Treatment Track

To view PPTicon-web  PowerPoint presentations click here.

To learn more about individual breakout sessions click on the title name (updated 3-25-16):

Tuesday
The Five-Year Recovery Standard for the Evaluation of Treatment
Best Practices in Treating Opioid Addiction in the Criminal Justice Population
Closing Treatment Gaps in the Health Care and Criminal Justice Systems
 
Wednesday
Treatment and Long-Term Outcomes of Neonatal Abstinence Syndrome (NAS)
Recovery Ready Ecosystems
Buprenorphine: Knocking Out Pill Mills and Minimizing Diversion

Overview
More than 1.3 million people aged 12 or older received treatment for Rx pain reliever or heroin use during their most recent substance-use treatment in the past year, according to the 2014 National Survey on Drug Use and Health. Unfortunately, that survey found that less than one in five of the 22.5 million people who needed treatment for alcohol or illicit drug use actually received it. Increasing treatment is key for easing the personal and societal toll of Rx drug and heroin abuse. Treatment is particularly important among the incarcerated population, as part of the National Drug Control Strategy to break the cycle of drug use, crime and incarceration. Topics in the Treatment Track will include the five-year recovery standard, recovery ready ecosystems, best practices in treating the criminal justice population, closing gaps in treatment within the criminal justice and healthcare systems, treatment of neonatal abstinence syndrome (NAS), and minimizing buprenorphine diversion.
The Five-Year Recovery Standard for the Evaluation of Treatment
Tuesday, March 29, 2016 | 4:15 pm to 5:30 pm
CE certified AMA | ANCC | APA | NASW | NAADAC | NCHES | NBCC | AAFP
Presenters Robert L. DuPont, MD
Founding President, Institute for Behavior and Health, Inc., and Member, Rx & Heroin Summit National Advisory Board
 
Nora D. Volkow, MD
Director, National Institute on Drug Abuse
Moderator Carla S. Saunders, NNP-BC
Advance Practice Coordinator, Pediatrix Medical Group, Neonatal Nurse Practitioner, East Tennessee Children’s Hospital

Session Description Substance abuse treatment is usually brief while the disease of addiction — and the risk of relapse — to alcohol and drugs are life-long. This mismatch makes relapse to substance use the expected outcome of treatment. The nation’s Physician Health Programs routinely produce five-year recovery by linking high-quality treatment with long-term monitoring and support. This session proposes using a new standard of five-year recovery for the evaluation of treatment. Nora D. Volkow, MD, Director of the National Institute on Drug Abuse (NIDA), will open the session by reporting the latest brain science about impacts of drug use on the brain, including the long-lasting effects. Robert L. DuPont, MD, President of the Institute for Behavior and Health and first director of NIDA, will describe the five-year recovery standard, which focuses treatment evaluation on the goal of sustained abstinence from any use of alcohol and other drugs.
Learning Objectives 1. Explain the brain science of addiction which has direct implications for the treatment of substance use disorders.
2. Describe the physician health program (PHP) model of care management.
3. Advocate a five-year recovery standard for the evaluation of substance use disorder treatment.
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Best Practices in Treating Opioid Addiction in the Criminal Justice Population
Tuesday, March 29, 2016 | 5:45 pm to 7:00 pm
CE certified AMA | ANCC | ACPE | APA | NASW | NAADAC | NBCC | AAFP | GA POST | GA Bar
Presenters Leslie Balonick, MA, CRADC
Vice President, WestCare Foundation, Inc.
 
Kevin Fiscella, MD, MPH
Professor of Family Medicine and Public Health Sciences, University of Rochester Medical Center
 
Margaret Jarvis, MD
Medical Director, Marworth, Geisinger Health System
Moderator Michael C. Barnes, JD
Executive Director, Center for Lawful Access and Abuse Deterrence, and Member, Rx & Heroin Summit National Advisory Board
Session Description Heroin and other opioid addictions present special challenges within the criminal justice system. Whether dealing with use during incarceration, problems with poor treatment options pre- and post-sentencing, or the very high risk of overdose death faced by people with addiction upon leaving the structure of the controlled environment of incarceration, dealing with the population requires an understanding of the science and best practices of treating this addiction.

Based on the latest evidence detailed in the recently released ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use, presenters will give an overview of best practices for treating individuals with opioid addiction who are involved in the criminal justice system. With this understanding, law enforcement, correctional and clinical professionals may work together to design the most useful programs for their communities.

A presenter also will identify best practices in evidence-based behavioral therapy in the criminal justice population, based on the 1,650-bed substance abuse and reentry program at the Illinois Department of Corrections – Sheridan Correctional Center. Heralded as one of the nation’s most comprehensive prison and reentry program models for medium/high-risk men, the Sheridan program has been shown to reduce recidivism by 44 percent among those who successfully complete program requirements, according to a 6.5-year longitudinal study. The presenter will share a first-hand perspective on the program’s design and operation and how it can be replicated at other prisons.

Learning Objectives 1. Outline the challenges faced in treating opioid addiction in the criminal justice population.
2. Identify best practices in using medication-assisted treatment (MAT) for opioid addiction in the criminal justice system.
3. Describe best practices in evidence-based behavioral therapy in the criminal justice population.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Closing Treatment Gaps in the Healthcare and Criminal Justice Systems
Tuesday, March 29, 2016 | 7:15 pm to 8:30 pm
CE certified AMA | ANCC | APA | NASW | NADAAC | NCHES | NBCC | AAFP | GA POST | GA Bar
Presenters Gail D’Onofrio, MD, MS
Chair, Department of Emergency Medicine, Yale University School of Medicine
 
Ross MacDonald, MD
Chief of Medicine, Division of Correctional Health Services, New York City Health and Hospitals
 
Jennifer McNeely, MD, MS
Assistant Professor, New York University School of Medicine
Moderator Christopher M. Jones, PharmD, MPH
Director, Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, and Member, Rx & Heroin Summit National Advisory Board
Session Description In this session, experts will present recent research about overcoming treatment barriers in the health care and criminal justice systems.

The first presentation will feature evidence-based practices for the screening and treatment of opioid use disorders (OUD). The presenters will outline gaps in the identification and treatment of OUD in health care systems. They will present research on: approaches for screening for opioid and other substance use disorders in primary care settings, comparing different approaches to engage opioid dependent emergency department patients in addiction treatment, and investigating adherence to practice guidelines and strategies for optimal care. Attendees will understand: novel approaches improving identification of OUD and engagement in treatment, advancements in OUD treatment research, and adoption of best practices into real-world settings.

The second presentation will focus on the cycle of addiction, housing instability and incarceration in the criminal justice system. The presenter will review a study that used “hot spotting” to characterize the persons most frequently admitted to the New York City jail system in 2013. The study concluded that frequently incarcerated persons have chronic mental health and substance use problems, their charges are generally minor, they are frequently homeless, and incarceration is costly. For example, significant substance use was highly prevalent in the frequently jailed group compared to the control group (96.9 percent vs. 55.6 percent). The presenter will recommend strategies to improve outcomes and increase treatment opportunities for these individuals.

Learning Objectives 1. Describe gaps in the identification and treatment of opioid use disorders (OUDs) in health care systems.
2. Identify approaches for improving identification of OUDs and engagement in treatment.
3. Distinguish the characteristics of persons most frequently admitted to the New York City jail system.
4. Outline strategies to improve outcomes for frequently incarcerated individuals.
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Treatment and Long-Term Outcomes of Neonatal Abstinence Syndrome (NAS)
Wednesday, March 30, 2016 | 11:15 am to 12:30 pm
CE certified AMA | ANCC | APA | NASW | AAFP
Presenters Henrietta S. Bada, MD, MPH
Professor and Vice Chair for Academic Affairs, Department of Pediatrics, College of Medicine and Department of Health Behavior, College of Public Health, University of Kentucky
 
Jennifer A. Hudson, MD
Medical Director for Newborn Services, Greenville Health System
Moderator Carla S. Saunders, NNP-BC
Advance Practice Coordinator, Pediatrix Medical Group, Neonatal Nurse Practitioner, East Tennessee Children’s Hospital, and Member, Rx & Heroin Summit National Advisory Board
Session Description From 2000 to 2012, there was a five-fold increase in the proportion of babies born with neonatal abstinence syndrome (NAS) — equivalent to one baby suffering from opiate withdrawal born every 25 minutes, according to the National Institute on Drug Abuse. With an average hospital stay of 16.9 days, this alone costs hospitals an estimated $1.5 billion a year. This session will address early treatment options and long-term outcomes.

An innovative model of care for otherwise healthy newborns with NAS will be presented. Practiced for more than a decade in a large regional level I nursery, it is designed to prevent severe opioid withdrawal in high-risk newborns. The model combines pharmacologic treatment within 24 hours of birth, inpatient stabilization on a family-centered maternity care unit and regimented outpatient weaning by a pediatric medical home. Data reflect low rates of adverse events, NICU transfer and readmission. Neonates treated with the model had an average length of stay of eight days, peak weight loss of 7 percent, peak modified Finnegan score of 11 and hospital cost of $5,485. This model may be feasible for other low­acuity nurseries to consider for implementation.

Attendees will learn the long-term effects reported in children with prenatal exposure to opiates. Outcomes will include the children’s performance in motor, cognitive, speech and language, and behavior. The presenter will enumerate and discuss factors that may influence and mitigate these outcomes.

Learning Objectives 1. Define neonatal abstinence syndrome (NAS).
2. Describe a palliative model for early treatment of neonatal opioid withdrawal.
3. Explain the long-term effects reported in children with prenatal exposure to opiates.
4. Outline factors that may influence and mitigate the long-term outcomes related to NAS.
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Recovery-Ready Ecosystems
Wednesday, March 30, 2016 | 2:00 pm to 3:15 pm
CE certified AMA | ANCC | APA | NASW | NADAAC | NCHES | NBCC | AAFP
Presenters Kimber Lee Falkinburg, PRS
Program Manager, Young People in Recovery
 
Paige Miller, CP
Development Director, Hope House
Moderator Michelle C. Landers, JD
Executive Vice President & General Counsel, Kentucky Employers’ Mutual Insurance, and Member, Rx & Heroin Summit National Advisory Board
Session Description As multiple paradigm shifts have occurred within the treatment of behavioral health concerns (substance use disorders, mental health concerns and co-occurring disorders), it is paramount that primary care physicians, addiction specialists, therapists and all practitioners of wellness become well educated on integrating long-term sustained recovery practices into each level of care. This presentation will expand upon the transition away from the acute model of behavioral health treatment, exploring the full continuum of care modality. The presenters will identify innovative practice methods, such as the “My Recovery is E.P.I.C.” program, that have integrated into treatment facilities to expand recovery-oriented systems into residential and outpatient services. The presenters will go further into exploring primary and tertiary intervention methods that include primary care, recovery-oriented practices and follow-up community aftercare resources. A third exploration will include an overview of the “recovery ready ecosystems” framework that incorporates integration of primary care, behavioral health care and aftercare with a continuum of recovery practices.
Learning Objectives 1. Identify innovative practice methods for treatment facilities to expand recovery-oriented systems into residential and outpatient services.
2. Outline primary and tertiary intervention methods.
3. Describe the “recovery ready ecosystems” framework.
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Buprenorphine: Knocking Out Pill Mills and Minimizing Diversion
Wednesday, March 30, 2016 | 3:30 pm to 4:45 pm
CE certified AMA | ANCC | ACPE | AAFP
Presenters Michael C. Barnes, JD
Executive Director, Center for Lawful Access and Abuse Deterrence, and Member, Rx & Heroin Summit National Advisory Board
 
Kelly J. Clark, MD, MBA, FASAM, DFAPA
President-elect, American Society of Addiction Medicine, and Member, Rx & Heroin Summit National Advisory Board
 
Yngvild Olsen, MD, MPH
Medical Director, Institutes for Behavior Resources, Inc.
Moderator Anne L. Burns, RPh
Vice President, Professional Affairs, American Pharmacists Association, and Member, Rx & Heroin Summit National Advisory Board
Session Description Buprenorphine is used in medication-assisted treatment (MAT) of Rx opiate and heroin addiction. Because it can be prescribed in less restrictive settings than methadone, buprenorphine has expanded access to treatment. Unfortunately, because it produces effects similar to opioids, such as euphoria, it is a candidate for misuse and abuse. This session will equip attendees to respond to those challenges.

The first presenter will describe factors contributing to the proliferation of buprenorphine pill mills, the common practices of rogue prescribers of the drug, risks and harms to patients and communities, and how to put an end to problem. Topics will include the role of law enforcement and public health officials, state prescriber education and safer prescribing requirements, and the federal Drug Addiction Treatment Act of 2000. Recommendations will be given to reduce buprenorphine diversion, misuse and abuse while simultaneously ensuring individuals with legitimate medical needs have access to the medication through responsible health care providers.

Next, presenters will provide data on the problem of buprenorphine diversion, as well as health policy, medical guidelines, and regulatory efforts to combat diversion while ensuring access to good quality treatment opioid addiction. They will discuss the nature of the problem as seen on the street, regulatory and clinical approaches to diversion control, and review the approaches taken by several states. In the realm of “unintended consequences,” it is important to build policy with an understanding of likely outcomes. Their goal is to help attendees who are concerned about how to decrease buprenorphine diversion in their community.

Learning Objectives 1. Describe the problems of buprenorphine diversion and pill mills.
2. Identify strategies to reduce buprenorphine pills mills.
3. Outline effective regulatory and clinical approaches to control diversion of buprenorphine.
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The content and scheduled time of these breakout sessions are subject to change.