Volume 12 | April 2024

Maine SUD Learning Community Newsletter

Amy Langley, FNPC

Amy has 31 years of experience as a Registered Nurse and Nurse Practitioner. Her experiences span a variety of patient populations with expertise that includes adult and geriatric medicine, chronic non-malignant pain disorders, substance use disorders, and evidence-based de-prescribing.

She is the President of the Maine Nurse Practitioner Association and has held many leadership roles. Currently, she is a member of the Controlled Substance Stewardship Committee through the Community Care Partnership of Maine, the Provider Credentialing Committee through Community Health Options, the High Utilization Review Committee, and the Premature Death Review Committee through Penobscot Community Care.

She is the recipient of the 2017 Award Winner of the Nurse Practitioner Excellence Award through the Maine Primary Care


Read More


Saving Lives: Working Together to Improve SUD and OUD Care and Outcomes

Held March 15, 2024 | Thomas College

Conference Materials

The ME SUD Learning Community's 2nd Annual Conference was held on March 15, 2024, "Saving Lives: Working Together to Improve SUD and OUD Care & Outcomes", was held at Thomas College in Waterville, ME, as well as virtually via Zoom

It served as Maine's primary platform for clinicians and community partners to receive updates on cutting-edge collaborative practices for treating individuals with Substance Use and Opioid Use Disorders (SUD/OUD). The conference showcased various experts from both the state and national levels who presented and explored highly effective models and accessible practices aimed at combating the current lethality of fentanyl and the epidemic of drug overdose deaths. Attendees had the opportunity to learn practical methods for integrating these approaches into their practice, whether in primary care or behavioral health settings, and when working with youth or adults.

National keynote speakers included:

  • Nabarun Dasgupta, PhD, MPH Senior Scientist, UNC Injury Prevention Research Center Innovation Fellow, UNC Gillings School of Global Public Health 

  • Stephen Martin, MD, EdM, FAAFP, FASAM Associate Professor of Family Medicine and Community Health at the University of Massachusetts Medical School

  • R. Corey Waller, MD, MS, FACEP, DFASAM Editor and Chief of The ASAM Criteria, Chief Medical Officer, BrightView

  • VonZell Wade, PhD, LPC Co-founder of Lost Dreams Awakening, Owner of Luo Counseling Center, Adjunct Faculty of Faces & Voices of Recovery

Additionally, local speakers shared relevant and updated knowledge and experiences.

For further details and to access conference materials, including recorded session please visit our Conference Materials page on the Maine SUD website.

Conference Materials

Gordon Smith, JD Director of Opioid Response, State of Maine

Stephen Martin, MD, EdM, FAAFP

Stephen Memorial Hospital and Partners

R. Corey Waller, MD, MS, FACEP

VonZell Wade, PhD, LPC


SUD Learning Community Journal Club 

Dear Colleagues,


This headline grabbing paper recently came through, and also pops up on the well-known point of care decision support resource, UpToDate when searching ADHD treatment. It reports on an observational study done with Swedish registry data evaluating the impact of treatment for ADHD on mortality in those aged 6-64. The authors reported a protective effect in overall mortality of 0.79 (0.70-0.88), which subgroup analysis suggests was driven by accidental poisoning, ie, overdose, in men. The authors made efforts to adjust for confounders in the data but the bias introduced when comparing those treated versus not is a notorious cause of bias (Schneeweiss et al 2007) that is very possibly in effect here. The authors suggest that because of this, and because of multiple comparisons made, their findings should be considered exploratory.


Further, with the generous input about validity concerns from our psychiatry research colleague, Dr Lauren Moran, further doubt is cast on these findings. As Dr Moran shared with me, given that the mortality finding was driven by accidental overdose, the study would have to measure and account for important substance use disorder (SUD) features, however those are notoriously underrecognized and missing from data sets such as these, where the groups are defined by those who were treated versus those who weren’t. An example is that in this group, the stated rate of tobacco use disorder was 0.4% while epidemiologic data from Sweden suggests 6% of adults and 6-19% of high school kids smoke (Public Health Agency of Sweden, 2021). It is possible that those patients with ADHD who were “non initiators”, ie not prescribed medication, displayed risks or features for SUD (such as a single positive urine) without be asked for, or coming forth with, DSM criteria for an SUD, making findings due to a “healthy user bias”. Other concerns about the methods are described in the commentary below.


In combination with a previous report of increased mortality in the setting of new stimulant prescriptions in adults (Westover et al, 2018), the limitations above indicate that data about ADHD impact on mortality remain inconclusive.


Andrea Truncali, MD MPH 

Read More

Should I use the buprenorphine monoproduct with my patients? 

It is complicated. Andrea Truncali, MD, MPH and Stephanie Nichols, PharmD, BCPP, MPH tackled this question in their review. See their findings here.

For these questions and technical assistance, contact the ME SUD Learning Community


Protecting Yourself and Your Practice: The DEA Perspective

April 30,2024 | 12:00-1:00PM

Speakers: Jed Nitzberg, DEA Investigator

How SUD Treatment Providers Can Promote Safe Sleep Messaging

May 22,2024 | 12:00-1:00PM

Speakers: Alane O'Connor, DNP; Lisa Letourneau, MD, MPH; Meredith Jackson, MD; Victoria Hayes, LCSW, MSW

Online Self Paced Courses

Pressed for time?

Enroll in one of our convenient online self-paced courses today!

Enroll Today

Personal Recovery Story

Sobriety is a Gift

That Keeps on Giving

By Natasha Osbourne-Howe

One of the greatest gifts sobriety has taught me is the concept of choice.

Sobriety has been my chosen lifestyle since June 14, 2001, and it has made all the difference. It is freedom from a self-sabotaging way of life.

Alcohol’s presence was predominant in my family growing up – sophisticated, except for an aunt. My mother was my first drinking buddy in my mid-teens, and I felt so privileged. My parents had the good stuff, from wine to brandy and everything in between. The attitude in my home was “eat, drink and be merry.”

Read More

Please visit the ME SUD Learning Community website for upcoming Events and Resources.
Visit our website