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

May 2024

Dear Anna,

May is Mental Health Awareness Month, a time to increase knowledge about

mental health conditions and provide resources to individuals and families affected by mental illness. In the United States, 17.3% of people aged 12 or older had a substance use disorder in 2021. Mental health problems and substance use disorders sometimes occur together and affect each other; more than one in four adults living with serious mental health conditions also have a substance use problem. It is important to treat co-occurring mental health and substance use disorders because when a mental health disorder goes untreated, the substance use usually increases. The MACS team of addiction specialists can offer support to providers caring for individuals with co-occurring mental health and substance use disorders.

National Women’s Health Week, May 12-18, highlights women’s health issues and encourages women to take care of their physical and mental health. It also provides an opportunity to reflect on and address health challenges such as chronic pain, mental health conditions, and substance misuse. In the United States, women are almost twice as likely to develop depression and anxiety than men, and about 1 in 10 women report symptoms of major depression. Women also report higher rates of chronic pain and are more likely to be prescribed opioid medication than men for pain relief. Women with mental health disorders and chronic pain are at an increased risk of substance use, as approximately 4.3 million US women have both a substance use disorder and a serious mental illness. Preventing mental health and substance use disorders and related problems is critical to mental, emotional, and physical health. For more information on women and addiction treatment, explore the resources available on the MACS website.

-The MACS Team

MACS Survey

The Maryland Addiction Consultation Service (MACS) is surveying practitioners to better understand prescribing practices in Maryland. Please take a moment to complete this quick survey. Your input will improve both access to lifesaving treatment and how we support you

EDUCATION

Upcoming MACS Training Opportunities

MACS for MOMs Webinar

Plans of Safe Care: Supporting Pregnant Patients Living with Substance Use Disorders

Friday, June 14 | 12:00 PM - 1:00 PM

Presented by MACS for MOMs consultant Katie Mark, MD, FACOG and guest speaker Shawnett Mills, LCPC

Upcoming Trainings of Interest

SAMHSA, Maryland Department of Health, and University of Maryland School of Medicine

Clinical Guidance for Treating Pregnant and Parenting Women* with Opioid Use Disorder and Their Infants

*This training also uses the term "people" to include women, nonbinary, transgender or non-conforming individuals experiencing pregnancy or in a parenting role.

Friday, May 10 | 8:15 AM - 5:00 PM

Presented by Hendrée E. Jones, PhD, LP, Essence Hairston, LCSW, LCAS, CSI, and MACS for MOMs Consultant, Katrina Mark, MD, FACOG

Central East PTTC, Prevention Technology Transfer Center Network

Stigma and Substance Use Prevention Part 2: What Prevention Professionals and Others Can Do

Thursday, May 16 | 1:00 - 2:30 PM

Grayken Center for Addiction Training & TA

Addiction 101

Wednesday, May 29 | 11:00 AM - 12:00 PM

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.

Maternal Health ECHO

Urine Drug Screening and Pregnancy

Tuesday, May 14

8:00 AM - 9:00 AM

SUD ECHO

Buprenorphine Misuse and Diversion

Wednesday, May 15

12:30 PM - 1:30 PM

MACS ECHO: Providing MOUD from a Trauma-Informed Perspective

Recognizing Trauma During MOUD Treatment

Wednesday, May 22

12:00 PM - 1:00 PM

Opioid Treatment Program ECHO

Ethical Issues in Opioid Treatment Programs

Wednesday, June 5

12:30 PM - 1:30 PM

MACS Fact Sheet

Do you have questions about buprenorphine and pain?

This new Fact Sheet created by the MACS Team highlights the evidence, safety profile, and patient consideration

Announcement: Updated Prescriber Enrollment Requirement for Behavioral Health Practitioners

To comply with federal regulations, the below changes are being implemented by the Maryland Medicaid Program related to reimbursement for prescribed medications effective July 1, 2024:

All practitioners who order, refer, and/or prescribe to Medicaid participants must be actively enrolled with the Maryland Medicaid Program in order for the program to reimburse claims for prescribed medications
Effective July 1, 2024 Medicaid will deny all pharmacy claims that do not include the National Provider Identifier (NPI) of a prescribing practitioner who is actively enrolled with Maryland Medicaid
All prescribing practitioners treating Medicaid participants must enroll with Medicaid by April 15, 2024 to comply with state and federal regulations
Practitioners may check their current Maryland Medicaid enrollment status using the Provider Verification System (PVS) at https://encrypt.emdhealthchoice.org/searchableProv/main.action
To enroll, please visit the Maryland Medicaid’s Electronic Provider Revalidation and Enrollment Portal (ePREP) at https://eprep.health.maryland.gov/sso/login.do?
For information about enrollment requirements and instructions, please visit https://health.maryland.gov/mmcp/provider/Pages/eprepresources.aspx
Updated information can be found on MDH’s Ordering, Referring, and Prescribing (ORP) Providers webpage at https://health.maryland.gov/mmcp/provider/Pages/opr.aspx

Providers can reach out to MACS for more information and enrollment support.

NEWS

Telehealth Treatment for Opioid Use Disorder During Pregnancy

Treatment with buprenorphine during pregnancy is safe, effective, and reduces maternal mortality, but pregnant people face barriers to treatment. This cohort study found that telehealth-based opioid use disorder (OUD) treatment is associated with continuous OUD care and positive pregnancy outcomes in the United States.

Physician Empathy and Chronic Pain Outcomes

This cohort study found that physician empathy was associated with better outcomes in pain, function and health-related quality of life among patients with chronic low back pain. Results suggest that physician empathy is an essential aspect of the patient-physician relationship among those with chronic pain.

The Lived Experiences and Treatment Needs of Women with Opioid Use Disorder and Posttraumatic Stress Symptoms: A Mixed Methods Study

A mixed-methods study found that integrated treatments should be modified to meet the preferences of women with co-occurring opioid use disorder (OUD) and post-traumatic stress symptoms (PTSS) as well as the providers who work with these women. To increase uptake and reach, treatments should consider therapeutic content, structural and contextual factors, social support, and severity of PTSS of women with OUD and post-traumatic stress disorder.

Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge

Medications for alcohol use disorder (MAUD) are significant underutilized and hospitalizations may provide an unmet opportunity to initiate MAUD in patients. This study found that discharge initiation of MAUD after alcohol-related hospitalization was associated with reduction in return to hospital within 30 days.

Higher First 30-Day Dose of Buprenorphine for Opioid Use Disorder Treatment Is Associated With Decreased Mortality

This cohort study assessed the relationship between buprenorphine dose in the early stages of opioid use disorder treatment and the subsequent risk of death. Higher first 30-day buprenorphine doses were associated with reduced opioid-involved overdose death and death from other causes, suggesting that higher dosing reduces mortality.

Use of In-Network Insurance Benefits Is Critical for Improving Retention in Telehealth-based Buprenorphine Treatment

This study examined the relationship between insurance status, payment source, and outcomes among patients with opioid use disorder (OUD) on telehealth platforms. Findings demonstrate that insurance status, specifically the use of in-network benefits, is associated with successful retention on buprenorphine in telehealth-based opioid treatment settings.