WORK TEMPLATE. Name of Program/Services: Medication-Assisted Treatment: Buprenorphine FY17 SCOPE OF WORK TEMPLATE Name of Program/Services: Medication-Assisted Treatment: Buprenorphine Procedure Code: Modification of 99212, 99213 and 99214: 99212 22 99213 22 99214 22 Definitions: Buprenorphine

More information

Latest Research on Addiction and Treatment

Latest Research on Addiction and Treatment Latest Research on Addiction and Treatment Joshua D Lee MD MSc joshua.lee@nyumc.org / @DrJoshuaDLee Associate Professor NYU School of Medicine, Department of Population Health Disclosures, LeeJD Grants:

More information

Opioids Research to Practice

Opioids Research to Practice Opioids Research to Practice CRIT/FIT 2016 April 2016 Daniel P. Alford, MD, MPH Associate Professor of Medicine Assistant Dean, Continuing Medical Education Director, Clinical Addiction Research and Education

More information

Opioids Research to Practice

Opioids Research to Practice Opioids Research to Practice CRIT Program May 2008 Daniel P. Alford, MD, MPH Associate Professor of Medicine Boston University School of Medicine Boston Medical Center 32 yo female brought in after heroin

More information

Opioids Research to Practice

Opioids Research to Practice Opioids Research to Practice May 2013 Daniel P. Alford, MD, MPH, FACP, FASAM Associate Professor of Medicine Assistant Dean, Continuing Medical Education Case 32 yo female brought in after heroin overdose

More information

MAT 101: TREATMENT OF OPIOID USE DISORDER

MAT 101: TREATMENT OF OPIOID USE DISORDER MAT 101: TREATMENT OF OPIOID USE DISORDER WITH SPECIAL EMPHASIS ON BUPRENORPHINE/NALOXONE ICADD May 22, 2018 Alicia Carrasco, MD Debby Woodall, LCSW, ACADC Magni Hamso, MD, MPH Terry Reilly Health Services

More information

6/6/2018. Objectives. Outline. Rethinking Medication Treatment for Opioid Use Disorder

6/6/2018. Objectives. Outline. Rethinking Medication Treatment for Opioid Use Disorder Rethinking Medication Treatment for Opioid Use Disorder International Conference on Opioids June 10, 2018 Dustin Patil, MD Fellow, Addiction Psychiatry Boston Medical Center John Renner, MD Professor of

More information

Agenda. 1 Opioid Addiction in the United States. Evidence-based treatments for OUD. OUD Treatment: Best Practices. 4 Groups: Our Model

Agenda. 1 Opioid Addiction in the United States. Evidence-based treatments for OUD. OUD Treatment: Best Practices. 4 Groups: Our Model Agenda 1 Opioid Addiction in the United States 2 Evidence-based treatments for OUD OUD Treatment: Best Practices 4 Groups: Our Model 2 Groups is a national network of clinics providing affordable, evidencebased

More information

2/21/2018. What are Opioids?

2/21/2018. What are Opioids? Opioid Crisis: South Carolina Responds Carolyn Bogdon, MSN, FNP-BC Coordinator for Emergency Department Medication Assisted Treatment Program Medical University of South Carolina Opioid Crisis: A Mounting

More information

Opioid Use Disorders as a Brain Disease Why MAT is so important. Ron Jackson, M.S.W., L.I.C.S.W.

Opioid Use Disorders as a Brain Disease Why MAT is so important. Ron Jackson, M.S.W., L.I.C.S.W. Opioid Use Disorders as a Brain Disease Why MAT is so important Ron Jackson, M.S.W., L.I.C.S.W. Affiliate Professor School of Social Work University of Washington Organization Name: CareOregon Course Title:

More information

The available evidence in the field of treatment of opiate: The experience of developing the WHO clinical guidelines

The available evidence in the field of treatment of opiate: The experience of developing the WHO clinical guidelines The available evidence in the field of treatment of opiate: The experience of developing the WHO clinical guidelines Background, Objectives and Methods Systematic reviews (SRs) published by Cochrane Drugs

More information

AGENDA U.S. SURGEON GENERAL, VIVEK MURTHY MD 2/5/2019

AGENDA U.S. SURGEON GENERAL, VIVEK MURTHY MD 2/5/2019 FORMER U.S. SURGEON GENERAL, VIVEK MURTHY MD AN ESTIMATED 20.8 MILLION PEOPLE IN OUR COUNTRY ARE LIVING WITH A SUBSTANCE USE DISORDER. THIS IS SIMILAR TO THE NUMBER OF PEOPLE WHO HAVE DIABETES, AND 1.5

More information

U.S. SURGEON GENERAL, VIVEK MURTHY MD

U.S. SURGEON GENERAL, VIVEK MURTHY MD FORMER U.S. SURGEON GENERAL, VIVEK MURTHY MD AN ESTIMATED 20.8 MILLION PEOPLE IN OUR COUNTRY ARE LIVING WITH A SUBSTANCE USE DISORDER. THIS IS SIMILAR TO THE NUMBER OF PEOPLE WHO HAVE DIABETES, AND 1.5

More information

Buprenorphine for Family Medicine. Hannah Snyder, MD Addiction Medicine Fellow, UCSF 12/7/17

Buprenorphine for Family Medicine. Hannah Snyder, MD Addiction Medicine Fellow, UCSF 12/7/17 + Buprenorphine for Family Medicine Hannah Snyder, MD Addiction Medicine Fellow, UCSF 12/7/17 + Disclosures No conflicts of interest Off-label use of medications + Who here: Has taken care of a patient

More information

Medication-Assisted Treatment (MAT) for Opioid Use Disorders

Medication-Assisted Treatment (MAT) for Opioid Use Disorders Medication-Assisted Treatment (MAT) for Opioid Use Disorders Sybil Marsh MA MD FASAM Department of Family Medicine and Community Health Case Western Reserve University/UHCMC Learning Objective 1 Following

More information

Building capacity for a CHC response to Ontario's Opioid Crisis

Building capacity for a CHC response to Ontario's Opioid Crisis Building capacity for a CHC response to Ontario's Opioid Crisis Rob Boyd Oasis Program Director Luc Cormier, RN, MScN Community Health Nurse Sandy Hill Community Health Centre #AOHC2016 @rboyd6 @SandyHillCHC

More information

Disclosures. Topics of today s training 4/24/2017. Evolving Treads in Medication Assisted Treatment. Christopher J Davis D.O.

Disclosures. Topics of today s training 4/24/2017. Evolving Treads in Medication Assisted Treatment. Christopher J Davis D.O. Evolving Treads in Medication Assisted Treatment Christopher J Davis D.O. CAADC, FASAM Medical Director, The Ranch of Pennsylvania Medical Director, Pyramid Healthcare Diplomate of The American Board of

More information

Buprenorphine: An Introduction. Sharon Stancliff, MD Harm Reduction Coalition September 2008

Buprenorphine: An Introduction. Sharon Stancliff, MD Harm Reduction Coalition September 2008 Buprenorphine: An Introduction Sharon Stancliff, MD Harm Reduction Coalition September 2008 Objective Participants will be able to: Discuss the role of opioid maintenance in reducing morbidity and mortality

More information

MAT - ICAAD 2018 Ron Jackson, MSW, LICSW

MAT - ICAAD 2018 Ron Jackson, MSW, LICSW The ATTC Network Ten Regional Centers northwest@attcnetwork.org www.attcnetwork.org/northwest phone. 206-685-4419 1107 NE 45 th St, Ste 120, Seattle, WA 98105 http://attcnetwork.org/northwest U.S. Opioid

More information

Opioids Research to Practice

Opioids Research to Practice Opioids Research to Practice CRIT Program May 2010 Daniel P. Alford, MD, MPH Associate Professor of Medicine Boston University School of Medicine Boston Medical Center 32 yo female brought in after heroin

More information

The CARA & Buprenorphine Prescribing for APNs & PAs

The CARA & Buprenorphine Prescribing for APNs & PAs The CARA & Buprenorphine Prescribing for APNs & PAs William J. Lorman, JD, PhD, MSN, PMHNP-BC, CARN-AP FIAAN Assistant Clinical Professor, Drexel University, Philadelphia, PA V. P. & Chief Clinical Officer,

More information

Initiation of MAT for Opioid Use Disorder in the Hospitalized Patient and ER Setting: Promoting Best Outcomes in the Wake of an Opioid Crisis

Initiation of MAT for Opioid Use Disorder in the Hospitalized Patient and ER Setting: Promoting Best Outcomes in the Wake of an Opioid Crisis Initiation of MAT for Opioid Use Disorder in the Hospitalized Patient and ER Setting: Promoting Best Outcomes in the Wake of an Opioid Crisis Sponsored by the Florida Alcohol and Drug Abuse Association

More information

Opioids. October 29, Addiction Medicine Review Course CSAM, Newport Beach, CA

Opioids. October 29, Addiction Medicine Review Course CSAM, Newport Beach, CA Opioids October 29, 2010 Addiction Medicine Review Course CSAM, Newport Beach, CA Daniel P. Alford, MD, MPH, FACP, FASAM Associate Professor of Medicine Boston University School of Medicine Boston Medical

More information

Medication Assisted Treatment

Medication Assisted Treatment Meeting the Needs of Your Clients: Building Competencies in Mental Health and Addiction Services Medication Assisted Treatment November 5, 2018 In partnership with: House Keeping Because this is a webinar,

More information

Medical Assisted Treatment. Dr. Michael Baldinger Medical Director Haymarket Center Harborview Recovery Center

Medical Assisted Treatment. Dr. Michael Baldinger Medical Director Haymarket Center Harborview Recovery Center Medical Assisted Treatment Dr. Michael Baldinger Medical Director Haymarket Center Harborview Recovery Center Current Trends Prescription Drug Abuse/Addiction Non-medical use of prescription pain killers

More information

Management of Opioid Use Disorder in Primary Care

Management of Opioid Use Disorder in Primary Care 1 Northwest ATTC presents Management of Opioid Use Disorder in Primary Care Joseph O. Merrill, MD, MPH University of Washington Associate Professor of Medicine 4/26/2018 Today s Presenter 2 Joseph Merrill,

More information

Medication Assisted Treatment:

Medication Assisted Treatment: Medication Assisted Treatment: A Training For Multidisciplinary Addiction Professionals Module III Medications 101 Goals for Module III This module reviews the following: Overview of three medications

More information

It s Not Just One More Thing! Overcoming Obstacles for Buprenorphine Treatment by Residents, Faculty and Programs

It s Not Just One More Thing! Overcoming Obstacles for Buprenorphine Treatment by Residents, Faculty and Programs It s Not Just One More Thing! Overcoming Obstacles for Buprenorphine Treatment by Residents, Faculty and Programs Ken Saffier, MD Maureen Strohm, MD May 7, 2017 Disclosures Ken Saffier, MD, has nothing

More information

Substance Use Disorders (SUDs) and Medication Assisted Treatment (MAT) for Opiates

Substance Use Disorders (SUDs) and Medication Assisted Treatment (MAT) for Opiates Substance Use Disorders (SUDs) and Medication Assisted Treatment (MAT) for Opiates What is MAT? Medication Assisted Treatment (MAT) is the use of medications, in addition to counseling, cognitive behavioral

More information

Opioid Use Disorder Treatment: Buprenorphine Treatment Basics

Opioid Use Disorder Treatment: Buprenorphine Treatment Basics Opioid Use Disorder Treatment: Buprenorphine Treatment Basics Daniel Warren, MD Eastern Oregon Coordinated Care Organization Provider Forum on Chronic Noncancer Pain Management Pendleton, OR February 24,

More information

Medication Assisted Treatment of an Opioid Use Disorder. J. Craig Allen, MD. Medical Director, Rushford

Medication Assisted Treatment of an Opioid Use Disorder. J. Craig Allen, MD. Medical Director, Rushford Medication Assisted Treatment of an Opioid Use Disorder J. Craig Allen, MD. Medical Director, Rushford Learning objectives At the conclusion of this activity, participants will be able to: Understand

More information

Arwen Podesta, MD. ABIHM, ABAM, Forensic Psychiatry

Arwen Podesta, MD. ABIHM, ABAM, Forensic Psychiatry The State of Medicine in Addiction Recovery Arwen Podesta, MD ABIHM, ABAM, Forensic Psychiatry www.podestawellness.com 504-252-0026 http://www.addictionpolicy.org/ Overview Addiction is a serious, chronic

More information

Methadone and Naltrexone ER

Methadone and Naltrexone ER Methadone and Naltrexone ER Laura G. Kehoe, MD, MPH, FASAM Medical Director MGH Substance Use Disorder Bridge Clinic Assistant Professor of Medicine Harvard Medical School Disclosures Neither I nor my

More information

Virginia Opioid Addiction ECHO*

Virginia Opioid Addiction ECHO* Virginia Opioid Addiction ECHO* Project ECHO: July 27th *ECHO: Extension of Community Healthcare Outcomes Agenda Agenda Agenda Introductions Clinical Director Administrative Medical Director ECHO Hubs

More information

Medication-Assisted Treatment (MAT) Overview

Medication-Assisted Treatment (MAT) Overview Medication-Assisted Treatment (MAT) Overview 2014 Opiate Conference: Don t Get Me Started Hyatt Regency, Columbus, Ohio June 30-July 1, 2014 Christina M. Delos Reyes, MD Medical Consultant, Center for

More information

Medication Assisted Treatment. Nicole Gastala, MD

Medication Assisted Treatment. Nicole Gastala, MD Medication Assisted Treatment Nicole Gastala, MD Objectives Training Goals: To enhance the understanding of the participants in use of medication assisted therapy To increase the knowledge of participants

More information

Opioid dependence and buprenorphine treatment

Opioid dependence and buprenorphine treatment Opioid dependence and buprenorphine treatment David Roll, MD Revere Family Health, Cambridge Health Alliance Instructor in Medicine, Harvard Medical School Joji Suzuki MD Medical Director of Addictions

More information

Confronting the Opioid Epidemic: Suboxone in Primary Care

Confronting the Opioid Epidemic: Suboxone in Primary Care Confronting the Opioid Epidemic: Suboxone in Primary Care Kami Harless, MD 1 The Opioid Epidemic 2 The Opioid Epidemic 3 Washington Epidemic 4 King County Epidemic 5 King County Epidemic 6 Outline Opioid

More information

Identification and Treatment of Opioid Use Disorders in Primary Care Settings

Identification and Treatment of Opioid Use Disorders in Primary Care Settings Identification and Treatment of Opioid Use Disorders in Primary Care Settings 17th Annual Primary Care Symposium February 24, 2018 Kelly S. Barth, DO Associate Professor, Psychiatry & Internal Medicine

More information

What Is Heroin? Examples of Opioids. What Science Says about Opioid Use Disorder and Its Treatment 6/27/2016

What Is Heroin? Examples of Opioids. What Science Says about Opioid Use Disorder and Its Treatment 6/27/2016 What Science Says about Opioid Use Disorder and Its Treatment Perilou Goddard, Ph.D. Department of Psychological Science Northern Kentucky University Examples of Opioids Agonists (activate opioid receptors)

More information

Disclosures. Objectives 2/5/2018. Women and opioid use disorder: Optimizing care during pregnancy and beyond

Disclosures. Objectives 2/5/2018. Women and opioid use disorder: Optimizing care during pregnancy and beyond Women and opioid use disorder: Optimizing care during pregnancy and beyond Susanne Astrab Fogger, DNP, PMHNP-BC, CARN-AP, FAANP Ashley L. Hodges, PhD, CRNP, WHNP-BC Disclosures Dr. Fogger has nothing to

More information

Wasted AN INTRODUCTION TO SUBSTANCE ABUSE

Wasted AN INTRODUCTION TO SUBSTANCE ABUSE Wasted AN INTRODUCTION TO SUBSTANCE ABUSE Dr. Brian L. Bethel Child and Family Therapist Independent Trainer and Consultant LPCC-S, LCDC III, RPT-S www.brianlbethel.com INTERPLAY COUNSELING & CONSULTING

More information

9/13/2017. Buprenorphine Treatment (Suboxone) Disclosures. We ve Got a Big Opioid Problem. Selahattin Kurter, MD Spectrum Healthcare

9/13/2017. Buprenorphine Treatment (Suboxone) Disclosures. We ve Got a Big Opioid Problem. Selahattin Kurter, MD Spectrum Healthcare Buprenorphine Treatment (Suboxone) Selahattin Kurter, MD Spectrum Healthcare Board Certified in Psychiatry and Addiction Medicine Disclosures No financial reimbursement for this lecture Consultant for

More information

Medication for Addiction Treatment (MAT)

Medication for Addiction Treatment (MAT) SBIRT Training Screening, Brief Intervention & Referral to Treatment Medication for Addiction Treatment (MAT) The Faith & Spirituality Integrated SBIRT Network Navigating the Training Welcome! These health

More information

Pharmacotherapy Works for Opioid Use Disorders in CJ Populations

Pharmacotherapy Works for Opioid Use Disorders in CJ Populations Pharmacotherapy Works for Opioid Use Disorders in CJ Populations Peter D. Friedmann, MD, MPH, FASAM, FACP Chief Research Officer Baystate Health Associate Dean for Research University of Massachusetts

More information

Understanding Medication in Addiction Treatment for Drug Court Participants

Understanding Medication in Addiction Treatment for Drug Court Participants Understanding Medication in Addiction Treatment for Drug Court Participants Introduction This pocket guide is for drug court participants who may be prescribed or considering medication as a part of addiction

More information

HARM REDUCTION & TREATMENT. Devin Reaves MSW

HARM REDUCTION & TREATMENT. Devin Reaves MSW HARM REDUCTION & TREATMENT Devin Reaves MSW The mission of PAHRC is to promote the health, dignity, and human rights of individuals who use drugs and communities impacted by drug use. Recognizing that

More information

SW OREGON OPIOID SUMMIT. Medication Assisted Recovery for Opioid Use Disorder. Gregory S. Brigham, Ph.D. Adapt / SouthRiver CHC / Compass

SW OREGON OPIOID SUMMIT. Medication Assisted Recovery for Opioid Use Disorder. Gregory S. Brigham, Ph.D. Adapt / SouthRiver CHC / Compass SW OREGON OPIOID SUMMIT Medication Assisted Recovery for Opioid Use Disorder Gregory S. Brigham, Ph.D. Adapt / SouthRiver CHC / Compass Opioid Agonists Mu (μ) receptors stimulated by opioids causing full

More information

Restoration of Parenting Ability Through Treatment for Substance Use Disorders

Restoration of Parenting Ability Through Treatment for Substance Use Disorders Restoration of Parenting Ability Through Treatment for Substance Use Disorders DEBRA M. BARNETT, MD Board Certified in General Psychiatry, Addiction Psychiatry, Geriatric Psychiatry, and Forensic Psychiatry

More information

NORTHWEST AIDS EDUCATION AND TRAINING CENTER. Opioid Use Disorders. Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014

NORTHWEST AIDS EDUCATION AND TRAINING CENTER. Opioid Use Disorders. Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014 NORTHWEST AIDS EDUCATION AND TRAINING CENTER Opioid Use Disorders Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014 Opioid Use Disorders Importance of opioid use disorders Screening and

More information

Serious Mental Illness and Opioid Use Disorder

Serious Mental Illness and Opioid Use Disorder Serious Mental Illness and Opioid Use Disorder Serious Mental Illness and Opioid Use Disorders Arthur Robin Williams, MD MBE Columbia University, Department of Psychiatry Nick Szubiak, MSW, LCSW Director,

More information

Pennsylvania Coordinated Medication Assisted Treatment: A Penn State and Pennsylvania Psychiatric Institute Story

Pennsylvania Coordinated Medication Assisted Treatment: A Penn State and Pennsylvania Psychiatric Institute Story Pennsylvania Coordinated Medication Assisted Treatment: A Penn State and Pennsylvania Psychiatric Institute Story Sarah Sharfstein Kawasaki, MD Director of Addictions Services, Pennsylvania Psychiatric

More information

Treating Opioid Use Disorders: An Update for Counselors and Other Providers

Treating Opioid Use Disorders: An Update for Counselors and Other Providers Treating Opioid Use Disorders: An Update for Counselors and Other Providers Brad Shapiro, MD Medical Director Opiate Treatment Outpatient Program Zuckerberg San Francisco General THE DOSING WINDOW HISTORICAL

More information

GOALS AND OBJECTIVES

GOALS AND OBJECTIVES SUBOXONE AND VIVITROL: ARE THERE DISPARITIES SURFACING IN MEDICATION ASSISTED TREATMENTS? P R E S E N T E D B Y D R. K I AM E M AH A N I A H & D R. M Y E C H I A M I N T E R - J O R D AN GOALS AND OBJECTIVES

More information

Noel Schenk MD. Davis Behavioral Health

Noel Schenk MD. Davis Behavioral Health Noel Schenk MD Davis Behavioral Health Michael Botticelli Director of National Drug Control Policy What is Addiction? Addiction is defined as a chronic, relapsing brain disease that is characterized by

More information

Medication Assisted Treatment: Right for you, Right for your Recovery? Robert Matylewicz, DO, FASAM Medical Director, Clarity Way Inc.

Medication Assisted Treatment: Right for you, Right for your Recovery? Robert Matylewicz, DO, FASAM Medical Director, Clarity Way Inc. Medication Assisted Treatment: Right for you, Right for your Recovery? Robert Matylewicz, DO, FASAM Medical Director, Clarity Way Inc. Elements Behavioral Health Diplomate, American Board of Addiction

More information

MARRCH Minnesota Society of Addiction Medicine Presents. Addiction as a Brain Disease

MARRCH Minnesota Society of Addiction Medicine Presents. Addiction as a Brain Disease MARRCH 2008 Minnesota Society of Addiction Medicine Presents Addiction as a Brain Disease Gavin Bart, MD Charles Reznikoff, MD Steven Fu, MD, MSCE David Frenz, MD, MS October 22, 2008 Schedule 10:00-12:00

More information

SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program

SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets Risk Evaluation and Mitigation Strategy (REMS) Program Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Prescribers

More information

MAT in the Corrections Setting

MAT in the Corrections Setting MEDICATION ASSISTED TREATMENT AND CORRECTIONS Frank Filippelli, DO, PhD September 2017 MAT in the Corrections Setting Who Does This Affect? What is MAT and What is the Evidence of Efficacy? Emphasis on

More information

Pharmacotherapy for opioid addiction. Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco

Pharmacotherapy for opioid addiction. Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco Pharmacotherapy for opioid addiction Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco Disclosure slide No commercial conflicts to disclose. Gaps in current treatment of opioid

More information

Opioid Use and Justice Involvement: Challenges in Treatment, Engagement, and Continuity

Opioid Use and Justice Involvement: Challenges in Treatment, Engagement, and Continuity Opioid Use and Justice Involvement: Challenges in Treatment, Engagement, and Continuity Holly Hills, Ph.D. June 13, 2017 Department of Mental Health Law and Policy Overview: Persons who have not been in

More information

Policy Evaluation: Substance Use Disorders

Policy Evaluation: Substance Use Disorders Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119

More information

Understanding Opioid Addiction and. Medication Assisted Treatment for. Families in the Child Welfare System

Understanding Opioid Addiction and. Medication Assisted Treatment for. Families in the Child Welfare System Understanding Opioid Addiction and Medication Assisted Treatment for Families in the Child Welfare System Medicine Jason B. Fields, MD, FASAM Associate Medical Director, DACCO Behavioral Health, Inc. President

More information

Medication Assisted Treatment. Michael Palladini, RPh MBA CAC

Medication Assisted Treatment. Michael Palladini, RPh MBA CAC Medication Assisted Treatment Michael Palladini, RPh MBA CAC palladini.michael@gmail.com History of MAT Addiction as a Disease The concept of addiction as a disease of the brain challenges deeply ingrained

More information

Addiction Medicine: What s new for primary care

Addiction Medicine: What s new for primary care Addiction Medicine: What s new for primary care Dan Vinson, MD Family and Community Medicine How to talk so our patients listen, and listen so our patients talk. 1 2 Comfortably engaging your patient in

More information

BUPRENORPHINE (PROBUPHINE & SUBLOCADE )

BUPRENORPHINE (PROBUPHINE & SUBLOCADE ) UnitedHealthcare Oxford Clinical Policy BUPRENORPHINE (PROBUPHINE & SUBLOCADE ) Policy Number: PHARMACY 291.6 T2 Effective Date: July 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE... 1 CONDITIONS

More information

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Executive Summary

More information

Suboxone, Zubsolv, Bunavail (buprenorphine with naloxone sublingual tablets and film), Buprenorphine sublingual tablets

Suboxone, Zubsolv, Bunavail (buprenorphine with naloxone sublingual tablets and film), Buprenorphine sublingual tablets Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.32 Subject: Suboxone Drug Class Page: 1 of 7 Last Review Date: June 24, 2016 Suboxone Drug Class Description

More information

SC MAT ACCESS. Medication Assisted Treatment Academic Community Capacity Expansion for Sustainable Success Kathleen Brady, MD, PhD, VPR, MUSC

SC MAT ACCESS. Medication Assisted Treatment Academic Community Capacity Expansion for Sustainable Success Kathleen Brady, MD, PhD, VPR, MUSC SC MAT ACCESS Medication Assisted Treatment Academic Community Capacity Expansion for Sustainable Success Kathleen Brady, MD, PhD, VPR, MUSC Overdose Death Rates from Opiates Most important sign of a

More information

THE OPIOID CRISIS 9/19/2018 DEFINING THE CRISIS DEFINING THE CRISIS NUMBER OF OPIOID-RELATED OVERDOSE DEATHS IN ALABAMA

THE OPIOID CRISIS 9/19/2018 DEFINING THE CRISIS DEFINING THE CRISIS NUMBER OF OPIOID-RELATED OVERDOSE DEATHS IN ALABAMA THE OPIOID CRISIS DEFINING THE CRISIS KATHLEEN DUPPER, MD MEDICAL DIRECTOR, HUNTSVILLE RECOVERY 19 th Annual Perinatal Conference: The Opioid Crisis September 21, 2018 DEFINING THE CRISIS NUMBER OF OPIOID-RELATED

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Buprenorphine Implant for Treatment of Opioid Dependence File Name: Origination: Last CAP Review: Next CAP Review: Last Review: buprenorphine_implant_for_treatment_of_opioid_dependence

More information

Opioid Step Policy. Description. Section: Prescription Drugs Effective Date: April 1, 2018

Opioid Step Policy. Description. Section: Prescription Drugs Effective Date: April 1, 2018 Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Opioid Step Policy Page: 1 of 6 Last Review Date: March 16, 2018 Opioid Step Policy Description

More information

Public Policy Statement on the Regulation of Office-Based Opioid Treatment

Public Policy Statement on the Regulation of Office-Based Opioid Treatment Public Policy Statement on the Regulation of Office-Based Opioid Treatment Background Office-based opioid treatment (OBOT) commonly refers to outpatient treatment services provided outside of licensed

More information

Methadone and Naltrexone ER

Methadone and Naltrexone ER Methadone and Naltrexone ER Laura G. Kehoe, MD, MPH, FASAM Medical Director MGH Substance Use Disorder Bridge Clinic Assistant Professor of Medicine Harvard Medical School Objectives Review Full Opioid

More information

Medications in the Treatment of Opioid Use Disorder: Methadone and Buprenorphine What Really Are They?

Medications in the Treatment of Opioid Use Disorder: Methadone and Buprenorphine What Really Are They? Medications in the Treatment of Opioid Use Disorder: Methadone and Buprenorphine What Really Are They? Yngvild Olsen, MD, MPH Cecil County Board of Health Workgroup Meeting Elkton, MD October 8, 2013 Objectives

More information

Health Systems and Addiction: Provider Issues

Health Systems and Addiction: Provider Issues Health Systems and Addiction: Provider Issues The Emerging Roles of Primary Care Patrick G. O Connor MD, MPH Dan and Amanda Adams Professor of General Medicine Chief, General Internal Medicine Yale University

More information

Medication Assisted Treatment. Karen Drexler, MD National Mental Health Program Director-Substance Use Disorders Department of Veterans Affairs

Medication Assisted Treatment. Karen Drexler, MD National Mental Health Program Director-Substance Use Disorders Department of Veterans Affairs Medication Assisted Treatment Karen Drexler, MD National Mental Health Program Director-Substance Use Disorders Department of Veterans Affairs Disclosures Employed by the Department of Veterans Affairs

More information

Optimizing Suboxone in Opioid Addicts

Optimizing Suboxone in Opioid Addicts Optimizing Suboxone in Opioid Addicts David Chim, D.O. Integrated Substance Abuse Programs Dept. of Psychiatry, UCLA K30 Translational Research Interest March 24, 2009 dchim@mednet.ucla.edu www.uclaisap.org

More information

Charles P. O Brien, MD, PhD University of Pennsylvania No financial conflicts, patents, speakers bureaus

Charles P. O Brien, MD, PhD University of Pennsylvania No financial conflicts, patents, speakers bureaus Pain & Opioid Epidemic 2018 Charles P. O Brien, MD, PhD University of Pennsylvania No financial conflicts, patents, speakers bureaus Opioids 3400 BC Mesopotamia, Joy plant 1843 morphine by syringe 1874

More information

A Drug Court Team Member s Guide to Medication in Addiction Treatment

A Drug Court Team Member s Guide to Medication in Addiction Treatment A Drug Court Team Member s Guide to Medication in Addiction Treatment Introduction This pocket guide is intended for non-clinical drug court team members (e.g., court coordinators, judges, defense attorneys,

More information

Aligning Evidence-Based Practices with CCBHC Financing, Operations, and Quality Reporting. October 25th, :00pm 3:00pm

Aligning Evidence-Based Practices with CCBHC Financing, Operations, and Quality Reporting. October 25th, :00pm 3:00pm Aligning Evidence-Based Practices with CCBHC Financing, Operations, and Quality Reporting October 25th, 2017 2:00pm 3:00pm Webinar Login Directions Recommend calling in on your telephone. Enter your unique

More information

Vivitrol Vs. Suboxone

Vivitrol Vs. Suboxone Vivitrol Vs. Suboxone Vivitrol - Naltrexone Indicated for opiate dependence and alcohol withdrawal pure antagonist 380mg once every 4 weeks IM Peak plasma concentration in 2 hrs, followed by a second peak

More information

MEDICATION ASSISTED TREATMENTS (MAT) FOR SUBSTANCE USE DISORDERS

MEDICATION ASSISTED TREATMENTS (MAT) FOR SUBSTANCE USE DISORDERS MEDICATION ASSISTED TREATMENTS (MAT) FOR SUBSTANCE USE DISORDERS PHYLLIS RAYNOR, PHD, PMHNP-BC, APRN CLINICAL ASSISTANT PROFESSOR, USC COLLEGE OF NURSING LEARNING OBJECTIVES: Define types of SUD and purposes

More information

Buprenorphine and MAT 101

Buprenorphine and MAT 101 Buprenorphine and MAT 101 Why is Medication Assisted Treatment so Important for Recovery? KEN SAFFIER, MD 7 TH ANNUAL INTEGRATION SUMMIT DECEMBER 8, 2016 Disclosures: u Ken Saffier, MD, has nothing to

More information

Responding to the Opioid Epidemic

Responding to the Opioid Epidemic Responding to the Opioid Epidemic Jessica Gray, MD Addiction Medicine Fellow Boston Medical Center ROME New England August 17, 2017 Disclosures for Jessica Gray, MD No conflicts Learning Objectives Describe

More information

Building Community Coalitions to Address the Opioid Crisis

Building Community Coalitions to Address the Opioid Crisis Building Community Coalitions to Address the Opioid Crisis Understanding the Overdose Epidemic, Addiction, and Treatment Barry Zevin MD Medical Director Street Medicine and Shelter Health San Francisco

More information

BUPRENORPHINE (PROBUPHINE & SUBLOCADE )

BUPRENORPHINE (PROBUPHINE & SUBLOCADE ) UnitedHealthcare Oxford Clinical Policy BUPRENORPHINE (PROBUPHINE & SUBLOCADE ) Policy Number: PHARMACY 291.5 T2 Effective Date: April 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE... 1 CONDITIONS

More information

National Opioid Treatment Guideline Dr. Ronald Lim

National Opioid Treatment Guideline Dr. Ronald Lim National Opioid Treatment Guideline Dr. Ronald Lim (MD, CCFP, DFASAM, ABAM(D), FISAM, CCSAM, MRO) Clinical Assistant Professor, Department of Psychiatry and Family Practice Cumming School of Medicine University

More information

Buprenorphine is the most effective office-based treatment available for heroin and prescription opioid addiction

Buprenorphine is the most effective office-based treatment available for heroin and prescription opioid addiction Buprenorphine is the most effective office-based treatment available for heroin and prescription opioid addiction The Problem The overdose death rate in Missouri and in the country has been rising for

More information