Volume 13 | June 2024

Maine SUD Learning Community Newsletter

David Kispert, MD

David Kispert graduated from Creighton School of Medicine in Omaha, NE in 2016. He completed his internal medicine residency program at Maine Medical Center in 2019. Touched by the challenges and stigma those with substance use disorders face, he then enrolled in a one-year addiction medicine fellowship at Boston Medical Center. Upon completion in 2020, he returned to southern Maine where he continues to practice. He currently works as medical director for two opioid treatment programs in the Portland area. He lives in Portland with his loving and patient wife and two dogs - Logan and Linus.

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SUD Learning Community Journal Club 

Greetings Colleagues,

What do you do when your patient who wants to quit nicotine accepts a prescription for NRT or varenicline and comes back in 6 weeks still smoking? Do you keep them on the same medication with a few behavioral tweaks? Do you add medication? Or something else? This study –punchline approaching --suggests you switch them to varenicline if they are using NRT or increase the current therapy dose (if it is NRT or varenicline). Hallelujah – it is wonderful to have a novel approach, as well as evidence that is beyond that first step of treatment. The concept of dosing to effect is consistent with lessons learned over the years of treating OUD -and from that, we know that the dose of the blockade/replacement can make all the difference.

Here are the caveats. First, there was a loss to follow which probably doesn’t but could lead to an overestimation of effect. Second, you’ll note that this study excluded patients with substance use disorders (other than nicotine use do), so in addition to these higher doses being off-label, we cannot easily weigh the risks and benefits in our patients with SUD. In those with OUD, quit rates are so low that there is no evidence that medication helps at all 1, making extrapolation to that group even less clear. Third, the benefits of a quit by twelve weeks were mostly gone by 6months. However, we know that it takes many quits for a sustained one, and all quits and returns to use are learning experiences that can set the stage for long-term improvement. So, despite the limitations, I think this data puts a new card up our sleeves for a difficult-to-treat use disorder.

Thank you for reading, details ahead…


Andrea Truncali, MD, MPH

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Can I get CME credit for presenting a webinar to the ME SUD Learning Community?


You can earn up to 4 AMA PRA Category 1 Credits for presenting a one-hour webinar to the ME SUD LC. Also, share a clinical question at an upcoming ECHO and earn up to 2 AMA PRA Category 1 Credits. It just takes a little extra paperwork. Contact Bethany at bunderhill@gmail.com if you would like to learn more.

 The Maine Medical Education Trust designates this live online activity for a maximum of 4 AMA PRA Category 1 Credit(TM). Physicians should only claim credit commensurate with the extent of their participation in the activity


Join the ME SUD Learning Community this Fall for the Project ECHO: Methadone.

The first session will begin on

August 8, 2024, at 12 pm ET.

Register now on the iECHO platform:


NEW this year, you can participate directly from your mobile device by downloading the iECHO app.

The app sets reminders, links directly to Zoom, and provides access to all iECHO materials.

Get the App here:

Apple | Google Play

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



Maine Prescription Monitoring Program (PMP) Resources

The Prescription Monitoring Program (PMP) is a secure database available to prescribers (and their staff) and pharmacists (and their staff). It provides valuable information regarding the usage of controlled substances before or as they are prescribed or dispensed. This program plays a pivotal role in multiple areas of the State of Maine’s Opioid Response Strategy.

Explore our online resource page for valuable information and access to recorded webinars.

The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain: Context, Overview, Application, and Policy Implications

June 25, 2024 | 1:00 pm - 2:00 pm

Speakers: Andrew Suchoki, MD, MPH; Nadejda Razi-Robertson, PhD, LCSW

Best and Promising Practice

June 26, 2024 | 12:30 pm - 1:00 pm

Speaker: Stephanie Nichols, PharmD, BCPP, MPH

Hospital Care of Opioid Exposed Newborns

July 24, 2024 | 12:00 pm - 1:00 pm

Speaker: Meredith Jackson, MD

Online Self Paced Courses

Pressed for time?

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

For our complete course list, please visit the MeSUD Learning Community website.

Online Self-paced Courses

Enroll Today

Personal Recovery Story

Transforming Struggles into Service for Sobriety

by Jamie Lovely

Geoff Smith is a man driven by a desire to serve others. In addition to running his machine shop, he works for Volunteers of America, driving incarcerated men from the Maine Coastal Regional Reentry Center to recovery meetings, and also mentors individuals as a recovery coach. His gentleness, tempered through experience and humility, allows him to use his redemptive story as a tool to help save other people’s lives, just as sobriety saved his.

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