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

March 2024

Dear Anna,

For the first time in over 20 years, HHS released updates to rules governing treatment in opioid treatment programs. Highlights include:

✔️Permanently expanding take home doses of methadone

✔️Allowing NPs and PAs to order medications

HHS also announced plans to remove the one-year opioid addiction requirement for OTP admission, integrating harm reduction and recovery support services into OTPs, and providing clarification on DEA registration for carceral settings to facilitate methadone treatment. Additional details about these updates, including funding opportunities to purchase xylazine test strips, can be found in the HHS fact sheet.

To learn more about these changing regulations, OTP providers can attend our upcoming ECHO session on Changing Regulations and their Impact on OTPs.

The MACS Team

EDUCATION

Upcoming Opportunities

MACS for MOMs Virtual Training

PCSS Half & Half Buprenorphine Training

Thursday, March 21 | 12:00 - 4:30 pm

Presented by MACS for MOMs Consultant, Katrina Mark, MD, FACOG

Completion of this training fulfils the 8-hour training requirement for DEA registration or renewal as mandated by the MATE Act.

Save the date for a MACS Webinar on

Benzodiazepines

Thursday, March 28 | 12:00 - 1:00 PM

Presented by Devang Gandhi, MD

MACS for MOMs Webinar

Newer Street Drugs and Pregnancy

Tuesday, April 2 | 12:00 - 1:00 pm

Presented by MACS for MOMs Consultant, Christopher Welsh, MD

MACS Webinar

The Opioid Epidemic and Public Health: Impact, Interventions, and Innovation

Thursday, April 4 | 12:00 - 4:30 pm

Presented by Sara Whaley, MPH, with Johns Hopkins School of Public Health

The ASAM/AAAP Management of Stimulant Use Disorder Webinar Series #3

Behavioral Treatments for Stimulant Use Disorder

Wednesday, March 6 | 3:00 pm - 4:00 pm

Grayken Center for Addiction Training & TA Journal Club

Less is More? Buprenorphine Dose Association with Treatment Retention in the Fentanyl Era

Thursday, March 7 | 1:00 pm - 2:00 pm

Maryland's Office of Overdose Response

Community Overdose Action Town Hall Series

Visit the website to view the upcoming dates

Details

Conferences

MACS will be tabling and/or presenting at the following conferences:

April 6 - Maryland Academy of Advanced Practice Clinicians

April 11 - American College of Emergency Room Physicians Educational Conference & Annual Meeting 2024

April 19 - Maryland Society of Health System Pharmacy

April 23 - 36th Annual Tuerk Conference on Mental Health and Addiction Treatment

April 26 - 20th Annual Maryland Patient Safety Conference

MACS ECHO Clinics

Join our learning communities for continuous case-based discussions and didactic presentations linking expert specialist teams with healthcare providers and their practices. MACS ECHO Clinics count toward the required 8-hours of SUD training for DEA license renewal or registration.

OTP ECHO

Changing Regulations and their Impact on OTPs

Wednesday, March 6

12:30 pm -1:30 pm

Maternal Health ECHO

Breastfeeding and SUD

Tuesday, March 12

8:00 am - 9:00 am

SUD ECHO

Pregnancy and SUD

Wednesday, March 20

12:30 pm - 1:30 pm

Providing MOUD from a Trauma-Informed Perspective

Introduction to Trauma in MOUD

Wednesday, March 27

12:00 pm - 1:00 pm

Registration coming soon.

Watch at your convenience

MACS for MOMs Webinar

Considerations in Perinatal Substance Use Treatment: Patient Education and Ethical Issues

Watch

MACS Webinar

Taking the Sting Out of Pain Management: Strategies for Assessment and Treatment

Watch

NEWS

Buprenorphine misinformation and willingness to treat patients with opioid use disorder among primary care-aligned health care professionals

Buprenorphine is a highly effective medication for opioid use disorder (OUD) that is underused by health care professionals (HCPs). This study found that misinformation related to buprenorphine is common among HCPs and associated with lower willingness to treat patients with OUD.

Explaining Health Inequalities: The Enduring Legacy of Historical Biases

This NEJM review discussed how articles in the New England Journal of Medicine (NEJM) have historically helped to perpetuate racism and discrimination against Black and Indigenous Americans. The authors concluded that going forward NEJM must “act on its commitment to heath equity not only by publishing the best, most rigorous research on this important topic, but also by interrogating the racial assumptions and sociopolitical consequences of everything it publishes.”

Impact of the Communities That HEAL Intervention of Buprenorphine-Waivered Practitioners and Buprenorphine Prescribing

A randomized clinical trial assessed whether the Communities That HEAL (CTH) intervention increased the number of practitioners with buprenorphine waivers or the rate of buprenorphine prescribing for treatment of opioid use disorder. The CTH intervention was not associated with waiver uptake among practitioners or buprenorphine prescribing, highlighting the need to improve the understanding and mitigation of barriers to equitable buprenorphine expansion within healthcare systems.

Emergency Department Access to Buprenorphine for Opioid Use Disorder

A cohort study in California examined the association between buprenorphine treatment in the emergency department (ED) and subsequent engagement in OUD treatment one month later. ED patients treated with buprenorphine were almost twice as likely to be engaged in subsequent OUD treatment after discharge than untreated patients, suggesting that ED buprenorphine treatment is an effective strategy to support participation in follow-up care.

Prescription Opioid Exposure During Pregnancy and Risk of Spontaneous Preterm Delivery

In this case-control study, a positive association was identified between prescription opioid exposure during pregnancy and spontaneous preterm birth. Findings support recommendations to prescribe the lowest dose necessary in pregnancy to reduce the risk of spontaneous preterm birth.

Treating Adolescent Opioid Use Disorder in Primary Care

Despite the doubling of adolescent drug overdose mortality from 2019 to 2021 and recommendations from the AAP, less than 5% of adolescents with OUD receive recommended medications. This study surveyed US pediatricians to assess their preparedness in providing adolescent OUD care, their approaches to substance use management, and the perceived barriers to prescribing OUD medications.