13: Pain Medication and Adolescents: Special Considerations
Participants will be introduced to the vocabulary of addiction and the root causes of addiction especially in the adolescent, as well as the epidemiology of opioid overdoses and deaths in the United States as a public health phenomenon, with particular attention paid to the decreasing rate of illicit opioid use in adolescents over the past decade. The learner will also, with this background, have reinforced the predicates of opioid misuse in adolescents and, through clinical examples, learn how to recognize possible misuse and address misuse in adolescents seen in a medical setting. Finally, safe prescribing principles will be introduced.
Stimulant Use Disorder Pocket Guide for Patients
Developed by AAAP and ASAM, this guideline focuses on the identification, diagnosis, treatment, and promotion of recovery for patients with stimulant use disorder, stimulant intoxication, and stimulant withdrawal.
Management of Stimulant Use Disorder Guideline
Developed by AAAP and ASAM, this guideline focuses on the identification, diagnosis, treatment, and promotion of recovery for patients with stimulant use disorder, stimulant intoxication, and stimulant withdrawal.
Psychiatric Comorbidities: Diagnosis and Treatment of Comorbid Psychiatric Disorders and Opioid Use Disorders
This module provides clinicians with tools to screen and diagnose patients with psychiatric illnesses and discusses how to treat common psychiatric comorbidities in patients with co-occurring substance use disorders. Covered topics include the epidemiology of co-occurring psychiatric illness and substance use disorders, comorbidity theories, clinical relevance, and diagnostic and treatment implications. The module utilizes three case vignettes to highlight specific diagnostic and treatment challenges and provides up-to-date treatment recommendations.
Opioid Use Disorder in Pregnant and Postpartum People: The Treatment and Policy Landscape
Opioid use disorder (OUD) can be a fatal addiction with complex implications for new and/or expecting mothers. OUD challenges can lead to many complications for mother and child, including low birth weight, clinical challenges with medical dosing and increased risk of accidental death. In the U.S. alone, a baby is born passively dependent every 15 minutes. To ensure best health outcomes for both mother and child, policies must allow engagement in evidence-based treatment and protect clients from legal ramifications. Hear from a physician, clinic director and an individual with lived experience to broaden understandings about the treatment and policy landscape for pregnant and postpartum women with OUD.
Exploring Perinatal Prescription Opioid Use and Misuse in Primarily Rural Settings
Escalation of perinatal opioid overdose and mortality has become a national public health concern. Prescription opioids are considered a gateway drug to misuse and dependency of other illicit drugs such as fentanyl and heroin. This study explored the 1) the pain-related experiences, 2) the social-ecological factors and experiences, and 3) the healthcare-related experiences of perinatal women who used or misused prescription opioids. The women’s shared experiences provided insights regarding how socio-ecologic and healthcare-related factors intersected with their pain experiences, which will be presented in three major themes of the study. This intersection was collectively identified as contributing to their initiation and perpetuation of misuse which hindered their journey to recovery and motherhood.
Healing the Opioid Crisis with Mindfulness Oriented Recovery Enhancement : Outcomes and Mechanisms of An Evidence Based Therapy for Chronic Pain, Opioid Misuse, & Addiction
Half of all people with a substance use disorder (SUD) have chronic pain, and more than a third have a co-occurring psychiatric disorder. The ongoing opioid crisis is a case in point, where physical and emotional pain fuel opioid addiction and continue to drive countless deaths of despair to this day. Unfortunately, there are few evidence-based therapies that can simultaneously treat this complex comorbidity. To meet this need, Mindfulness-Oriented Recovery Enhancement (MORE) was generated through a decade-long treatment development process funded by the National Institutes of Health. Rooted in affective neuroscience, MORE unites mindfulness training, cognitive-behavioral therapy, and principles from positive psychology into an integrative therapy designed to target addiction, stress, and pain. This session will detail the theory underlying MORE, research data demonstrating MORE’s effectiveness, and unique clinical skills integral to this novel treatment. MORE has been tested in 11 clinical trials funded by more than $40 million in federal research grants. In the largest trial of MORE (250 patients with opioid misuse/OUD), MORE decreased opioid misuse by 45% by 9-month follow-up, more than doubling the effect of standard therapy. MORE also significantly decreased chronic pain, distress, depression, and PTSD. In addition, MORE has been shown to improve outcomes among people receiving medication assisted treatment. Neuroscience shows that MORE decreases the extent to which the brain is triggered by drug cues, while increasing brain responses to natural, healthy rewards. MORE is now being disseminated across the U.S. This dissemination effort is urgently needed, in light of the opioid settlement monies that are now reaching the states to help alleviate the opioid crisis.
Co-occurring Opioid and Stimulant Use Disorders: Treatment and Management Approaches
Research indicates a lack of training and programming specific to treating and managing co-occurring opioid and stimulant use disorders, despite the increased risk of overdose bolstered by the ever-changing and adulterated drug supply. While MOUD is the gold standard of care for treating OUD, there are no FDA-approved medications for treating stimulant use disorder, though behavioral therapies like contingency management have been well-studied. These challenges highlight the need to identify promising treatment strategies to ensure individuals with co-occurring opioid and stimulant use disorders are effectively engaged in care to prevent overdose. This session will equip BH providers and organizations in this space, including Community Behavioral Health Clinics (CCBHCs), with the tools necessary to effectively engage and provide quality, team-based care and services to individuals with co-occurring opioid and stimulant use disorders in order to improve health outcomes, reduce overdose risk, and support long-term recovery.
1: Overview of Substance Use Disorders
Understanding addiction is essential to successfully addressing it. In this overview of substance use disorders we discuss the spectrum of use, neurobiological responses to substances, theories that explain the disorders, public health impact and epidemiology, comorbidity, and integrated care for this chronic condition.
15: Managing Common Psychiatric Conditions in Primary Care
Co-occurring psychiatric conditions are frequently seen in patients with substance use disorders. Clinicians should be alert to the signs and symptoms of common psychiatric disorders and should understand how to distinguish independent psychiatric disorders from substance-induced disorders. Depressive disorders and anxiety disorders, including post-traumatic stress disorder, are the most common co-occurring conditions, though ADHD is often encountered across the range of substance use disorders. Substance use disorder patients with co-occurring psychiatric disorders will respond to most standard psychological and pharmacological treatments for these psychiatric conditions, though clinicians should avoid the use of scheduled medications and must always focus on sobriety as a primary treatment goal. Treatment that integrates addiction and psychiatric care is the most effective.
